2001, 12-17 Permit App: 01010879 Sewer, Plumbing ReversalProject Number: 01010879 Inv: 1
Application
THIS IS NOT A PERMIT
Date: 12/17/2001 Page 1 of 2
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION - VALLEY VISTA & Contact: H & S CONSTRUCTION
PLUMBING REVERSAL Address: 11817 E. VALLEYWAY AVE
C - S - Z: SPOKANE WA 99206
Setbacks: Front Left: Right: Rear: Phone: (509) 926-8964
Group Name:
Project Name:
Site Information:
Plat Key: 001836 Name: OPP.TR. 1-354 District:
Parcel Number: 45063.0414 Block:
SiteAddress: 11022 E NIXON AVE
SPOKANE, WA 99216
Location:: SPO
Zoning: UNK
Water District:
Area: 0 Sq Ft
Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Lot:
Owner: Name: YOUNG, RONNIE
Address: 11022 E NIXON AVE
SPOKANE, WA 99216
Hold: E]
Depth: 0 Right Of Way (ft): 0
Review
Road Obstruction
Permits:
6/ siol 35
Contractor: JACKSON PLUMBING
Address: P.O. BOX 7272
SPOKANE, WA 99207
Item Description
WATER PIPING - DWV
PROCESSING FEE
MINIMUM FEE ADJUSTMENT
Plumbing Permit
Firm: RANDY JACKSON PLUMBING
Phone: (509) 926-7101
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
1 Select
Operator: RMB Printed By: RMB
Fee Amount
$6.00
$25.00
$4.00
Permit Total Fees: $35.00
Print Date:
12/17/2001
Project Number: 01010879 Inv: 1
Application Date: 12/17/2001 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Sewer Connection Permit
Contractor: H & S CONSTRUCTION Firm: 11 & S CONSTRUCTION
Address: 11817 E VALLEYWAY AVE Phone: (509) 926-8964
SPOKANE, WA 99206
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
Fee Amount
$85.00
$15.00
Amount Paid
$0.00
$0.00
$100.00
Amount Owing
$35.00
$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 fmds 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: 12/17/2001