1992, 06-08 Permit: 92004109 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 in it and submitted by me or my agent to compile said permit/application is true
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= ER'- :1:: i:rt?41is>!
APPLICATION DATE-, 06/08/92
:yt• ft• )t• * 9t• n• THIS NOT PERMIT * 3y. 3(. 3t. * 3:.
PENALTIES Wj.#.i...t... BE ASSESSED !•• :iR COMMENCING c Wt..!R;;, WITHOUT r•! PERMIT
-------------------
SITE STREET= 1 i # 5 S BURNS RD
3?'•:?-.�? # k
9 r. _x •,
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PARCEL!4... :
PERMIT USE=
SEWER CONNECTION ,ti.CR (92,3-573)
1'.....,i::.!::. #'•? 1.} # #::. * * :
'TO= 001, -.) PLAT NAME= JANSON ADD.
OWER:::: BAKER, :: 0 PHONE—
S
s'i"i?: NE:.S BURNS RD
(-1 _ ) 7 t'•. 1::. ... -• 7` i~:. #''.`, t D f I... I:'. xE (? 99037
D0NTAC:: NAME= 1 i... i:: CONSTRUCTION
PHONE NUMBER= 50 927 6760
rs!t1.#...7.1.#'?lx '''ETBAC i'•:;> E#:::: .? !- (.t:#'2 #°:.#.lxl'1;:::: N/A l': -EAR= 3 ,!!
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STREET= `i '3 8 1 ,"? ;:. »? _1. i •i F` -i \!'` I::.
ITEM EM T)E:.:`.?i_:i:1.P tION
PROCESSING FEE
SEWER CONNECTION
• PERMIT TYPE
SEWER PERMIT50.00
FEE AMOUNT
50.00
Pit01 1::.;:'• :'•L l :t :r DO;i.I. t i";l.)'t,:E1..: 1"I
. tNTEjBY:(.} I I e t l.1 0 7# :'i , i'.i.iY.{ TN
PHONE= y0y9 927 676:.
QUANTITY F E :. AMOUNT
•
. ----------
40,00
AMOUNT PAID AMOUNT OWING
------------
.00 50.00
.00 50.00
,.x k UB AS—BUILT INFORMATION N S 2''nA.#.LABL.::. AT THE COUNTY
UTIL1:IES DEPARTMENT (456-3604)
:,
CONTRACTOR ORftl"y APPLICANT .. O , TO FIR ._S1
E L #::. a f.:! # .#. t } 3'J 6•? #~N D POE ,':• .#. # 1.} #''N I^ SEWER I::. ! . :TU}
AND CONFIRM THE
TO LOCATE LOCATE.BURIED CABLES, rlS PIPING, 1x762 # #::.1': LINES, ECT,
.:A#_.._ BEFORE 1..#';#::. Yr DIG (456-8000)
SEWER STUBS ARE:. TO BE CHECKED PRIOR
THAT THEY Ai';E CLEAR ANeiT? UNOBSTRUCTED
,>,t:•P:*x**3i•u 1.:(?I...t.. FOR INSPECTION PRIOR TO
3i 3;. 3t 3t 3l * 3t' 3t - 4 HOUR NOTICE REQUIRED
lt k *R9tP9456-3604
cONNE:CT.i.ON I c.? i.!`•i,':URE
COVER Pi3t'R•3t:•)t•3r3i'P•3ka:
* : 3y. •A: •'t+• 3{ 3s: . 3k .
3(''?t 3i.• * 3x 3R. * . 3!• 3E 3c 3e 3r 3r 3E •p ) . * * 3i• * * * 3;. 3,: 3,. * * . 3{ 3 3i THANK 0 , : *****K***************************