1991, 07-08 Permit App: 91004023 Sewer SPOKANE COUNTY DbPARTMENT 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= 91004023 APPLICATION DATE= 07/08/91 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WI:L.L.. BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
----------------------------------------------------------------------------
SITE STREET= 2916 S RAYMOND CIR PARCEL4= 29544-0608
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWE:R CONNECTION -•• SOUTH KOKOMO
*** SEE NOTE. ***
PLAT := 000 376 PLAT NAME= CHESTER HILLS HEIGHTS
BLOCK= LOT= ZONE= AGRI DIST4== F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W= 50
4 OF BLDGS= r DWELLINGS= WATER DIST =
OWNER= HARDER, HANS PHONE=
STREET= 2916 S RAYMOND CIR
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
*** c**** ** •*** •x•*********** SEWER PERMIT ar•> • • **•> •>r• *• •x•> •>f•x• • •>r• ***ai• • •***• •
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
STREET-: 16402 E VALLEYWAY
ADDRESS= VERADALE. WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEEY.__..____.__..._______- --�--- — — •Y10.00
SEWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 .00 50.00
50.00 .00 50.00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE ANI) CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL. BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO DE 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 *********************************.
illR
SPECIAL CONDITION CHECKLIST
Project
Address: --- -- Project# _Use:- ___--
Dept: Date: Condition: snit: Appr:
(in) (out)
Dept.of Bldgs.
-- —__ Special Insp.Final Report_
Hydrant( ) _ _______. — _-_.._._.
Lock Box. _ — ----- -----� .---
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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: ._____.___ _ ___.______-_—-------- ---_--- Date __.___.___ ._ _ _____
Plans returned: _----- -----_—_._ __. Received by:__ _ _._.__-- -_ -__.__-__ __.___
No response from owner/contractor-plans destroyed: __— _______
JOB ADDRESS: af,:t` 4) 4' � do,
SUBDIVISION: ` J�"C� v CEJ (-) LOT: BLOCK:
OWNER: /4-0 ---Z.c - 4-6L/ PHONE:
ADDRESS:
CONTRACTOR: PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY:
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