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2002, 06-10 Permit App: 02004611 Sewer, Plumbing ReversalProject Number: 02004611 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 6/10/2002 Page 1 of 2 Project Information: ............... . Permit Use: SEWER CONNECTION - VALLEY VISTA & PLUMBING REVERSAL Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 001834 Name: OPP.TR. 1-354 District: F Contact: H & S CONSTRUCTION Address: 11817 E. VALLEYWAY AVE C - S - Z: SPOKANE WA 99206 Phone: (509) 926-8964 Group Name: Project Name: Parcel Number: 45163.0406 Block: Lot: SiteAddress: 10904 E VALLEY WAY Owner: Name: SPOKANE, WA USA 00000 Address: Location:: SPO ACKERMAN, C C 10904 E VALLEYWAY AVE SPOKANE, WA 99206-5055 Zoning: UR -3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 15,513 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Road Obstruction Contractor: H & S CONSTRUCTION Address: 11817 E VALLEYWAY AVE SPOKANE, WA 99206 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT :_i.e.,,,.1 Released.':. tC� [ Plumbing Permit Firm: H & S CONSTRUCTION Phone: (509) 926-8964 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK 1 Select Operator: RMB Printed By: RMB Permit Total Fees: Print Date: Fee Amount $6.00 $25.00 $4.00 $35.00 6/10/2002 Project Number: 02004611 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 6/10/2002 Page 2 of 2 Sewer Connection Permit Contractor: H & S CONSTRUCTION Finn: H & S CONSTRUCTION Address: 11817 E VALLEYWAY AVE Phone: (509) 926-8964 SPOKANE, WA 99206 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 $85.00 $15.00 $100.00 Fee Amount Invoice Amount Amount Paid Amount Owing $35.00 $35.00 $0.00 $100.00 $100.00 $0.00 $135.00 $135.00 $35.00 $100.00 $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: 6/10/2002