1991, 07-10 Permit: 91004112 SewerSPOKANE'COUNTY DEPARTMENT OF BLRLDUNGS
W. 1303 BROADWAY.AVENUE
SPQKANE, WASHINGTON 99260
(509)456+3675
/mmfy that I have examined this permit/application, state that the information contained in a and submitted by me or my agent to compile saidpermit/application true
and correct. and authorrze Spokane Gounly to proceed with processing In addition, 1 have read and undersland the INSPECTION REQUIREMENTS/NOTICE
provlsions included herein and agree to complywith same. All provisions o,laws and ordinances governing this type v/work will bocomplied with whether specified
herein or not. 1 understand that the issuance ofthss permit/application and any subseqtimnm,moavPmvmoo,uem/iom,om0000p^m?o^unoot bwconstrued t"
give authority mviolate o,cancel the pmv*/o .fpnrftate olocal law rego/atipoconstruction, om,uwarranty o^conformance with the provisions o,any state o'local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OnAGENT i �� L-'/�����»�'°��� DATE ' /�' / /
� .
� > �
PROJECT.NUMBER= 9i8841i2^ - ISSUED PERMIT DATE= 87/10/91 PAGE= .81
**********************�***** PERMIT INFORMATION ****************************
SITE STREET= 2109 S PINES RD
ADDRESS= SPOKANE WA 99206....
PERMIT USE= SEWER CONNECTION 888i
*** SEE NOTE *** � •
PARCEL0=, 27542-2245
..
,^
PLAT0= 001222 PLAT N M - HILLC AC ~i% . .•
BLOCK=. 3 .. ' LOT= � 2.ZONF= UR ^5 DISH= F ' .
AREA= 88880089 F/A= F WIDTH= 1f00 'DEPTH- 125 R/W= 68
0 OF BLDG%= i 0 DWELLINGS= 1 WATER DIET = SPO CO WATER DIJTO3A
'
OWNER=
GERARD, A. Jc -- • PHONE= 509 927 2188
STREET= POB 328 ' � ^
ADDRESS= ELECTRIC CITY WA 99123
�
CONTACT NAME= A. J. GERARD PHONE NUMBER= 509 q27'2i88
BUILDING SETBACKS: FRONT= NA LEFT= NA- RIGHT= NA REAR= NA
.***************************** SEWER PERMIT ,******************************
CONTRACTOR= UNKNOWN PHONE= :
• STREET= UNKNOWN
ADDRESS= UNKNOWN -WA UNKNOWN
; ITEM. DESCRIPTION ^ QUANTITY FEE AMOUNT
/- •
, PROCESSING FEE � Y . .' 18^80
SEWER CONNECTION - 1` 48'08 .
. . .
******************************* PAYMENT SUMMARY ****************************
.. PAYMENT DATE ""RECEIPTO PAYMENT AMOUNT �
/ .
. 87/i0/91� 4587 58^88 -
� � �
� ' ------~--.--
�,
. TOTAL DUE= T. �.,08 TOTAL.PAID= . 58'08
.PERMIT, - TYPE ' FEE-AMOUNt AMOUNT PAID AMOUNT OWING
....------- ------------- ------.,---- --------...-.
SEWER PERMIT - • - - 58^88 - 58^88- .08
i� ------------- ---~-------- �-------'�-�--�-
� � �
. 5,8'88 58^88 . • ^88 ' .
PROCESSED BY: JOHN LAR%ON' ' I.
PRINTED BY: JULIE- SHATTO '
. ^ � � ' �
SEWER %TUB.A%=BUILT.INFORMATIDN IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT • • _ '
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
�
TO LOCATE BURIED-CAMLE% GAS PIPING,�/�TER LI �E%/ ECT^
! / � ..
CALL BEFORE^YOU DIG' <45u-8888) ' ' ��
'-
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY 'AR��C R� AND %T D TO THE SEWER MAIN '{. *`^
********* CALL FOR.INJPECTI0N PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED ^ **********
********* . '456-3684 ` • ********** . `
******************************** THANK YOU *****************************'+***
'
/
SPECIAL CONDITION CHECKLIST
Project
Address Project #________ _Use:
Dept: Date Condition:
Dept. of Bldgs.
Special Insp. Final Report_
Hydrant ( )
Lock Box
Engineer's i __ ( .__ RID/CRP
Easements ---—____--
Road Plans/Improvements
Bonds.
Planning Bonds
Utilities —_ ( Double Plumbing
ULID
Other
Init
(in)
Appr:
(out)
*******************************THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY***************************
Date received for C/0 processing: Plans pulled f,pr final processing•
Temporary C/0 issued` Certificate of Occupancy issued:
Office the review by .: .Date:
Filed insp finaled by: Date
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans Date:
Plan, returned Received by:
No response from owner/contractor - plans destroyed: