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2002, 07-15 Permit App: 02005845 Sewer, Plumbing Reversal, FixturesProject Number: 020058-15 Inv: 1 Air Application THIS IS NOTA PERMIT Penalties will be assessed for commencing work without a permit Date: 7/15/02 Page 1 of 2 . Project Information: Permit Use- SEWER CONNECTION - EASTON / TOILET, Contact: NORM'S EXCAVATING SHOWER, REVERSAL Address P.O. BOX 574 C - S - Z: VERADALE, WA 99037 Setbacks: Front Left: Right. Rear: Phone- (509) 928-0580 Group Name: Site Information! Project Name' � r Plat Key CONY Name: CONVERTED CNTY DATA Parcel Number: 45162.0309 Block Lot: SiteAddress: 11412 E MAXWELL AVE SPOKANE, WA 99206 Location:. SPO Zoning: SFR District: E Owner: Nance: CHAPMAN. LETA Addicss: 11412 E MAXWELL AVE SPOKANE, WA 99206 - Water District: Hold. ❑ Arca: 15,000 Sq Ft Width: 100 Depth: 150 Right Of Way (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: • Review Road Obstruction Permits: l Released By:2 1— (S. -0 2- t S Cc,5 .. Plumbing Permit Contractor: BELKNAP PLUMBING Firm: BELKNAI' PLUMBING Address 3414 S. ADAMS RD Phone: (509) 921-5913 VERADALE, WA 99037 Item Description TOILE I'SBIDETS SI 1O\VERS WATER PIPING - DWV PROCESSING FEE Units Unit Desc 1 NUMBER OF I NUMI3FR OF 1 NUMI3ER OF 1 'YORWANK Operator: CKF Printed By: CKF Permit Total Fees: Fee Amount $6.00 56.00 56.00 `525.00 $43 00 Print Date: 7/15/02 Project Number: 02005845 Inv. 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/15/02 Page 2 of 2 Sewer Connection Permit 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: Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Payment Summary: Permit Type Plumbing Permit Sewer Connection Permit Fee Amount $43.00 $100.00 Invoice Amount $43.00 $100.00 Amount Paid $0.00 $0.00 Amount Owine $43.00 $100.00 $143.00 $143.00 $0.00 $143.00 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: 7/15/02