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1991, 07-24 Permit App: 91004442 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS W. 1303 BROADWAY AVENUE SPOKANE, WASHINGTON $g2G0 (509) 456-3675 / certify that / have examined this »mmu/upnwuoon' state that the information contained mxu�u anu,oum��ouvm^u,mr�nvvomnnooump nnu�»nxouovn/atrue uno correct o auMor&e Spokane County toeu withnmcmmmo In addition, / have read and understand mvINSPECTION nsoumsmswru/wonos provisions included herein and °um°to"""pvwith "='".=w"~~~^~~''~~~~^~ordinances governing thistypeofwork will becomplied ��o»onnmu,von�moum hommorno�/unoemmnummthe /soanvomm/ permit/application /�msubsequent mmmm/a /un^nuo»vnv»n«pp» vrC«"�� '°°"'"""p" �vno�unvo�mo,/oo« o*eovmon�m,/o/umo,cancel monwv/ownomany uta�o,local law mou/mmouonmmonon.vmsa*m,mn��mmprovisions . laws regulating construction. 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