2004, 04-06 Permit: BLD-04-03984 Plumbing Reversal t
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Ville PLUMBING PERMIT
11707 E.Sprague Ave.,Suite 106
Spokane Valley,WA 99206 Permit#: BLD-04-03984
Job Address: 12015 E 21ST AVE Applied: 04/06/2004
SPOKANE WA 99206-7017 Issued: 04/06/2004
Description: PLUMBING REVERSAL FOR SEWER CONNECTION Expires: 10/03/2004
Subdivision: Lot: Blk: Parcel No: 45281.0513 Zoning:
Owner: EWAN, RUSSELL C
Applicant: H&S CONSTRUCTION Phone: (509)926-8964
Address: 11817 E VALLEYWAY AVE
SPOKANE,WA 99206-5128
Contractor: BELKNAP PLUMBING Phone: (509)921-5913
Address: 3414 S ADAMS RD Lic No: BELKNAP*071 D6
VERADALE WA 99037-9101
General Information: Fees:
SUPPLEMENTAL PERMIT N PLUMBING PROCESSING FEE 35.00
WATER PIPING/DRAIN-IN WASTE 1 WATER PIPING/DRAIN-IN WASTE 6.00
Total Calculated: 41.00
Deposits/Receipts: 41.00
Total Due: 0.00
Disclaimer:
The permitee verifies,acknowledges and agrees by their signature that: 1)If this permit is for construction of or on a dwelling,the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3)The signatory is the property
owner or has permission to represent the property owner in this transaction. 4)All construction is to be done in full compliance with the City of
Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5)This City of
Spokane Valley Permit is not a permit or approval for any violation of federal,state or local laws,codes or ordinances.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature Date
Staff Initials
THIS IS NOT A RECEIPT