1991, 10-31 Permit App: 91007438 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 conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 91007438
lt�`F'L ICf T
DATE= 10/31/91
kyr*;i•#•h• THIS IS NOT A PERMIT it'''#•
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET=:: 1121 y5 MCDONALD RD
ADDRESS= SPOKANE WA 99216
PERMIT USE- SEWER CONNECTION .... WOI.._FCRES T
** SEE NOTE •#>>:.
F'L..AT:n:=:
BLOCK=
AREA=
OF BLDG'S==
OWNER=:
STREET.:-
ADDRESS=
002:p3 F'I...AT NAME=
LOT==
F/A=
DWELLINGS=
..JOHNSON, CLARENCE
1121 S MCDONALD RD
SPOKANE WA 99216
PARCEL:» = 22544-1220
VERA
ZONE:::: UR 3.':? D1i.ST'•"a.
F 7 WIDTH= DEPTH=
1 WATER DIST --
PHONE=
CONTACT NAME= H &S CONSTRUCTION -- LEONARD PHONE NUMBER= 509
BUILDING SETBACKS: FRONT== N/A I._EFT:-- N/A RIGHT= N/A REAR= N/A
SEWER
-�{• r- is ii -it :u �� 3f a- �: •n• •!i• -ii• ;;..k..h..h..h..y�.:A..i�. >+: �h:- �a: �i..}�.:a..p� .}�. F'E:.: t1'J.
CONTRACTOR== H & S CONSTRUCTION
STREET • 11817 E: VAL..LE::YWAY AVE:
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION
PROCESSING FEE
SEWER CONNECTION
PERMIT TYPE
SEWER PERMIT
PROCESSED
PRINTED
F E E: AMOUNT
50.00
50.00
ROBIN
ROBIN
BY: DOMITROVICH,
BY: DOMITROVICH,
F
R W
926
8964
i' X -iii Jc: 3.*;4;4••R-*..*•.-.........-H-*•R•Y'r*4: '***K**
PHONE= 509 926 8964
QUANTITY FEE AMOUNT
10.00
i 40.00
AMOUNT PAID AMOUNT OW7:P4c;
,00 50.00
0 50.00
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE:
ELEVATION ArJD POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS F':I:FICC, WATER I...INEE, ECT.
CALL.. BEFORE YOU I G (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
3t•xJc-*•tt•* *** CALL. FOR INSPECTION PRIOR TO COVER *'***#* -*•k
•ii•###ii-#kk# 24 HOUR NOTICE REQUIRED *******:k**
****-;k*fl•• •* 456-3604 'N:'R-'f:P--C:ik)t-;l•3t-*
3: i i. it •iE * # }k 3r * tic :M- * it it- 7i- it * * Yi # :a * tr # * )r: * # •;r # # THANK T C) U *****************.K************
JOB ADDRESS: 9 r 801 ine,IoiJ4t3
C3 �Isy
SUBDIVISION: ? 5 jL/- /aao yea Mro s
LOT:
/ BLOCK: a 75 3
OWNER: _JoNftLcnuJ G,ike•N OE PHONE:
ADDRESS:
CONTRACTOR:
PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY:
weLFCetesTa