2001, 11-29 Permit App: 01010508 Sewer, Plumbing Reversal Project Number: 01010508 Inv: 1 Application Date: 11/29/01 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: PLUMBING REVERSAL/SEWER Contact: ALLIED SEWER&BORING
CONNECT/APPLE VALLEY Address: 9317 S FREEMAN DR
C-S-Z: MEDICAL LAKE,WA 99022
Setbacks:Front Left: Right: Rear: Phone: (509)924-8508
Group Name:
Site Information: Project Name:
Plat Key: 999999 Name: RANGE District: F
Parcel Number: 45213.9147 Block: Lot:
SiteAddress: 11407 E 9TH AVE Owner:Name: GOTTSCHALK„J
SPOKANE,WA 99206 Address: 11407 E 9TH AVE
Location::SPO SPOKANE,WA 99206
Zoning: UNKN Unknown
Water District: Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: _ :.: . :_ F � .. _016'M
Review
Road Obstruction ` .,
I Released By: 44
D-! 5 GNB'17
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Plumbing Permit
Contractor: BESTWAY PLUMBING Firm: BESTWAY PLUMBING
Address: 18416 E ALKI AVE Phone: (509)922-1541
GREENACRES,WA 99016
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
Operator: JAS Printed By: JAS Print Date: 11/29/01
Project Number: 01010508 Inv: 1 Application Date: 11/29/01 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Sewer Connection Permit
Contractor: ALLIED SEWER BORING Firm: ALLIED SEWER BORING COMPA
Address: 9317 S FREEMAN DR Phone: (509)924-8508
MEDICAL LAKE,WA 99022
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
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Plumbing Pecnut $35.00 $35.00 $0.00 $35.00
Sewer Connection Permit $100.00 $100.00 $0.00 $100.00
$135.00 $135.00 $0.00 $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: JAS Printed By: JAS Print Date: 11/29/01