1991, 06-10 Permit: 91002505 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained/ it o submittedu t to compilesaid permit/application is to
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 9iOO2505 I%%UED PE�MIl
****************************
PERMIT INFORMATION
SITE STREET= 1i0i4 E 23RD AVE
ADDRESS= SPOKANE.WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
''' ~-- `'~-- '''
*** ��� NOTE •��x •
PLATt= O01393 PLAT NAME= KOKOMO TOWN%ITE
BL = LOT= ZONE= AG%UB
AREA= OOOOOOOO F/A= F WIDTH=
OF BLDc%= i 0 DWELLINGE=• i WATER DI%l
DATE= 06/10/91
PAGE= Oi
****************************
PARCELO= 28542-6O9
OWNER= MP% N'
STREET= iiOi4 E 23RD AV[
ADDRESS= %POKANE WA 992O6
CONTACT NAME= GENE FORD
PHONE=
vt!'
=
D/W=
• PHONE NUMBER= 509 924 6182
BUi%ECKRf-- NA LEFT= NA RIGHT= NA • REAR= NA
***************************** %EWER pERMIT ******************************
CONTRACTL A & V CONSTRUCTION__ PHONE= 509 924 6182
%T�EET= .425 N UNIVERSITY RD
ADDREJ%= SPOKANE WA 99206
IrFM DFS[RIPTION • QUANTITY.
---'
PROCESSING FEE Y
SEWER CONNECTION
FEE AMOUNT
10,00
40,00
****************************** PAYMENT SUMMARY- *******************:*******K
PAYMENT DATE RECElPT4 PAYMENT AMOUNT
06/10/913565 50.00
------------
TOTAL DUE= .0� TOTAL PAID=
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT ;WING
--------------- _---------~-_ ------------ SEWER PERMIT PERMIT .00
------------- ------------ -------------
50.00 50.00- .00
PROCESSED BY JULIE %HATTO
PRENTED BY: JULIE •%HATTO
SEWER STUB A% -BUILT 3mFORM TIOJ� AVAILABLE AT THE COUNTY
UTLITIE%-DEPARTMET (456-36O4}
- '
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
LE�A�ION AND POSITION,OF SEWER STUB PRIOR TO ANY OTHER
�,'
EXCAVATION •
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT,
CALLBEFORBYO8 Y)IG`(45048000) `
SEWER STUBS ARE Or - CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE AND -UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR J N PRIOR TU COVER **********
********* CALL
HOUR N6fICE.REQUIRED **********
********* 456-36O4...-` **********
*
******************************** THANK YOU•************************** *****
SPECIAL CONDITION CHECKLIST
Project
Address Project # Use.
Dept:
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other
Date: Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Pians/Improvements
Bonds
Bonds
Double Plumbing
ULID
Init: Appr:
(in) j (out)
******************************* THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY ******************************
Date received for C/O processing: Plans pulled for final processing -
Temporary C/O issued: Certificate of Occupancy issued'
Office file review by: Date:
Filed insp finaled by: Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: Date'
Plans returned: Received by*
No response from owner/contractor - plans destroyed.