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2002, 05-13 Permit App: 02003623 Sewer, Plumbing FixturesProject Number: 02003623 Inv: 1 Application Date: 5/13/02 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECT - VALLEY VISTA / TOILET, SHOWER, SINK, REVERSAL Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 001854 Name: OPPORTUNITY PLAT 3 Parcel Number: 45174.2443 Block: SiteAddress: 10404 E VALLEYWAY AVE SPOKANE, WA 99206 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Phone: (509) 924-5485 Group Name: Project Name: District: Lot: Owner: Name: BUSKO, KAREN Address: 10404 E VALLEYWAY AVE SPOKANE, WA 99206 Hold: ❑ Area: 0 Sq Ft Width: 76 Depth: 276 Right Of Way (ft): 40 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Permits: oa5rD3d 1 Contractor: BELKNAP PLUMBING Address: 3414 S. ADAMS RD VERADALE, WA 99037 Item Description TOILETS/BIDETS SINKS SHOWERS WATER PIPING - DWV PROCESSING FEE E Released By: Plumbing Permit Firm: BELKNAP PLUMBING Phone: (509) 921-5913 Units Unit Desc 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 Y OR BLANK Operator: CKF Printed By: CKF Permit Total Fees: Print Date: Fee Amount $6.00 $ 6.00 $6.00 $6.00 $25.00 $49.00 5/13/02 Project Number: 02003623 Inv: 1 Application 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: .1 Payment Summary :.= Permit Type Plumbing Permit Sewer Connection Permit Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Fee Amount $49.00 $100.00 $149.00 Permit Total Fees: Invoice Amount $49.00 $100.00 $149.00 Fee Amount $85.00 $15.00 $100.00 Amount Paid $0.00 $0.00 Amount Owing $49.00 $100.00 $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: CKF Printed By: CKF Print Date: 5/13/02