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2002, 05-13 Permit App: 02003627 Sewer, Plumbing ReversalProject Number: 02003627 Inv: I Appiication THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/13/02 Page 1 of 2 Project Information: Permit Use: SEWER CONNECTION - EASTON / PLUMBING REVERSAL Setbacks: Front Left: Right: Rear: I-Pwt 4740 . gym; ,.: =, .. . Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Phone: (509) 924-5485 Group Name: Site Information: Project Name. Plat Key: CONV Name: CONVERTED CNTY DATA District: F Parcel Number: 45162.1908 Block: Lot: SiteAddress: 10907 E SINTO AVE Owner: Name: SARQUILLA, PHIL SPOKANE, WA 99206 Address: 10907 E SINTO AVE Location:: SPO SPOKANE, WA 99206 Zoning: SFR Water District: Hold: ❑ Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 10 Review Information: tammatigam ;ttvr ,... ,,. Review Road Obstruction Contractor: BELKNAP PLUMBING Address: 3414 S. ADAMS RD VERADALE, WA 99037 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Plumbing Permit Firm: BELKNAP PLUMBING Phone: (509) 921-5913 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK 1 Select Operator: CKF Printed By: CKF Permit Total Fees: Fee Amount $6.00 $25.00 $4.00 $35.00 Print Date: 5/13/02 Project Number: 02003627 Inv: 1 Aripitcatiork THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/13/02 Page 2 of 2 Sewer Connection Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509) 928-0846 GREENACRES, WA 99016 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 $135.00 $135.00 Fee Amount $85.00 $15.00 $100.00 Amount Paid $0.00 $0.00 $0.00 Amount Owing $35.00 $100.00 $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