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2002, 04-22 Permit App: 02002797 Sewer, Plumbing Reversal Project Number: 02002797 Inv: 1 Application Date: 4/22/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION -EASTON &PUMBING Contact: VISTA CONSTRUCTION & DEV REVERSAL Address: 3420 N. TSCHIRLEY RD C - S -Z: SPOKANE,WA 99216 Setbacks: Front Left: Right: Rear: Phone: (509)926-2243 Group Name: Site Information: Project Name: Plat Key: 001834 Name: OPP.TR 1-354 District: F Parcel Number: 45084.0472 Block: Lot: SiteAddress: 1819 N RAYMOND RD Owner: Name: BENSON,DAVID S SPOKANE,WA USA 00000 Address: 398 S WASSON ST Location::SPO KOOS BAY,OR 97420 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 10,812 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Review Road Obstruction Released B ' o'3 BY: it.2z.- 6 2,4 C5.256 Permits: Plumbing Permit Contractor: VISTA CONSTRUCTION & Firm: VISTA CONSTRUCTION &DEV Address: 3420 N TSCHIRLEY RD#1 Phone: (509)926-2243 SPOKANE,WA 99216 Item Description Units Unit Desc Fee Amount WATER PIPING-DWV 1 NUMBER OF $6.00 PROCESSING FEE 1 Y OR BLANK $25.00 MINIMUM FEE ADJUSTMENT I Select $4.00 Permit Total Fees: $35.00 Operator: RMB Printed By: RMB Print Date: 4/22/2002 Project Number: 02002797 Inv: 1 Application Date: 4/22/2002 Page 2 of 2 THIS ISNOT A PERMIT Penalties will be assessed for commencing work without a permit Server Connection Permit Contractor: VISTA CONSTRUCTION & Firm: VISTA CONSTRUCTION & DEV Address: 3420 N TSCHIRLEY RD#1 Phone: (509)926-2243 SPOKANE,WA 99216 Item Description Units Unit Desc Fee Amount SEWER CONNECTION 1 NUMBER OF $85.00 PROCESSING FEE 1 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: RMB Printed By: RMB Print Date: 4/22/2002