1991, 05-16 Permit App: 91002645 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, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
i::pfl:JE 't., 1 rliJ("t:(.:;ER=. 91002645
APPLICATION DATE= 05/16/91 ,'AG -- 01
• ii' ii ii. i T I_I I >, •! S NOT .,_ .: R .
t 1 .i. s:> i'. A PERMIT 1�. 1�� L T )E li. JE )t. 3t. N.
PENALTIES IFIIL..I... FE: A,`>EE:: ':;E::D FOR COMMENCING WORK WITHOUT r'i PERMIT
_f.
--------------
SITER r' -• 2419
PIERCE RD 7 E' f••t . c:• i::. i....A. _ :
f�1DDEtii::.,3 :-: E't...Ik.f•11''31 WA '•r%'.:%!: 6 :..._.
PERMIT USE= - s.;E::WAIT :Ft: CONNECTION— NORTH k:'ftlt. i:iM
ii'** SEE NOTE ;i•yi;'
PLATT,— 001393 NAME= I':. (,l'', (a!• O 'T• j: 6. N E I: T E
+ L., f;t f•' tt :r.:LOT= ' a t l':) I:' = r'1 t Y ,:; t,_ B i_) ) .y...::
AREA= t;)s:,+; 0+r;,;+;; t`.`/A-: !:. iWj'7;-iH :f F "('Ei:::: R/iA;=
BLDGE= i 4 DWELLINGS= 1 WATi:^ii' DIST ....
OWNER,— i"I r-i'r' E' 1: E:: i... ii PHONE=
ETREET= 2419 E PIERCE RD
ADDRESS= SPOKANE WA 99206
CONTACT w-'1"JIM NTli':\PHONE NUMBER= 509 92
" 6077
BUILDING ,`.• t -.)Brit ` K i : FRONT= N A LEFT= NA RIGHT= Ny A REAR= NA
ik )+; -i+: •u• * it• * * ii• •u• h:• u• ii •a: 'J+i 9r •n• •h:• it• * •)i * li• x• i+i ii- k •ii• ri SEWER '' ::.: t!"I.. i13(: fit' 'Ai ij• •lE 4k 'N• •P.• i7 i!• 9C R' '1•: 'A: !!' ')k iC 'Ai tR '1+: P: 9C 7C 9?' :N: 'P: i4 'P: 9C
CONTRACTOR= :.i:.R, :L1: CONSTRUCTION
STREET= 10504 !, E:: 1;f-•ti._i...E:.•r�iAif-?Y AVEADDRESS= E"'t.OK fiNE:. WA 99206
PHONE= 50 924 6077
1:TE::i"f I)E::SC::R1:PT:EC:IN QUANTITY FEE AMi::it.iNT
PROC::E::ti `:'l:Nc; FEE 10,00
SEWER CONNECTION i 40,00
PERMIT TYPE I- LE AMOUNT AMOUNT PAID AMOUNT OWING
NG
:.>E ix1 E:. i", PERMIT 50,00 ,tj 0 50,00
50,00 0 .. 00 50.00
PROCESSED BY: •..iUL.:r.E s'H!iTTi.i
PRINTED BY: jULIE ``tiATTO
SEWER STUB AS—BUILT INFORMATION :I::: AVAILABLE AT .T.i..iE:' COUNTY
UTILITIES DI:::E `ART•i~il:: NT (456-3604)
CONTRACTOR OR APPLICANT IE TO FIE:.i.....) i._c:l('.flTE: AND CONFIRM THE
ELEVATION fi is l) E'' (.-i ,`_:1: T I ri r1 OF SEWER STUB ("'f:.°:r.CiI TO ANY OTHER
EXCAVATION
T1:CiN
TO LOCATE BURIED CABLES, G;AE PIPING, WATER LINEE, , i::.i_:T
CALL BEFORE OR fJO.li.J DIG (456-8000)
SEWER :TUBS ARE Ett ( E CHECKED iE11t, f CONNECTION r-IN
"_;:
THAT THEY ARE .iEfR AND UNOBSTRUCTED TO
THE
._,, _ MAIN
.• 9i' ')i• •)' •)' -)i• •)i• 'r: CALL EOR INSPECTION E''E;I[. iE ° TO COVER *.p..* * * •1+: A:• •)i• P: '*
i+: ii ii- * * * )l- * P 24 HOUR NOTICE i';E:.Qi. iIE;`1=:D ***:,******K
9 t k$A lt 9 9 456-3604 NAAPPE PA PC
it * f?• :+t• * * n• 3i• •n::"E h- if- ii• ii• 1i• 1t• ii• ii• ii• * 3r it )e 3E ii' 3i• ii ri i?• ii 3r ii• THANK 'f i_ i•I * ii• •iF• •'r.• it- h: n• •)i• ii• it' ii• iE N 3r :,i• i+: •iE ii• ii -.•y;. r;. ji- }t x-.yi. Vii. :; jr }i• ;ti• •)+: Jj• :;t
JOB ADDRESS:
SUBDIVISION: S`'t" a"4,6 q LOT:
OWNER:
ADDRESS:
CONTRACTOR
ADDRESS:
PHONE:
PHONE:
BLOCK:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: