1990, 03-27 Permit App: 90001112 SewerSPOKANE COUNTY DEPAFITMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(50) 456-7-A75
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 violateorcancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any stateor local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 90001112 DATE= 03/2?/9: PAGE= 01
APPLICATION
#•)i3+ii#•## ##}rYr•:k•ri•*##•*k•k•##3 *•3') *$ * APFLICA' ' # Eli•ie*3citK;e#i()i•ifk#>:i#•iE3rriii#•iE- *-irii-ie#*#
SITE STREET= 12513 `i=• MAIN AVE PARCEL4= 5547-2723A
ADDRESS- SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION
"F MOTE ***
• JF'F'.TR. 1-354
BLOCK=
LOT= ;_ONE= AGSUR DISr;I.::F
AREA= 0( 0{){:�') �0 F"�`F} :: E:' W r T 'T'I IW DEPTH= E.°: f., .
:N: OF BLI)GS= 4 DWEL...I....INGS:::: i
OWNER= MC AI...F' 1: N , ..J W
STREET= 12513 E MAIN AVE
ADDRESS= SPOKANE WA 99216
F Hr){JF - m;09 926 759C
CONTACT NAME= SIMF'SON SANITATION PHONE NUMBER= 5n9 9A
BUILDING SETBACKS: CKS: FRONT= NA LEFT= NA RIGHT= OA REAR= N
.**********K**************:*** SEWER
ER FrR"TT*# # # fi.# x kt*# kF *# ***nx K Y.* **
# uaa #
CONTRACTOR= SIiiPfN SANITATION
STREET-,. -.. .O. BALDWIN .,
ADDRESS= .SS= PO AI:NE WA
ITEM DESCRIPTION
PHONE= 509 92: 4791
L�L1A1'�T:s: I• EE ,
PROCESSING FEEy Y 1 �, . 00
SEWER CONNECTION , 40,00
TYPE
----------
SEWER PE::RMIT50.00
FI:::. AMOUNT
50,00
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
!'T PAID AMOUNT OWING
={_)0
00
70,00
SEWER STUB AS—BUILT INF'OR; S AVAILABLE AT THE C�3tit�TY
UTILITIES DEPARTMENT (456-3604)
)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE ANI) CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRTOR TO ANY 0.717
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER i ;; NI ; , FC;,
CALL BEFORE YOU DIG (456-0000)
SEWER STUBS ' r' TO BE CHECKED PRIOR Tfl cnow 0T'T'f)N Tf) 1 NSHF'E
THAT THEY ARE. CLEAR AND UNOBSTRUCTED TO 1`Hi : WEAR MAIN
•M•*#•h***#* C,AL.t.. FOR INSPECTION 1-'RIrii. TO rlivF'F.' ox-xx•*##*#
****4)*** 24 HOUR NOTICE REQUIRED ##•ii•*)4*#yrx
)i##3i •i(* 456-3604 .,.R.:n;ii-is •#ri-##
.i'4K Yr)IJ*it*#•)E)i•##k•*?rrh#k•#3i•#7i•it3i•##•9E
JOB ADDRESS:
105 (:B ;5; ‘,-(2& ,
SUBDIVISION: )'' ll17L-` a"L�-p3
R W
OWNE/IL/ l L/7 PHONE:
LOT: BLOCK:
ADDRESS:�j
CONTRACTOR: �jr ?� f
Ld [S ONE: (`� -I O 1
ADDRESS: -C. 13- 5
LICENSE #: �t f 6S` C 7 a -Le -
INSPECTION DATE:
TYPE OF OCCUPANCY: