1992, 06-04 Permit: 92002603 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, oras a warranty of conlormance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT i'dUMBER9200260
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m.3c:n: 3t "k}3E ii" PERMIT INFORMATION
SITE STREET= Yi". HAiMER RL)
ADDRESS= SPOKANE NE WA 99216
PERMIT USE= .R CONNECTION hCQ.LFEST (922-361)
)
3F3ii( SEE NOTE 3s 3c:*
PARCEL..::__ 2254i ....1.942
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Bi.-OCK::=
AREA==
01 BLDGE=
OWNER=_
STREET:':
ADDRESS=
i
P(. AT NAME=
F'%A
:i Dl§'EL{....FNGS
I:-
SPOKANE !.dA 9u9:2ib
CONTACT NAME= !i . . CONSTRUCTION
BUILDING SETBACKS: FRONT N/A LEFT
'J:i3Gti'i(.dOti<'ri.ii.ti:.1i'd(:ii*11'X11ii.* i(. a.p}.)t .h'di,iii:)(i('Y: SEWER
CONTRACTOR=
STREET=
ADDRESS=
MOORE:. I S
3 'ZONE:..' ... l+
P' 141DlH=: I,
1 I,.I •i
4 RIGHT,
PERMIT
iltis I i\aC I .11.1w
''dAi...LE_YHAY AVE_
IslA 99206
ITEM DESCRIP'TIOIN
PAYMENT l:'1 1TC.
06i'04/92
.
TOTAL
PERMIT TYPE
.............................
SEWER Fi._F(M].
PROCESSED
PRINTEED BY' DO
SE(::IAILR STiUI
UTILITIES A)
CONTRACTOR
ELEVATION t
EXCAVATION
TO LOC‘
CALL 1'.
FEE
"1(.j1.,1(: 1::1:2:-: 5I.)9
i:R IE. A R L2 N I (:)
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QUANTITY
i@38 PAYMENT SUMMARY "Y}
I:;FEC:i:i..I:PT'9
4127
,00 Ti.l)171
MOUNT AMOUNT
5.
,00
50.'Y0
-:El, ROBIN
ICH, ROEIIN
3UII...T INFORMATION IS A'':AT._Az31-E:.
RTMENT (456-3604)
is
09614
FEE AMOUNT
10.00
40,00
3(kii' i('3;*3i*ii3i*;;3(
AMOUNT
50.00
50,00
AMOUNT
14114I.NG
.00
(1(1
APPLICANT IS TO FIELD LOCATE
POSITION OF SEWER ETUr'.'_..'PF
BURIED CABLES, GAS PIPING,
'x is i„1 DI.l:. (456--8000)
SEA IE: l: T I.!i .,
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A.
'tR'It "
O £IEE CHECKED PRIOR
CLEAR AND UNOW,7TRUCTE
FOR INSPECTION PRIOR
24 HOUR NOTICE REQUIR
1.:,h
i =: .4
:ic':k.
.j(.3(. THANK
ANK
AT THE COUNTY
(:iN11 CONFIRM l I i"IE
TO ANY OTHER
HF:.R
,DATER Ll
!
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ECT.
( .i ON Ti] INSURE
EEI1E:.F': MAIN
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