1992, 05-21 Permit: 92003640 Sewer SPOKANE 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 anny sub—quent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provi f any state or locallaw�..ulatin. onstruction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction. /
SIGNATURE ADATLE ATION���
OWNER OR AGENT / i DATE
PROJECTNUMBER= I200364t:J ..S,:}1.1::.?? PERMIT DATE= 4:5! 21 /92. 1.:Ai..Y1::.::::
J9 ! t 1 t! Jtjk t 11JH) 9 7 t t! 1ti1t! `1 i w. fINFORMATION !l•*1!•1!•1!•il•1t•1!•!k 1R'9t'1L•!t•1?-9t'1!•1>:!t•*1!-)?•)t 1?•*!h!?.!t 1:.
SITE STREET= 1 z1 S PROGRESS tJ LfC1 ! + n _ : 15
s . • 4 ^
ADDRESS= V!:'RADAL E WA 99037
PERMIT USE:::::: SEWER CONNECTION .... 92c'_..515)
1!-1t•!t• :'E!::. NOTE 'ii'it•!k
PLATO= 002751 FLAT NAME= VERA
BLOCK=11 • ;:fit: LOT=.... CI J = SFR D ST:r....,, F
AREA= I-/';:y= I.. WIDTH= DEPTH= r';/+:;1-::
n1t _rLti : , D aELt ! WATER DIS T
....
OWNER= t , fl , Ff . PHONE= 509
922 7911
STREET=
1421 PR'l'?t• E=:; ': RD
ADDRESS=S:•• V E::i:r'i:tit"i1.....,, LdA 99037
CONTACT NAME= 't_,Y (^
_Al 1B PHONE NUMBER:: 509 922 7`9 i
BUILDING SETBACKS : FRONT= i /A LEFT-: N/A RIGHT:::: N/A REAR:::: N/A
................ [� +.. : ( •k•*it•*•it!t•ii:•a•ir!t ri i+i)t•�:•!t b•it•N•it 1•:•it it:�:!t!t!t 1t!r i1:•1t-
9R 9k•A i!•P.••A.•i!••Jk 1!•�P::•!t•!t•Jk•/t R•)l!t 1{.N.••>t•9t•)i•!t••ik!t••it••�:!t!t• :.3 E::t�#::.•� �•E:.t•:1~f J:-.
CONTRACTOR=- OWNER PHONE=
ITEM DESCRIPTION QUANTITY FEE
Fi!"lOUIW_i.
PROCESSING FEE I. 7' ill. 0{)
SEWER CONNECTION I 40.00
00
9Jk? b* t { t t N191 ) 11 { k p1NPti ! t Al PkN 'f : "iNSUMMARY t 1 { ;pa} unR*Rpt hit ht bu1er :Jna
PraYi-iE::i'i•i_ DATE RECEIPT:„: PAYMENT AMOUNT
05/21 /92 38.0 50.:00
TOTAL DUE:::: .00 TOTAL PAID:::: °0.00
PERMIT TYE'E:. FEE AMOUNT AMOUNT PAID A' OUN OWING
SEWER PERMIT
t-•„•,w: 50.00
:•.
50.00 50.00 .00
PROCESSED>ED BY : J'?CIMJ:TROV:i:i:`H , ROBIN
PRINTED BY : i.;isiMJ:Ti';Oa IC::H, ROBIN
SEWER STUB AS—BUILT :I:I'41 1ORM•MA 1IO IS AVAILABLE AT '('i..H E:; COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OF APPLICANT IS TO FIELD i..COC::ATE:' AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
I'1E-.!'•:
EXCAVATION
TO
LOCATE tURl _iCABLES ,
CA kiE } , 7 i, PIPING, ai tR LINES, EcT .
t.:r•ii...i... BEFORE YOU DIG 456••-8000 J
SEWER STUBS UBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT IIII-.''I ARE CLEAR AND UNOBSTRUCTED Itt THE SEWER MAIN
•N:!t•!t•1!•i;..H..;t:it•1t CALL FOR INSPECTION PRIOR I _ COVER !*nNi t riR !
t
ri•1t•***•'r.ii h:it 24 HOURNOTICE REQUIRED **•x m•!t:a*itit1t
1t 1t•P:1+:*1t. .i,,. .. 456-3604 i+:•i::•h:•a:*.i;...•p:•it••J+:
1t•I it*!.•it••it 1t•1 it!t•1t 1':•1t•ii•1t•i•::P 1t•1t•1+i 1t 1+'r P•i'tP 1L•1'P•1 !t•:e: THANK 1 i-11„1 **************************K******
60
JOB ADDRESS: ! ;- 7
SUBDIVISION:
LOT• BLOCK:
OWNER: 'Z / L14 pp, b PHONE: ?22. ) 9//
ADDRESS: I`F 2 reg r
CONTRACTOR: (TO y
6 PHONE:
ADDRESS:
LICENSE #: k 4 i Q[�O k 197 Al A
INSPECTION DATE:
TYPE OF OCCUPANCY:
vc , - I 5 t 28 4 0f t4 b of
Q-25( up-) r2