2004, 10-04 Permit: BLD-04-07835 Sewer, Plumbing ReversalSpokane
#Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
Job Address: 8520 E MAIN AVE
SPOKANE WA 99212
PLUMBING PERMIT
Description: PLUMBING REVERSAL - COUNTY SEWER CONNECTION - 04-6229
OWNER CONTRACTOR
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
DERWIN BEACH
Permit #: BLD -04-07835
Applied:
Issued:
Expires:
Lot: Blk: Parcel No: 45184.1664 Zoning:
45184.1666
DERWIN BEACH Phone: (509) 000-0000
8520 E MAIN AVE
SPOKANE, WA 99212
Phone:
Lic No:
10/04/2004
10/04/2004
04/02/2005
General Information:
SUPPLEMENTAL PERMIT
WATER PIPING/DRAIN-IN WASTE
N
1
Fees:
PLUMBING PROCESSING FEE
WATER PIPING/DRAIN-IN WASTE
Total Calculated:
Deposits/Receipts:
Total Due:
35.00
6.00
41.00
41.00
0.00
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.
Ownership of resulting development rights granted by any issuedpermithermit inure to the property owner.
URCA-1 ✓ IE 6 -enc4
Print Name Signature
Staff Initials
THIS IS NOT A RECEIPT
10
Date