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2002, 05-29 Permit App: 02004185 Plumbing Fixtures, Sewer, ROWProject Number: 02004185 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/29/02 Page 1 of 2 Project Information: Nr, w'AMY'4.IRt .: :3 Permit Use: R-INBATH/REVERSAL/SEWER Contact: COURCHAINE CONSTRUCTION CONNECT/EASTON Address: 19818 E SPRAGUE Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 003152 Name: WYATT ADD Parcel Number: 45162.1904 Block: SiteAddress: 10807 E SINTO AVE SPOKANE, WA USA 99206 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: .00 Acres Nbr of Bldgs: 0 Review Information: Width: 0 Nbr of Dwellings: 0 C - S - Z: GREENACRES, WA 99016 Phone: (509) 924-5485 Group Name: Project Name: .. ,g.....: -. District: F Lot: Owner: Name: DICKENS, ROBERT Address: 10807 E SINTO AVE SPOKANE, WA 99206-4852 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Road Obstruction PASTDLI Permits: n,. Contractor: BELKNAP PLUMBING Address: 3414 S. ADAMS RD VERADALE, WA 99037 Item Description TOILETS/BIDETS SINKS TUBS WATER PIPING - DWV PROCESSING FEE Released By: Plumbing Permit Firm: BELKNAP PLUMBING Phone: (509) 921-5913 Units 1 1 1 1 1 Operator: JAS Printed By: JAS Unit Desc NUMBER OF NUMBER OF NUMBER OF NUMBER OF Y OR BLANK Permit Total Fees: Print Date: Fee Amount $6.00 $6.00 $6.00 $6.00 $25.00 $49.00 5/29/02 Project Number: 02004185 Inv: 1 Application Date: 5/29/02 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 GREENACRES, WA 99016 Item Description SEWER CONNECTION PROCESSING FEE Phone: (509) 928-0846 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Notes: e§s Payment Summary: MM.IWA.4V Permit Type Plumbing Permit Sewer Connection Permit Fee Amount $49.00 $100.00 Permit Total Fees: Invoice Amount $49.00 $100.00 Fee Amount $85.00 $15.00 Amount Paid $0.00 $0.00 $100.00 Amount Owing $49.00 $100.00 $149.00 $149.00 $0.00 $149.00 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: JAS Printed By: JAS Print Date: 5/29/02