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2002, 08-02 Permit App: 02006593 Sewer, Plumbing ReversalProject Number: 02006593 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 8/2/02 Page 1 of 2 Project Information: Permit Use: SEWER CONNECTION - WALNUT / PLUMBING Contact: INLAND EXCAVATING & CONSTRUCTI REVERSAL Address: 3417 W OLSON RD C - S - Z: DEER PARK, WA 99006 Setbacks: Front Left: Right: Rear: Phone: (509) 276-8500 Group Name: Site Information: Project Name: Plat Key: 001835 Name: OPP.TR. 1-354 District: F Parcel Number: 45173.0411 Block: Lot: SiteAddress: 624 N WILLOW RD Owner: Name: BLOWERS, RAYMOND H SPOKANE, WA 99206 Address: 624 N WILLOW RD Location:: SPO SPOKANE, WA 99206 Zoning: TFR Water District: Hold: ❑ Area: 0 Sq Ft Width: 180 Depth: 310 Right Of Way (ft): 40 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Permits: VMK444, Contractor: KEN CARTER Address: 916 S UNIVERSITY RD SPOKANE, WA 99206 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Released By: Plumbing Permit Firm: KENNETH J. CARTER Phone: (509) 216-6539 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK 1 Select Operator: CKF Printed By: CKF Permit Total Fees: Fee Amount $6.00 $25.00 $4.00 $35.00 Print Date: 8/2/02 S Project Number: 02006593 Contractor: Address: Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 8/2/02 Sewer Connection Permit INLAND EXCAVATING & CONST 3417 W OLSON RD DEER PARK, WA 99006 Item Description SEWER CONNECTION PROCESSING FEE Notes: Payment Summary: _ Permit Type Plumbing Permit Sewer Connection Permit Firm: INLAND EXCAVATING & CONST Phone: (509) 276-8500 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 construed 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: 8/2/02