2011, 09-19 Permit App: 11002816 ResidenceProject Number: 11002816 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 9/19/2011 Page 1 of 4
Project Information:
Permit Use: NEW SFR W/ATT GAR
Setbacks: Front
Left: Right: Rear:
Site Information:
QuSL i�"i �7/4222=2222122222462
Plat Key: Name: Range
Parcel Number: 55073.2708 Block:
SiteAddress: 17131 E KNOX AVE
Location:: CSV
Contact: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN RD
C - S - Z: SPOKANE VALLEY, WA 99216
Phone: (509) 924-8964
Group Name:
Project Name:
Lot:
District: East
Owner: Name: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN RD
SPOKANE VALLEY, WA 99216
Zoning: R-3 SF Res District
Water District: 134 CONSOLIDATED ID #19
Area: 6,042 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: „.,y_il - 2:f_m2A2 a. 92
Review
Building Plan Review
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Released By:
Originally Released: 9/15/2011 By: tmelbourn
Landuse/Zoning/HE Conditions
Released By:
Driveway/Approach
Originally Released: 9/13/2011 By: mpalaniuk
Released By:
NOT REQUIRED PER TM - MICK
Originally Released: 9/16/2011 By: MBonduran
Operator: MBB Printed By: JD Print Date: 9/19/2011
Project Number: 11002816
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 9/19/2011 Page 2 of 4
Sewer Review
Released By:
PER SPOKANE COUNTY SEWER PERMIT #11004610
Originally Released: 9/13/2011 By: MBonduran
Permits: Ea., 1,7
Contractor: DIAMOND ROCK
Address: 2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Building Characteristics
Total Area
Building Height
Stories
Description Grp
1&2 FAMILY R-3
BASEMENT U R-3
COV DECK R-3
DECK OPEN R-3
GAR WOOD U-1
Building Permit
Firm: DIAMOND ROCK CONSTRUCTIO
Phone: (509) 924-8964
Type Notes
VB SFR
VB
VB COVERED
PATIO
VB OPEN
DECK
VB ATTACHED
GARAGE
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
SFR / DUP SITE PLN REVIEW
This Application: Total Project:
So Ft Valuation Sq Ft Valuation
1,188 $119,928.60 1,188 $119,928.60
1,188 $17,820.00 1,188 $17,820.00
90 $1,350.00 90 $1,350.00
100 $1,500.00
430 $8,170.00
100 $1,500.00
430 $8,170.00
Totals: 2,996 $148,768.60 2,996 $148,768.60
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
1 SELECT
Operator: MBB Printed By: JD
Fee Amount
$1,268.15
$4.50
$507.26
$50.00
Permit Total Fees: $1,829.91
Print Date:
9/19/2011
Project Number: 11002816 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 9/19/2011 Page 3 of 4
Contractor:
Address:
Mechanical Permit
SPOKANE HEATING & COOLING
PO BOX 28929
SPOKANE WA 99228
Item Description
DUCT WORK SYSTEM
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS 1 DUCT
CLOTHES DRYER
HOOD -TYPE II
Contractor:
Address:
Units
1
1
1
2
3
1
1
GOLD SEAL MECHANICAL INC
5524 E BOONE AVE
SPOKANE, WA 99212
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
CLOTHES WASHER
WATER PIPING - DWV
Firm: SPOKANE HEATING & COOLING
Phone: (208) 755-8345
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
Fee Amount
$11.00
$11.00
$13.00
$2.00
$33.00
$10.00
$11.00
Permit Total Fees: $91.00
Plumbing Permit
Units
2
3
1
1
1
1
2
Operator: MBB Printed By: JD
Firm: GOLD SEAL MECHANICAL INC
Phone: (509) 535-5944
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$12.00
$18.00
$6.00
$6.00
$6.00
$6.00
$12.00
$66.00
9/19/2011
Project Number: 11002816 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 9/19/2011
FLORA ESTATES -REFER TO ADE -19-06 FOR LOT WIDTH/FRONTAGE-MH
FLORA ESTATES -SEE FILE ADE -19-06 FOR LOT FRINTAGE/WIDTH-MH
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount
$1,829.91 $1,829.91
$91.00 $91.00
$66.00 $66.00
Amount Paid
$522.94
$0.00
$0.00
Amount Owing
$1,306.97
$91.00
$66.00
$1,986.91 $1,986.91 $522.94 $1,463.97
Page 4 of 4
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: MBB Printed By: JD
Print Date: 9/19/2011
1
Wane
Nz Valley
Community Development
u ® G"1
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevallev.org.com
Residential Construction
Permit Applicatio
SITE ADDRESS L 1 3 I F.. O%
ASSESSORS PARCEL NO: 5-5-0 73 . 2 ?'0 $
,New Construction
❑ Addition/Remodel
o Other:
PERMIT NUMBER: j/ I _zd it,PERMIT FEE: ipriihaigio
__
1619riliti"*;P
❑ Accessory Bldg
❑ Deck
s pb\Lcir \Jo -1\ ey , W I\ %IDRD
LEGAL DESCRIPTION: Lo -i U 3' ock. 1
FI ora. Mea.daws
dingo`
Name: 0I a wx.o rte) 206 K ( $ t:
Address:
City:
Zip:
Phone:
Fax:
Coact Person:
Name: Pett i,1
Phone: 2 ! - c/% Zt'
Describe the scope of work in detail:
t,01.4 a AeA i SF/
on
Name: I) t 4vrn.an d c /C Carr r 74:
Address: Z (0 cZ N. S u t l /Vet -IAS Id
City: SQ o IIA 11e7 Zip: 997/4
Phone: 7Zcf— S(96>cf Fax: ?z6- F109y
Lic No: .Exp. Date:
City Business Lic No:
Cost of Project:
1 $ GS, Go -U
**************The following MUST be complete: (write N/A if not a
HEIGHT TO PEAK: t
MAIN FLOOR TO SQ.
FTG: ti' r
FINISHED BASEMENT
SQ. FTG:
# OF BEDROOMS:
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the
dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done
in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of
Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
DIMENSIONS:
3'X53
2Nu FLOOR SQ. FTG:
GARAGE SQ. FTG:
# OF STORIES:
PP
licabler*********************
CONSTRUCTION TYPE:
UNFIN BASEMENT SQ. FTG:
(DECK/C
5'p o
HEAT SOU - G -t:
Naj'w-a+ 1 Ga $ For-n4c4
TOTAL HABITABLE SPACE:
llgl
IMPERVIOUS SURFACE
AREA: /(//,g
30% SLOPES ON
PROPERTY: /V/4
SEWER OR SEPTIC?
Signature aQ_
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash 0 Check ❑ Mastercard 0 VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
912/
0 Other
Spokane
Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.ors.com
Mechanical Permit Application ❑ Commercial
PERMIT NUMBER:
PERMIT FEE:
XResidential
SITE ADDRESS 111'' E. yArvDX
Building owner
Name: 0it4i toitd IZOG4 Coll S/" Phone: GI`2,1-f,--7.160 cf . Fax
Address: City State Zip
Contractor
Name:
Address:
�",, uu n
It: the. 1LOr(� iD $ e 0 Un Phone: Fax:
��JJ City State Zip
License No: City Business License No:
Contact
Name: a,(4t Phone: 74 r-%f92q
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
L
X
$12.00
=
) Z
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
$100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
$50.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00.
=
13
RANGE
X
$10.00
=
14
DRYER
1
X
$10.00
=
/ 0
15
FUEL BURNING WATER HEATER
1
X
$10.00
=
10
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
Z
X
$1.00
=
Z,
18
DUCT SYSTEMS
1
X
$10.00
=
/0
19
VENTILATING FANS
3
X
$10.00
=
30
20
AIR HANDLER (DOES NOT Include ducting)
Equal to or Tess than 10,000 CFM
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$15.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE II HOOD
1
X
$10.00
=
/D
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
15-30 TON
X
$25.00
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS
X
$15.00
=
34
VENTILATION SYSTEMS
X
$12.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR -RESIDENCE
X
$19.00
=
37
INCINERATOR -COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
❑CASH CICHECK 0 VISA 0 MC
CARD #:
SUBTOTAL
y
DATE:
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
Spokane
Community Development www.spokanevalle_y.ora.com
Plumbing Permit Application
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
❑ Commercial
PERMIT=NUMBER:
PERMIT FEE:
%Residential
StrE ADDRESS
I I J £ • pox
Building owner
Name: 014,441.024,91 g.c4 Cis t Phone: f2,q
Fax
Address: City
Contractor
Name: ! a' seal''
Address:
State Zip
Phone:
Fax:
City
License No:
City Business License No:
State Zip
ontaet
Name:
Phone: Z1-? — 9 Ly
METHOD OF PAYMENT:
❑ CASH
DATE:
0 CHECK
AUTHORIZED SIGNATURE:
❑ VISA ❑ MASTERCARD
EXPIRES:
TOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
z
X
$6.00
=
12
2
URINALS
X
$6.00
=
3
TUBS
1
X
$6.00
=
Ci
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
/
X
$6.00
=
/
is
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=in
r/
6
DISHWASHER
1 X $6.00
=
So
7
CLOTHES WASHER
1 X $6.00 =
f:
8
GARBAGE DISPOSAL
X $6.00 =
9
WATER SOFTENER
X $6.00 =
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X $6.00 =
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X $6.00 =
12
ROOF DRAINS/OVERFLOW
DRAINS
X $6.00 =
13
