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2002, 07-16 Permit App: 02005967 Sewer, Plumbing ReversalProject Number: 02005967 Inv: 1 Application THIS IS NOT A PERMIT Date: 7/16/02 Page 1 of 2 Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - MISSION / PLUMBING Contact: NORM'S EXCAVATING REVERSAL Address: P.O. BOX 574 C - S - Z: VERADALE, WA 99037 Setbacks: Front Left: Right: Rear: Phone: (509) 928-0580 Group Name: Site Information: Project Name: Plat Key: 001648 Name: MISSION ADD District: E Parcel Number: 45172.0605 Block: SiteAddress: 1303 N WOODRUFF RD SPOKANE, WA 99206 Location:: SPO Zoning: AGSUB Water District: Lot: Owner: Name: PORTER, CHUCK Address: 1303 N WOODRUFF R1) SPOKANE, WA 99206 Hold: ❑ Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 40 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Rte,<a Review Road Obstruction Permits: �Q 1ScG5'�i4 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 1 Select Operator: CKF Printed By: CKF I'erinit Total Fees: Fee Amount $6.00 $25.00 $4.00 $35.00 Print Date: 7/16/02 Project Number: 02005967 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/16/02 Page 2 of 2 Sewer Connection Permit Contractor: NORM'S EXCAVATING Firm: NORM'S BOBCAT SERVICE Address: PO BOX 574 Phone: (509) 928-0580 VERADALE, WA 99037 Item Description SEWER CONNECTION PROCESSING FEE Payment Summar': 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 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: 7/16/02