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2002, 05-13 Permit App: 02003626 Sewer, Plumbing ReversalProject Number: 02003616 Inv: 1"' �: AppllCa(1011 Date: 5/13/02 Page 1 oft THIS IS NOT A PERMIT' Penalties will be assessed for commencing work without a permit Proiect /ht formation: _ Permit Use. SEWER CONNEC'T'ION - PONDEROSA / Contact: COURCHAINE CONSTRUCTION PLUM BING-REV E,RSAL Address: 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Setbacks: Front Left: Right: Rear: Phone: (509) 924-5485 Group Name: Site /nforntation: Project Name: M Plat Key: 001743 Name: MYRON ESTATES NO 8 District: E Parcel Number: 44042.2028 Block: SiteAddress: 11123 E PONDEROSA DR SPOKANE, WA 99206 Location:: SPO Zoning: UR -3.5 Urban Residential 3.5 Water District - Area: 0 Sq Ft Width: 0 Nbr of Bldgs: I Nbr of Dwellings: 1 Lot: Owner: Name: SCHMISTER. SCOTT Address: 11123 E PONDEROSA DR SPOKANE, WA 99206 Hold: ❑ Depth: 0 Right Of Way (ft): 60 Review /nforntation • r—=---- — Review Road Obstruction -o N -STS . Permits: — -- - - P6unbingPerm it --- Contractor: BELKNAP PLUMBING Address: 3414 S. ADAMS RD VERADALE, %VA 99037 Item Description WATER PIPING -DWV PROCESSING I FE MININIUNI FEE ADJUSTibIENT Firm: BELKNAP PLUMBING Phone: (509) 921-5913 Units Unit Desc Fee Amount I NUMBEROF $6.00 1 Y OR BLANK 525.00 I Select $4.00 Pcrmit Total Fees: $35.00 Operator: CKF Printed By: CKF Print Date: 5/13/02 Project Number: 02003626 Inv: I Application' Date: 5/13/02 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Sewer Connection Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509) 928-0846 GREENACRES, WA 99016 Item Description Units Unit Desc Fee Amount SEWER CONNECTION I NUMBER OF $85.00 PROCESSING FEE I Y OR BLANK $15.00 Permit Total Fees: $100.00 Notes: _ Payment Summary: - Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Plumbing Permit $35.00 $35.00 $0.00 $35.00 Sewer Connection Permit $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: 5/13/02