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2002, 07-15 Permit App: 02005846 Sewer, Plumbing ReversalProject Number: 02005846 Inv: 1 1 4 Application Date: 7/15/02 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - EMPIRE HEIGHTS / PLUMBING REVERSAL Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 000735 Name: EMPIRE HEIGHTS ADD Parcel Number: 35241.3508 Block: Lot: Contact: NORM'S EXCAVATING Address: P.O. BOX 574 C - S - Z: VERADALE, WA 99037 Phone: (509) 928-0580 Group Name: Project Name: SiteAddress: 7106 E 5TH AVE SPOKANE, WA USA 99212 Location:: SPO Zoning: UR -7 Water District: Area: 7,620 Sq Ft Nbr of Bldgs: 0 Review Information: Review Road Obstruction Permits: Urban Residential -7 Width: 0 Nbr of Dwellings: 0 a2.ScC,5 69 Contractor: BELKNAP PLUMBING Address: 3414 S. ADAMS RD VERADALE, WA 99037 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT District: D Owner: Name: WING, JANET P Address: 7106 E 5TH AVE SPOKANE, WA 99212-0508 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Released By: Plumbing Permit Firm: BELKNAP PLUMBING Phone: (509) 921-5913 Units Unit Desc 1 NUMBER OF I Y OR BLANK 1 Select Operator: CKF Printed By: CKF Permit Total Fees: Print Date: Fee Amount $6.00 $25.00 $4.00 $35.00 7/15/02 Page 1 of 2 Project Number: 0200.5846 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/15/02 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 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 Permit Total Fees: Invoice Amount $35.00 $100.00 $135.00 $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: 7/15/02