FOUNTAINS, DRINKING
X $6.00 =
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X $6.00 =
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X $6.00 =
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X $6.00 = ' n
(—
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X $6.00 =
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X $6.00 =
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X $6.00 =
20
MISCELLANEOUS PLUMBING
FIXTURE
X. $6.00 =
21
PRIVATE SEWAGE DISPOSAUSYS
X $20.00 =
22
INDUSTRIAL WASTE
INTERCEPTOR
X $15.00 =
METHOD OF PAYMENT:
❑ CASH
DATE:
0 CHECK
AUTHORIZED SIGNATURE:
❑ VISA ❑ MASTERCARD
EXPIRES:
TOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05
••/.
Splikane
Valley®
Target Date sheet
For City Use Only
PLUS Project 1 '"' i
Project Address
/713( E k,toX 4-ve
11703 E Sprague Ave Suite B-3 ♦ Spokane Valley WA 99206
509.720-5240 ♦ Fax: 509.688.0037 ♦ permitcenter®spokanevaltey.org
As part of our on-going commitment to customer service during the review process of your project application, we are
providing you with a TARGET DATE for the initial technical application review. If for any reason we cannot meet
this date, we will contact you with a revised target date.
Your application review TARGET DATE is
The TARGET DATE is the date we estimate your project application will have had its initial technical review. It is
not the date for approval or permit issuance.
Tips for a Smoother Project Application Review
> Submit complete, accurate plans and documents.
Extra time may be required for re -submittals as project application reviewers work on multiple applications and it may be
several days before they can look at your new or revised information.
> Designate a specific contact person to communicate with the City.
While the person designated as the applicant's contact person with the City can be changed, one individual with the expertise
for dealing with reviewer comments would be the best choice for the entire review process.
> Call staff regarding the status of your project only after the target date shown at the top of the page.
Although you should be contacted on or by the target date, please feel free to contact us if you haven't heardfrom us by your
target date. Staff may contact you before the target date if the initial review is complete. By following this procedure, you will
save time and allow the reviewers to complete the work more expeditiously.
Steps in the Permit Process
1. Counter Complete. Your application has been accepted as counter complete. This means all of the required documents, as
indicated on your Pre -Application Checklist have been submitted or have been approved for deferred submittal. This does
not prevent technical staff from requesting additional information as a result of their technical review.
2. Quality Check. The next step in the process is a quality check to make sure that the application is reviewable and free from
substantive flaws that would prevent technical staff from completing the technical review once it is started. When this step is
complete, your application will be routed to the appropriate staff and remain in their review queue until it comes up for review.
3. Technical Compliance. Once an application is administratively complete, it is routed to technical staff for compliance review.
Depending on the type of project, technical staff may include multiple reviewers. You should be contacted by phone, fax, email,
or mail by your TARGET DATE once the initial technical compliance review is complete.
4. Permit Issuance. When the technical compliance review of the application is complete, including any subsequent re -
submittals, each reviewer will approve their section of the application and route it to the Permit Center. When all sections of the
application are received, a Permit Specialist will process the application and contact the person specified on your application for
permit pick-up. Information regarding fees and pre -construction meetings (if required) will be provided by the Permit Specialist at
that time.
