1992, 01-27 Permit App: 92000441 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
1 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
PRi,7. tEi. # j'•-IUMf.{E:.R= 9200044•1 APPLICATION DATE= Eji , `. i .``iy2 i'`AGi::.:::: Oi
PENALTIES W.i:Li... BE AS:-E,::•,.}i::D FOR CO"MENi.INi,:•, WORK WITHOUT
,r•'•? PERt`'=.1.i
-------------------------------------------------------------------------------
SITE STREET= 1904 S DAVIE RD
t•tt?r!F':!^.:',;'... ::it«'OKt'•ttL!t; WA 9906
PARCEL*= 2754i-2903
PERMIT USE= ,:}"_ f i 3::. i'{ CONNECTION .... Ai is i i E.� �..: r=•: ?::.:: i (92S-40)
PLATO= {;,5;1.9' :;5:;;. PLAT •t t' ::; ttt
BLOCK= .1
AREA= 00000000
F;
WIDTH= i .ODEPTH= a
0 ;r:1.i_ ! 0 D:_#iE`Yi:':WATER DIST
STREET- i904 S DAVIS
ADDRESS- i'- SPOKANE WA}'.:y'.� ::ti
CONTACT Ni"-= & : CONSTRUCTION
ic;,:ti.IfN PHONE NUMBER= 509:i'.,e,8964
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SEWER P_R"1T
i+7 '11l 'Pi •ii• N: i+i 'Pi ih :J,...p} .j,..ji. j,..:,i..j+: •!?• 1S• 'J+i 'fk -}+i 'Pi +i i++r .+ ........... .
CONTRACTOR= H & SCONSTRUCTION
STREET= j j :., ..,, E:: s?'f''',I...Li:::Y1.)A•Y A V i:::
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY
------------------------- --------
PROCESSING
SEWER CONNECTION i
PERMIT TYPE i::""E AMOUNT AMOUNT PFj.i.::
..---------- --- ....—_..--_..........._—._......_.— ------------
SEWER PERM!''I'' 5%00
------------- ------------
5%00 .0()
PROCESSED BY: DOMITROVICH, ROBIN
PRINTED BY: DOMITROVICH, ROBIN
PHONE= 509 926 8964
FEE AMOUNT
-------------
i 0 00
40
...................—_.--........—
%S0 0isj
AMOUNT OWING
----------------
50.00
--------------
SEWER STUB UB f:`'tt.`—Bi.j:i:LT INFORMATION IS AVAILABLE AT THi::: COUNT
'
UTILITIES DEPARTMENT (456-3604)
t:,fti'•-1_i`.E.•`Ai.TOR OR APPLICANT
APiIi ANi IS TO
FIELD LOCATE AND CONFIRM THEELEVATION tN) POSITION OF
SEWER :..t i, i%{ PRIOR t i, ! r" -t N r OTHER
EXCAVATION
1i..i LOCATE BU#•(.1.i::.D CABi...i::S, GAS PIPING, , W(•+:y'1E:.R i...INF:.S, i:.+,_i.,
CALL BEFORE YOU DIG (451-0000)
SEWER
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::}#i..iBS
ARE 1t..?
BE CHt::.Ci+,E:D
PRIOR 1I,1
CONNECTION
.fit
t..t
THEY
ARE 1._F:.F�ir�:
AND iij��`ii`{S'j"{z;:(_
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THE
'15' •P: •N: 'A•
M• 'P: '}r 9r 'Jt"
CALL r' O R
INSPECTION
PRIOR i O
COVER l+i yq� �,f• -!1: -ji• :Ir-je.:p: j,..j,:
24 HOUR
NOTICE
REQUIRED
456-3604
THANK
YOU
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