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2002, 07-15 Permit App: 02005847 Sewer, Plumbing ReversalProject Number: 02005847 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/15/02 Page 1 of 2 Project Information: Permit Use: SEWER CONNECTION - EMPIRE HEIGHTS / Contact: NORM'S EXCAVATING PLUMBING REVERSAL Address: P.O. BOX 574 C - S - Z: VERADALE, WA 99037 Setbacks: Front Left: Right: Rear: Phone: (509) 928-0580 Group Name: Project Name: Site Information: Plat Key: 000735 Name: EMPIRE HEIGHTS ADD Parcel Number: 35241.3313 Block: Lot: SiteAddress: 7315 E 5TH AVE SPOKANE, NN, A 99212 Location:: SPO Zoning: UR -7 Urban Residential -7 Water District: Owner: Name: REVINE, EDNA Address: 7315 E 51H AV E SPOKANE, WA 99212 Hold: ❑ District: F Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Road Obstruction 02 SC CSi n Permits: Released By: Plumbing Permit Contractor: BELKNAP PLUMBIN(, 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 Permit Total Fees: Fee Amount $6.00 $25.00 $4.00 $35.00 Print Date: 7/15/02 Project Number: 02005847 Inv: 1 Application Date: 7/15/02 Page 2 of 2 THIS IS NOTA PERMIT Penalties will be assessed for commencing work without a permit 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: , v Payment Summary: Permit Type Plumbing Permit Sewer Connection Permit Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount Invoice Amount $35.00 $35.00 $100.00 $100.00 $135.00 $135.00 Fee Amount $85.00 $15.00 Amount Paid $0.00 $0.00 $0.00 $100.00 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: 711 5/02