2011, 09-13 Permit: 11004640 Sewer\ SPOKANE COUMY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information Project Information
Site Address: 19024 E BLOOM CIR
Parcel Number: 55173.2519
Subdivision: CITY OF SPOKANE VALLEY
Block: Lot:
Zoning: RMH
Owner: LINDELL, REXFORD L.
•Address: 19024 E 13I.00M CIR
GREENACRES, \VA 99016
Building Inspector: DAN 110\YARD
Water Dist:
Project Number: 11004640 Inv:
Permit Use: SEWER CONNECTION
1 Issue Date:
Applicant: H & S CONSTRUCTION
11817 E VALLEYWAY AVE
SPOKANE, WA 99206
Contact: H & S CONSTRUCTION
11817 E VALLEYWAY AVE
SPOKANE. WA 99206
Setbacks - Front: Left: Right:
Group Name:
Project Name:
9/13/2011
Phone: (509) 926-8964
Phone: (509) 926-8964
Rear:
Permits
Server Connection Permit
Contractor: H & 5 CONSTRUCTION License #: HSCON**123KF
SEWER CONNECTION
1 $125 00 PROCESSING FEE 1 $25 00
Total Permit Fee: $150 00
**FOR SEVER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO
COVER ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL
INSPECTION FEES APPLY AFTER 30 MINUTES.
**CALL 1-800-424-5555 BEFORE YOU DIG --AT LEAST 2 WORKING DAYS IN ADVANCE. SPOKANE COUNTY CODE
REQUIRES TI IE INSTALLER COMPLY WITH ALL REQUIREMENTS OF Tit WA STATE DEPT OF LABOR & INDUSTRIES.
INCLUDING THOSE RELATED TO TRENCH SAFETY.
**INSTALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO'FI IE SEWER AND MAY
BE REQUIRED TO PERFORM TESTS FOR VERIFICATION. INSTALLER IS TO FIELD LOCATE AND CONFIRM THE
ELEVA'T'ION AND POSITION OF SEWER STUB PRIOR TO ANY -OTHER EXCAVATION.
**SEWER STUBS AND DRY SIDE SEWERS ARE TO BE CHECKED PRIOR TO CONNECTION TO ENSURE THAT THEY
HAVE ACCEPTABLE GRADE AND ARE CLEAR AND UNOI3STRUCTED. SEWER LINES SIIOULD BE CONSTRUCTED'1'0
ALLOW FOR GRAVITY FLO\V FROM THE LOWEST LEVEL OF THE STRUCTURE.
**TI IE INSTALLER AND THIS PERMIT MUST BE PRESENT AT THE JOB SITE AT THE SCHEDULED INSI'ECTION TIME.
BOTH STATE LAW RCW 19.122 AND COUNTY CODE REQUIRES TFIE'INSTALLER TO GIVE NOTICE OF EXCAVATION TO
OWNERS OF UNDERGROUND FACILITIES.
Payment Summary
Total Fees AmountPaid AmountOwing
$150.00 5150.00
$0 00
Tran Date Receipt # Payment Amt
9/13/2011 4064 5150.00
Processed By: SI-IATTO, JULIE
Printed By: Force, Faith Page 1 of 1
PERMIT