1989, 11-02 Permit App: 89004427 SewerSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. 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 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 LATE
PROJECT NUMBER=- 89004427 DATE= 11 /02/09 PAGE= 01
APPLICATION
********************************* APPLICATION ******************************
SITE STREET= 12709 E FORREST AVE: PARCE:1..." == 27542-1752
ADDRESS= SPOKANE. WA 99216
PERMIT USE= SEWER CONNECTION — 8801
*** SEE NOTE ***
PLATO= 001846 PI...AT NAME= OPPORTUNITY TERRACE 4TH ADD
BLOCK= 8 LOT= 6 ZONES= AGSUB DI,T4= F
AREA= 00000000 F/A = F WIDTH= DEPTH= R./W=::
ir
OF BL.DGS= 4 DWELLINGS= i
OWNER= I<AHANA, BERT
STREET= 12709 E FORREST AVE
ADDRESS= SPOKANE WA 99216
PHONE:-:
CONTACT NAME= D PANGBORN PHONE. NUMBER= 509 325 9705
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= D PANGBORN EXCAVATING
STREET= 5704 N BIRCH P1...
ADDRESS- SPOKANE WA 99205
PHONE= 509 325 9705
ITEM DE:SCRIPTION CUANTTTi' FEE AMOUNT
PROCESSING, FEE Y 10.00
SEWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING;
-------------
SEWER PERMIT 50.00 ,00 550.00
50.00 .00 50,00
PROCESSED BY: JULIE SHATTO
PRINTED BY: JUI...IE SHATTO
SEWER STUB AS—BUILT INFORMATION IS AVA]:E..ABI..E AT THF COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIEL..I) LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT..
CALL.. BEFORE YOU DIG (4556••-$000)
SEWER STUB,; ARE TO BE: CHECKED PRIOR TO CONNECTION TO :ENSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
*******•** CAI...L. FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
•rc******** 456....3604 ***r:******
**********•********************** THANK YOU ********************************3t
DEPARTMENT OF BUILDING AND SAFETY • A DIVISION OF THE PUBLIC WORKS DEPARTMENT
JAMES L. MANSON, DIRECTOR DENNIS M. SCOTT, DIRECTOR
November 2, 1989
D PANGBORN EXCAVATING
North 5704 Birch Place
Spokane, Washington 99205
To whom it may concern:
Pursuant to your request for a sewer permit at East 12709 Forrest
Avenue we are issuing an authorization to proceed with construction.
Please be advised that the fee for the permit is $50.00 and payment
must be received no later than November 12, 1989.
Failure to remit this amount on or before the specified date will
result in a double fee being assessed.
Thank you for your prompt attention.
Sincerely,
c172 LLA -t J2_
Julie A. Shatto
Permit Technician
JAS:rmd
- 3
WEST 1303 BROADWAY • SPOKANE. WASHINGTON 99260-0050 • (509) 456-3675
FAX (509) 456-4703
JOB ADDRESS : G L ( .�
SUBDIVISION:
OWNER:
ADDRESS:
LOT : Cj BLOCK: F
PHONE:
CONTRACTOR: P__ CD 5e PHONE:
ADDRESS: (6 L )\j - ;eat l P\ S
LICENSE #: CFA A 'J& *' 5 C
INSPECTION DATE:
000, te4��
TYPE OF OCCUPANCY: