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2002, 03-15 Permit App: 02001635 Sewer, Plumbing ReversalProject Number: 02001635 Inv: 1 Application Date: 3/15/02 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 - MILLER PARK / Contact: ALLIED SEWER & BORING PLUMBING REVERSAL Address: 9317 S FREEMAN DR C - S - Z: MEDICAL LAKE, WA 99022 Setbacks: Front Phone: (509) 924-8508 Group Name: Project Name: Left: Right: Rear: Site Information: „ za.... w'n'�"�,�d41���"ui}�Nnde=4-�'=y hhan N•a. •v 'f��'Aif Plat Key: 002810 Name: WALLACE ADD Parcel Number: 352413006 Block: SiteAddress: 601 S THIERMAN RD SPOKANE, WA 99212 Location:: SPO Zoning: UR -3.5 Water District: Area: 10,683 Sq Ft Urban Residential 3.5 Lot: District: D Owner: Name: SCHULLER, GORDON & NANCY Address: 601 S THIERMAN RD SPOKANE, WA 99212 Hold: ❑ Width: 138 Depth: 77 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Permits: SL -Ii !22_ Contractor: BESTWAY PLUMBING Address: 18416 E ALKI AVE GREENACRES, WA 99016 ',A4MAlgttkine Plumbing Permit Firm: BESTWAY PLUMBING Phone: (509) 922-1541 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 1 Select $4.00 Operator: CKF Printed By: CKF Permit Total Fees: $35.00 Print Date: 3/15/02 Project Number: 02001635 Inv: 1 Application THIS IS NOT A PIRMIT Penalties will be assessed for commencing work without a permit Date: 3/15/02 Page 2 of 2 Sewer Connection Permit Contractor: ALLIED SEWER BORING Firm: ALLIED SEWER BORING COMPA Address: 9317 S FREEMAN DR Phone: (509) 924-8508 MEDICAL LAKE, WA 99022 Item Description SEWER CONNECTION PROCESSING FEE Payment Summary: p, e:; Permit Type Plumbing Permit Sewer Connection Permit Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Fee Amount $35.00 $100.00 Permit Total Fees: Invoice Amount $35.00 $100.00 Fee Amount $85.00 $15.00 $100.00 Amount Paid $0.00 $0.00 MOM 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 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: 3/15/02