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2002, 05-13 Permit App: 02003624 Sewer, Plumbing ReversalProject Number: 02003624 Inv: I 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 CONNECTION - EASTON 2 / PLUMBING REVERSAL Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 001857 Name: OPPORTUNITY SUBURBS Parcel Number: 45163.0209 Block: 109 Lot: Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Phone: (509) 924-5485 Group Name: Project Name: SiteAddress: 10821 E VALLEYWAY AVE SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: 1.06 Acres Nbr of Bldgs: 0 Review Information: Review Road Obstruction Permits: Width: 0 Nbr of Dwellings: 0 off_ MP3(e2 Owner: Name: Address: District: F KOLBAR, E L PO BOX 2803 SPOKANE, WA 99220-2803 Hold: 0 Depth: 0 Right Of Way (ft): 0 Released By: Plumbing Permit Contractor: BELKNAP PLUMBING Firm: BELKNAP PLUMBING Address: 3414 S. ADAMS RD Phone: (509) 921-5913 VERADALE, WA 99037 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Units Unit Desc 1 NUMBER OF 1 Y OR BLANK I Select Operator: CKF Printed By: CKF Permit Total Fees: Print Date: Fee Amount $6.00 $25.00 $4.00 $35.00 5/13/02 5I131to? Project Number: 02003624 Inv: 1 Contractor: Address: Application " THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/13/02 Sewer Connection Permit COURCHAINE CONSTRUCTION 19818 E SPRAGUE AVE Phone: (509) 928-0846 GREENACRES, WA 99016 Firm: COURCHAINE CONSTRUCTION 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 Fee Amount $35.00 $100.00 $135.00 Permit Total Fees: Invoice Amount $35.00 $100.00 $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 Page 2 of 2 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