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2002, 05-20 Permit App: 02003861 Sewer, Plumbing ReversalProject Number: 02003861 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/20/02 Page 1 of 2 Project Information: Pemut Use: SEWER CONNECTION - EASTON 2 / PLUMBING Contact- COURCHAINE CONSTRUCTION REVERSAL Address 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Setbacks: Front Left: Right: Rear Phone: (509) 924-5485 Group Name: Site Information:Project Name. Plat Key: 001570 Name MAXWELL'S SUB District: F Parcel Number. 45162.0421 Block SiteAddress: 10806 E MAXWELL AVE SPOKANE, WA 99206 Location: SPO Zoning: UR -3.5 \Vater District Urban Residential 3.5 Lot: Owner- Name MILLER, MARTIN & PEGGY Addiess: 10806 E MAXWELL AVE SPOKANE. WA 99206 Hold. ❑ Area 0 Sy Ft Width: 105 Depth. 116 Right Of Way (ft): 50 Nbr of Bldgs: 0 Nbr of Dwellings 1 Review Information: Review Road Obstruction 02_,,S0> 1t 2c$o Permits: . --- Contractor: UNKNOWN Address- UNKNOWN Phone: (000) 000-0000 UNKNOWN, WA UNKNOWN Plumbing Permit Firm: UNKNOWN Item Descimtton WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Units Unit Desi Fee Amount I NUMBER OF $6.00 I Y OR BLANK $25.00 I Select $4.00 Permit Total Fees: $35.00 Operator CKF Printed By. CKF I'rint Date 5/20/02 Project Number: 02003861 Inv: 1 At; ?Ili cation Date. 5/20/02 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Sen r Connection Permit Contractor COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509) 928-0846 GREENACRES, WA 99016 Item Description SEWER CONNECTION PROCESSING FEE Notes: — -- Payment Summary: Permit Type Plumbing Pernut Sewer Connection Permit Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Fee Amount Invoice Amount Amount Paid Amount Owing $35.00 $35.00 $0.00 $35.00 $100.00 $100.00 $0.00 $100.00 $135.00 $135.00 $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: CKF Printed By: CKF Print Date: 5/20/02