1991, 12-04 Permit: 91007597 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
PROJECT NUMBER= 91 007597
ISSUEI) PERMIT DATE= 12/04/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE. STREET= 2020 S PIERCE RD PARCEL*= 2854'-2712
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION -- NORTH KOKOMO (15)
*** SEE NOTE ***
PLAT= 001393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 110 LOT= 23 ZONE= AGSUB DIST*=
AREA= F/A= F WIDTH= DEPTH= R/W=
* OF BLDGS= i 4 DWELLINGS= 1 WATER DIST =
OWNER= HASSON, J S PHONE=
STREET= 2020 S PIERCE RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= COURCHAINE EXCAVATION PHONE NUMBER= 509 927 5485
BUILDING SETBACKS: FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
***************************** SEWER PERMIT ******************************
CONTRACTOR= COURCHAINE CONSTRUCTION
STREET= 16402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY
PROCESSING FEE
SEWER CONNECTION
Y
1
PHONE= 509 924 5485
FEE AMOUNT
10.00
40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT*
12/04/91 91 8i
TOTAL DUE= .00 TOTAL PAID=
PAYMENT AMOUNT
50.00
50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00
50.00 .00
50.00 50.00
PROCESSED BY: DOMITROVICH, ROBIN
PRINTED BY: DOMITROVICH, ROBIN
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 AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
.00
TO LOCATE BURIED CABLES ,A,' PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE.
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL.. FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address:
Dept:
Dept. of Bldgs.
Date:
'
Planning
33 Y
UtiIites
Other
Condition:
Project # Use.
Special Insp. Final Report
Hydrant ( )
Lock Box
!nit:
(in)
3'51D/CRP
Easements
f• Road PlaiirSiirtiO:Oviieri'e-rifi i ,;•••••,
Bonds
1r.I7T9
1.1
•
!!! ..,
•
:17
Double Plumbing
ULID
f-14 1 7; - o f
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1'11 •tv.:10
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00.0
TT0';11:.
17
Appr:
(out)
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ri
THIS SPACE FOR COMMERCIAL PLANS TRACKING, EVRTIIMATEIOVIOCIt010fiNtfilbNLYi4S.***f....—****—.
• • • .• .• ••••
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Date received for CIO processing:
01 „
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Temporary C/Q;jsst,ted ;., or •:4;.,:•-,...-, i--;v..i i i: ,..i ::.•-: c.:.,Gert,Oicatei-gjipcyNirry,-..istmiri - '.--"'.' -.- -; ' . :•••••
Office file review by •-T:irl 1 ' 1 1 '•'1' - ! ' , r;!!1....vi •••:: rietk . ; .,., 1 Li 133,- ; i ; ; . ; 0..! 3., OE, './1 ki i A
1,;1Ci TT
Filed insp finaled by: ____ Date:
Ai: ...i 0 1, .::i T ':1, .2", ±.t) :I : 2, 4J ',:.i. if.., .. i.1 7-71TA.:10
i. t.'; ,. .,.., i.-.)- ;"" -,.., ,.• ,...; I. '..; 0 f..., , ::1,-,1.., --: 1.1. ..., .. 4.1..
Ninety days after C/O issuance:
' I ; " '::; I ;•T
f"; T •:! >,•71 3. . • , to,
Owner/COntrattor caNd regarding qt-Adians,. : ,••• ,:• -•t ;r a ;ti
Plans returnedif " " • a• t .7! ci :::;14e6etVeo fiV"i 7;1 ; •;f:
fl
No response ft:0T pwnprIcptor - plans destroyed tdested:. - •
., •••• , — •