1991, 07-24 Permit App: 91004442 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON $g2G0
(509) 456-3675
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SIGNATURE OF APPLICATION
OWNER OnAGENT DATE
PROJECT NUMBER- 0004442]APPLICATION ' DATE= 07/24/9i
.
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE A%%E%%ED FOR COMMENCING WORK WITHOUT A PFRMIT
-----------------------------------------------------------_---------_'
%ITE STREET- 2620 % PIERCE RD PARCELO= 28543-3515
ADDRESS= SPOKANE WA 99206
PERMIT USE- SEWER CONNECTION — SOUTH KOKOMO
***
SEE NOTE am-.1f-
PLATO=
**PLATO= 001393 PLAT NAMF= KOKOMO TGWN%ITE
BLOCK= 35 LOT= 7;NE= UR -3.5 DISTO= F
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= 1 0 DWELLINGS= i WATER DIST ='
OWNER= DAVIE% PHONE=
STREET= 2620 % PIERCE RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE PHONE NUMBFR= 509 924 54q�
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
SEWER PERMIT
CONTRACTOR= COURCHAINE CONSTRUCTION
STREET= 16402 E VALLEYWAY
ADDRESS- VERADALE WA 99037
******************************
PHONE= 509 924 5485
PROCESSED BY: JULIE %HATTQ
PRINTED BY: JULIE %HATTG
'
SEWER STUB A%—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THF
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY UTHER
EXCAVATION '
TO LOCATE BURIED CABLES,GAS PIPINGWATER !I�E% FCT
' ' ^
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNFCTION Tn 7NSUR1::'
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MATN
********* CALL FOR INSPECTION PRIOR TO COVER **********
24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
Project
Address:
Dept: Date:
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other
SPECIAL CONDITION CHECKLIST
Project #
ndition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
THIS SPACE FOR COMMERCIAL PLANSTRACKING, CERTIFICATE OFOCCUPANCY ONLY
Date received for C/O processing: . Plans pulled for final processing:
Temporary C/O issued: Certificate of Occupancy issued:
Office file review by: Date:
Filed insp finaled by: Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed:
Date:
Received by:
Init:
(in)
Appr:
(out)
P -A
Spokane County jEmployees
MAJOR MEDICAL PLAN
Administered by Medical Service Corporation of Eastern Washington
General Information
THIS IS A CERTIFICATE OF COVERAGE
The statements contained in this pamphlet are intended to describe in general
terms the features of the plan and do not constitute a contract. The specific
terms and conditions governing the coverage are set forth in the master contract
and are the basis on which claims are paid. The master contract is on file with
your group agent, Spokane County Personnel Department. If you have any
questions call 456-5750.
TO RECEIVE BENEFITS
Within the service area (Spokane, Stevens, Pend Oreille, Lincoln, Whitman,
Okanogan, Ferry, Benton, Franklin, Grant, Adams, Kittitas, Chelan and Douglas
counties), you must obtain care from a participating provider to receive full
benefits. Service obtained from a nonparticipating provider in the service area