CD -003 V-7/ 06-21-11 Page 1 of 1
ScOkaig, ne
Valley
Site Address: 17131 E KNOX AVE
Parcel Number: 55073.2708
Zoning: R-3
Fire District: FD 01
Project �
Transmittal
City of Spokane Valley
Community Development
Department
11703 E. Sprague Ave, Suite B3
Spokane Valley, WA 99206
Phone: 509.688.0036
New project 0
Previous pre -app meeting 0
Plan revisions
Transmittal Date:
Tuesday, September 13, 2011
Project Number: 11002816
Water District: CONSOLIDATED ID #19
Applicant: DIAMOND ROCK CONSTRUCTION
2602 N SULLIVAN RD
SPOKANE VALLEY. WA 99216
(509) 924-8964
e-mail:
Contact: DIAMOND ROCK CONSTRUCTION
2602 N SULLIVAN RD
SPOKANE VALLEY. WA 99216
(509) 924-8964
e-mail:
Contractor: DIAMOND ROCK CONSTRUCTION
2602 N SULLIVAN
SPOKANE VALLEY WA 99216
(509) 924-8964
Owner: DIAMOND ROCK CONSTRUCTION
2602 N SULLIVAN RD
SPOKANE VALLEY, WA 99216
e-mail:
Occupant:
e-mail:
Arch / Engineer:
e-mail:
Project NEW SFR - SINGLE FAMILY RESIDENCE
Description:
Please send all plan review and project comments via e-mail to the
highlighted individuals.
Building
Landuse
Engineer
Utilities
Health
Fire Dist
Assessor
SITE PLAN
CONSTRUCTION
DRAWINGS
ENERGY COMPLIANCE
WOORKSHEET
1
—
APPLICATION
1
TDS
I
Please send all plan review and project comments via e-mail to the
highlighted individuals.
SPOKE Cout rY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Project Information
Site Address: 17131 E KNOX AVE
Parcel Number: 55073.2708
Subdivision: CITY OF SPOKANE VALLEY
Block: Lot:
Zoning:
Owner: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN
SPOKANE VALLEY, WA 99216
Building Inspector:
Water Dist:
Project Number: 11004610 Inv: 1 Issue Date: 9/12/2011
Permit Use: SEWER CONNECTION
Applicant: DIAMOND ROCK CONSTRUCTION
2602 N SULLIVAN
SPOKANE, WA 99216 Phone: (509) 924-8964
Contact: DIAMOND ROCK CONSTRUCTION
2602 N SULLIVAN
SPOKANE, WA 99216 Phone: (509) 924-8964
Setbacks - Front: Left: Right: Rear:
Group Name:
Project Name:
Permits
Sewer Connection Permit
Contractor: DIAMOND ROCK CONSTRUCTION License #: DIAMORC032OQ
SEWER CONNECTION 1 $125.00 PROCESSING FEE
1 $25.00
Total Permit Fee: $150.00
**FOR SEWER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO
COVER. ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL
INSPECTION FEES APPLY AFTER 30 MINUTES.
**CALL 1-800-424-5555 BEFORE YOU DIG --AT LEAST 2 WORKING DAYS IN ADVANCE. SPOKANE COUNTY CODE
REQUIRES THE INSTALLER COMPLY WITH ALL REQUIREMENTS OF THE WA STATE DEPT OF LABOR & INDUSTRIES,
INCLUDING THOSE RELATED TO TRENCH SAFETY.
**INSTALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO THE SEWER AND MAY
BE REQUIRED TO PERFORM TESTS FOR VERIFICATION. INSTALLER IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER EXCAVATION.
**SEWER STUBS AND DRY SIDE SEWERS ARE TO BE CHECKED PRIOR TO CONNECTION TO ENSURE THAT THEY
HAVE ACCEPTABLE GRADE AND ARE CLEAR AND UNOBSTRUCTED. SEWER LINES SHOULD BE CONSTRUCTED TO
ALLOW FOR GRAVITY FLOW FROM THE LOWEST LEVEL OF THE STRUCTURE.
**THE INSTALLER AND THIS PERMIT MUST BE PRESENT AT THE JOB SITE AT THE SCHEDULED INSPECTION TIME.
BOTH STATE LAW RCW 19.122 AND COUNTY CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO
OWNERS OF UNDERGROUND FACILITIES.
Payment Summary
Total Fees AmountPaid AmountOwing
$150.00 $150.00 $0.00
Tran Date Receipt # Payment Amt
9/12/2011 4044 $150.00
Processed By: SHATTO, JULIE
Printed By: Force, Faith Page 1 of 1
PERMIT
b
S&cJe t/Z-1 5
ora iVectdot-is"
1-7 131 L i(vvt,x
LOT ,0q2:131
PLANNING DEPT. APPROVED
DATE: /3
N
Z-0