2000, 03-21 Permit App: 00001819 Sewer •
Project Number: 00001819 Inv: 1 Application Date: 03/21/20 Page 1 of 1
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION-SPRINGFIELD Contact: KETO CONSTRUCTION
ADDITION TO AUTUMN CREST Address: 4920 S BELLA VISTA DR
Setbacks:Front Left: Right: Rear: C-S-Z VERADALE,WA 99037
Phone: (509)994-4716
Site Information:
Plat Key: 005950 Name: SPRINGFIELD ADDITION @ AUT District: F
Parcel Number: 45261.5607 L (o ff 15.1
SiteAddress: 15108 E 18TH CT Owner: Name: KETO CONSTRUCTION
VERADALE,WA USA 9903 Address: 4920 S BELLA VISTA DR
Location::VER VERADALE,WA 99037
Zoning: UR-3.5 Urban Residential 3.5
Water District: 999 UNKNOWN Hold: ❑
Area: 16,267 Sq Ft Width: 0 Depth: 135 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: ,,,, ., .w�,v i sS w M .4'iTt, amutIrswenwa,.....,..
Department Review
UTILITIES Review by Utilities 0 K.TC7 k'S(A E_ t T_F
Comments:
li�1v 3 -23 o
Permits:
Sewer Permit
Contractor: KETO CONSTRUCTION Firm: KETO CONSTRUCTION
Address: 4920 S BELLA VISTA DR Phone: (509)922-1226
VERADALE,WA 99037
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
Payment Summary: o . ��n
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Operator: DMD Printed By: DMD Print Date: 03/21/2000
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Permit $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $0.00 $100.00
Notes:
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APPLICATION INFORMATION A, — fr(17
What is the JOB SITE address? ASSESSOR'S tax parcel number?
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Legal daao.tptien ae it appears on the property deed
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OWNER or OCCUPANT Phone
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Mailing address City,state Zip
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Who should we contact regarding this project? ' Phone
What work is being done under this permit?
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Lone ......: Inspector district Property size Right of way width
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Water district
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Building Building height 1 #of stories
Conte for dimensions TOTAL SQUARE FOOTAGE
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WA State Contractor license# Main floor area Unfinished basement area
Mailing address -2nd floor area Finished basement area
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Architect/Engineer Garage area Size of decks,etc.
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What is the heat source? ., What is the cost of your project?
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Manufactured Home Sign
Width: Length: What is the square footage of How high is the sign?
the sign face?
Year: Make:
Installer Contractor
Wa State Contractor license# Wa State Contractor license#
Mailing address Mailing address
Relocation Fire Safety
Previous address Fire Sprinkler Tent _
Paint booth_ Fire Alarm Fireworks display _
VALUE
Contractor Contractor
WA State Contractor license# WA State Contractor license#
Mailing address Mailing address
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'Fuel Storaae Tanks (Swimming Pool
(Circle one) Above-ground Underground Size/gallons Private
Contents of tank(s) Size/gallons
Public/semi-private
Contractor Contractor
Wa State Contractor license# WA State Contractor license#
Mailing address Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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❑ All roadways, driveways & easments 0 Underground utilities
❑ Distances from center of roads, right of ways, 0 North arrow
private roads & property lines ❑ Septic tanks & wells
0 All existing & proposed buildings