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2002, 02-14 Permit App: 02000908 Sewer, Plumbing ReversalProject Number: 02000908 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: ...................................................................................... Permit Use: SEWER CONNECTION - WOLFLAND & PLUMBING REVERSAL Date: 2/14/2002 Page 1 of 2 Setbacks: Front Left: Right: Rear: Site Information: Plat Key: CONV Name: CONVERTED CNTY DATA Contact: NORM'S EXCAVATING Address: P.O. BOX 574 C - S - Z: VERADALE, WA 99037 Phone: (509) 928-0580 Group Name: Project Name: District: Parcel Number: 45074.0229 SiteAddress: 8621 E MANSFIELD AVE SPOKANE, WA 99212 Location:: SPO Block: Zoning: UNK Water District: Lot: Owner: Name: BARKER, DAVID J Address: 8621 E MANSFIELD AVE SPOKANE, WA 99212 Hold: ❑ Area: 0 Sq Ft Width: 78 Depth: 138 Right Of Way (ft): 0 Nbr of Bldgs: 2 Nbr of Dwellings: 10 Review Road Obstruction Permits: Released 13y: Contractor: BELKNAP PLUMBING Address: 3414 S. ADAMS RD VERADALE, WA 99037 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Plumbing Permit Firm: BELKNAP PLUMBING Phone: (509) 921-5913 Units Unit Desc Fee Amount 1 NUMBER OF $6.00 1 Y OR BLANK $25.00 1 Select $4.00 Operator: RMB Printed By: RMB Permit Total Fees: $35.00 Print Date: 2/14/2002 Project Number: 02000908 Inv: 1 Application Date: 2/14/2002 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Sewer Connection Permit Page 2 of 2 Contractor: NORM'S EXCAVATING Firm: NORM'S BOBCAT SERVICE Address: PO BOX 574 Phone: (509) 928-0580 VERADALE, WA 99037 Item Description SEWER CONNECTION PROCESSING FEE Notes: .:. Payment Summary::;::;::;::;::;::;::;::; Permit Type Plumbing Permit Sewer Connection Permit Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount Invoice Amount $35.00 $35.00 $100.00 $100.00 $135.00 $135.00 Fee Amount $85.00 $15.00 Amount Paid $0.00 $0.00 $100.00 Amount Owing $35.00 $100.00 $0.00 $135.00 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 contrued 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: RMB Printed By: RMB Print Date: 2/14/2002