HomeMy WebLinkAbout2001, 01-08 Permit App: 01000123 SewerProject Number: 01000123 Inv: 1
' Application
Date: 1/8/01 Page 1 of 1
THIS 1S NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION - LEISURE COURT Contact: WRS & ASSOCIATES
Address' P.O. BOX 14084
C - S - Z: SPOKANE WA 99208
Setbacks: Front Left: Right: Rear: Phone: (509) 922-0782
Group Name:
Site Information: Project Name:
r
Plat Key: 005492 Name: LEISURE COURT District: F
Parcel Number: 45153.5506
Block: 1 Lot: 6
SiteAddress: 231 N HOUK LN
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -7
Water District:
Urban Residential -7
Area: 4,170 Sq Ft Width: 47
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Owner: Name: W.R.S. & ASSOCIATES
Address: PO 14084
SPOKANE, WA 99214
Hold: ❑
Depth: 68 Right Of Way (ft): 26
Review Information:
Department Review
UTILITIES Review by Utilities
Hold Reasons:
Permit Conditions:
Released By:
Permits•
Sewer Permit
Contractor: WRS & ASSOCIATES Firm: BILL SMITH/W R S & ASSOCIATE
Address: P O BOX 14084 Phone: (509) 922-0782
SPOKANE, WA 99214
Item Description
SEWER CONNECTION
PROCESSING FEE
Payment Summary: r—
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
Fee Amount
$85.00
$15.00
Permit Total Fees: $100.00
Operator: RMB Printed By: RDIB Print Date: 1/8/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owina
Sewer Permit $100.00 $100.00 $0.00 $100.00
5100.00 5100.00 30.00 3100.00
Notes: ,
OK TO ISSUE SEWER PERMITS PER BILLY 9/5/95 CKF
SEWER CONNECT`ONPERMIT'APPLICATION.FORM :>
PLEASE NOTE: This application form must be filled out accurately and in its Entirety, and'sigatd,'or'a permit will not be issued. Also vote
that sewer permits are valid for 12 months form the date of issuance. No extensions will be granted. A separate right-of-way permit is
required for any work performed in or from the county right-of-way. -' ' " '
�nt PROJECT INFORMATION • •. -
Job Address: Ota / /VP geeCii<
/ Owner's name:
Parcel Number: yl /,rd - O 6 ` Lot: Block: _ ..-
Project Name: %. £ / J UR C re, re/1 r Address: Ii- /50 K' (y'b 3"
ULID Name:
(//' /LS v' ae-a-er--
CHECK APPLICABLE BOXES
CH' Regular
O Dry Sewer
❑ Repair
❑ Addition
❑ Abandonment
Cr esidential cA'New
O Commercial O New
O Temporary
•
City/State: cPoKGC/c(.: .: • t , -.
Zip: 9 9z/#4
Phone: SO? - 922—O76-
* FIRST TIME CONTRACTORS OR HOME OWNERS PERFORMING THE INSTALLATION MUST FIRST CONTACT MEI'
UTILITIES DIVISION BEFORE PERMIT(S) CAN BE ISSUED. TU 7—s6 LC PS' i'�..,:
* SIGNATURE OF UTILITIES DMSION PERSON CONTACIED:
Con,tr� for (company name):
k< V//s/ F•o/Scm £z c Venn
Sate contractor license number:
Business address:
City/State:
Zip:
Contact Name:
Phone Number:
INTERIOR PLUMBING ALTERATIONS? (yes/no) circle one
Fill out the information in the table below ifapplicable**
Contractor (if different from above):
Business Address:
Phone:
City/State/Zip
kitragingtS °F.o;'u liimbiii meytdFjee,mfdiprtatfon,Cern"eReise,"sidtgof,+fhufarnrai'3lw"' y ' -
FEE INFORMATION
Number of Buildings connecting to sewer
/00 X (times) $100 (per bldg) - $ /ao
TOTAL FEE
• Fora single-family residential unit, one permit is required; •
• For a condominium, townhouse, duplex, triplex or fourplex with separate ownership (as determined by lot lines) separate address and separate stub, one permit is required per
address per nub; '
• For a single building duplex, triplex or fourplex with single ownership, one permit is required
• Multiple buildings (apartments, industrial complexes) with single ownership, one permit required per building connecting to the sewer.
(FOR SITUATIONS NOT COVERED HERE, CALL THE COUNTY DIVISION OF UTILITIES AT 477-3604) .
Is any of the work to be performed in or from the county right-of-way? 0. Yes 0 No
APPLICANT SIGNATURE:
DATE:
Method of Payment:
O Cash ekheck O Visa 0 MasterCard 0 Discover Card
Date: Expires:
Bankcard Number:
Authorized Signature:
Spokane County Division of Building & Code Enforcement
1026 West Broadway Avenue * Spokane WA 99260
Tel. No. (509) 477-3675' Fax No. (509) 477-7198* TDD No. (509) 477-7133