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2001, 05-16 Permit App: 01003662 Sewer, Plumbing Reversal Project Number: 01003662 Inv: 1 Application Date: 5/16/01 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-WELLESLEY MANOR& Contact: WALDORF CONSTRUCTION PL REV Address: PO BOX 840 C-S-Z: NEWMAN LAKE,WA 99025 Setbacks:Front Left: Right: Rear: Phone: (509)226-2055 Group Name: Site Information: Project Name: Plat Key: 002849 Name: WELLESLEY MANOR 3RD ADD District: H Parcel Number: 46363.0118 Block: Lot: SiteAddress: 16025 E WELLESLEY AVE Owner:Name: HELMS,DOUG SPOKANE,WA 99216 Address: 16025 E WELLESLEY AVE Location::SPO SPOKANE,WA 99216 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 0 Sq Ft Width: 96 Depth: 128 Right Of Way(ft): 60 Nbr of Bldgs: 1 Nbr of Dwellings: •1 Review In formation: . ,�. �A� •�. - 4. ._ . _a.._. Department Review r: ENGINEER Road Obstruction Released By. � � � Hold Reasons: Permit Conditions: ✓ Plumbing Permit Contractor: WALDORF CONSTRUCTION Firm: RICHARD WALDORF/WALDORF Address: PO BOX 840 Phone: (509)226-0880 NEWMAN LAKE,WA 99025 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 Permit Total Fees: $35.00 Project Number: 01003662 Inv: I Application Date: 5/16/01 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Sewer Permit Contractor: WALDORF CONSTRUCTION Firm: RICHARD WALDORF/WALDORF Address: PO BOX 840 Phone: (509)226-0880 NEWMAN LAKE,WA 99025 Item Description Units Unit Desc Fee Amount SEWER CONNECTION 1 NUMBER OF $85.00 PROCESSING FEE 1 Y OR BLANK $15.00 Permit Total Fees: $100.00 Operator: MKC Printed By: MKC Print Date: 5/16/01 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Plumbing Permit $35.00 $35.00 $0.00 $35.00 Sewer Permit $100.00 $100.00 $0.00 $100.00 $135.00 $135.00 $0.00 $135.00 Notes: