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2002, 07-16 Permit App: 02005968 Sewer, Plumbing Reversal, FixturesProject Number: 02005968 Inv: Application Date: 7/16/02 Page 1 of 2 THIS ISNOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - MISSION / 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: Plat Key 000848 Name FARR-MISSION SUB District: F Parcel Number: 45083.0461':: Block Lot: SiteAddress• 9707 E MISSION AVE SPOKANE, WA 99206 Location:: SPO Zoning: AGSUB Water District Owner: Name: RO'1'HGEB, HAROLD Addicss: 9707 E MISSION AVE SPOKANE, WA 99206 Hold: LI Arca: 0 Sq Ft Width: 135 Depth: 142 Right Of Way (ft): 60 Nbr of Bldgs: 0 Nbr of Dwellings .1 Review Information: • ., Review Road Obstruction Permits: Released By7_/4... o} 0 —oP,,Ica-577 Contractor: BELKNAP PLUMBING Addiess: 3414 S ADAMS RD VERADALE. WA 99037 Item Description TOILETS/BIDETS SHOWERS WATER PIPING - DWV PROCESSING FEE Plumbing Permit Firm: BELKNAP PLUMBING Phone: (509) 921-5913 Units Unit Desc 1 NUMBER OF 1 NUMBER OF I NUMBER OF I Y OR BLANK Operator: CKF Printed By: CKF Fee Amount 56.00 S6.00 56.00 525 00 Permit Total Fees: S43 00 Print Date: 7/16/02 Project Number: 02005968 Application THIS IS NOTA I1 RMIT Penalties will be assessed for commencing work without a permit Inv: I Date 7/16/02 Page 2 of 2 Contractor: NORM'S EXCAVATING Address: PO BOX 574 VERADALE, WA 99037 Item Description SEWER CONNECTION PROCESSING FEE Notes: Server Connection Permit Firm: NORM'S BOBCAT SERVICE Phone: (509) 928-0580 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Payment Suuuaurf: L Permit Type Plumbing Permit Sewer Connection Permit Fee Amount Invoice Amount $43.00 $100.00 $43.00 $100.00 Amount Paid $0.00 $0.00 Amount Owing $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 Dale: 7/16/02