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2001, 07-27 Permit App: 01006201 Sewer J Project Number: 01006201 Inv: 1 f ,Application Date: 7/27/01 Page 1 of 1 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: ow, a . ...... .�,, � P.,� �. Permit Use: SEWER CONNECTION-TOWNER Contact: BEN PETERSON CONSTRUCTION Address: 11516 E 6TH AVE C-S-Z: SPOKANE,WA 99206 Setbacks:Front Left: Right: Rear: Phone: (509)990-5167 Group Name: Site Information: Project Name: Plat Key: 002565 Name: SULLIVAN WAY District: F Parcel Number: 45234.3610 Block: Lot: SiteAddress: 15421 E 14TH AVE Owner:Name: BLOUIN,BETTY L VERADALE,WA USA 99037 Address: 15421 E 14TH AVE Location::VER VERADALE,WA 99037-9767 Zoning: UNKN Unknown Water District: Hold: ❑ Area: 11,813 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: -am� Department Review - . + I IN Rele a sed'By: ® 'e �' �Ce . i Rsons: 't Con.' 'ons: Arvar. _'/ Sewer Permit Contractor: UNKNOWN Firm: UNKNOWN Address: UNKNOWN Phone: (000)000-0000 UNKNOWN,WA UNKNOWN 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: b•„ a . � � .� : . ,..n. � u �._ . ,,;. ... "0",,.r n •. ,.,. . � Operator: JAS Printed By: JAS Print Date: 7/27/01 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: _ . r ..F.M.o, a ,_„ . .<aF �.:. m W: � - aA� �s. ems J CRUMCC DEPARTMENT OF LABOR AND INDUSTRIES CRIS ID: 01 prod CONSTRUCTION CONTRACTOR INFORMATION ?OPTION (ADD,CHG,REN,REP,PRT,CRL or Screen ID) ?LICENSE NUMBER: BENPEC*022L9 ?Status: A ACTIVE ?Contractor Type: CC CONST CONT Contractor Name: BEN PETERSON CONSTRUCTION UBI: 601885434 Parent Company : Search Name : BEN PETERSON CO Address Line 1 : 11516 E 6TH Address Line 2 : City,State,Zip : SPOKANE WA 99206 Telephone 5099271072 County: 32 SPOKANE ?Reg Reason Code: Effective Date : 062998 ?Business Type: I INDIVIDUAL Expiration Date: 062502 ?Specialty Code 1: 01 GENERAL Suspended Date : 000000 ?Specialty Code 2: 00 UNUSED Audit Until Date: 000000 Nbr of Type Chg: 0 Employees: (Y/N) Fee Received Dt: 000000 LINIIS ID: F1=Hlp F2=USH F3=End F4=Adr FS=Pry F6=Nxt Const Contractor Renewed Successfully —_— — nncn�r�� si5 ii •-r_: _al4 � 1_�ijl