1992, 10-09 Permit: 92008690 Sewer -`. -
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 B Y AVENUE
SPOKANE, ASHINGTON 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= 92008690 ISSUED PERMIT DATE= 10/09/92 PAGE= O1
**************************** PERMIT INFORMATION ****************************
SITE STREET= 3026 S RAYMOND CIR PARCELO= 45294 O9O3
ADDRESS= SPOKANE WA 99206
^
PERMIT USE= SEWER CONNECTION - SOUTH BLAKE (92%-1035)
*** SEE NOTE ***
PL 4= 000376 PLAT NAME= CHESTER ILL% HEIGHTS
BLOCK= 4 LOT= 3 - - DIS
TO=
= A�R TO= F �
AREA= F/A= F WIDTH= 100 DEPTH= 145 R/W= 50
0 OF BLDGS= i 0 DWELLINGS= 2 WATER DIST =
STREETOWNER= P R6A MOND VICTOR CIR PHONE= 509 928 9093
ADDRESS= SPOKANE WA 992O6
�
BUILDING
CONTACT
%NAME=KCOURCHAINE
N/A EXCAVATION
LEFT= N/A RIGHT=
MUMBER=N/A REAR= /A 5O9 924 5485
: FRONT=***************************** SEWER PERMIT ******************************
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
STREET= 16402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
- -------- ---
PROCESSING FEE Y 10,00
SEWER CONNECTION i 4O^OO
******************************* PAYMENT •SUMMARY ****************************
-
PAYMENT DATE RECEIPT� PAYMENT AMOUNT
10/09/92 8815 50.00
____________
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT
-
50°OO 5O.00 .00
----
5O.00 50.00 .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
TOLL LOCATERBURIED
YOUDCABLE%IG (45l_GA%O)PIPING, WATER LINES, ECT.CA
SEWER STUBS ARE TO BEBECHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION OR TO **********
***
****** 24 HOUR NOTICE REQUIRED- COVER uxw*''''''
********* 456-3604 ***'''''''
******************************** THANK YOU *********************************
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SPOKANE.:COUNTY.•PAYMENT�VOUCH:ER NUMBER l�Gull
VENDOR REQ 4 . DATE
11%4/92
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COURCHAINE CONSTR ,,;I i+�. g.axi. 7 1i Fs�r ` AGENCY CODE ENFORCEMENT
.r.,A�:.1:.•-. NAME
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UCTION a 44, 1,i05 s.. .�. hast
NAME +t, M' ti ;?"•;►� J'� rte,•ri�nl�'cr:,
°a' ! J4 i � Srtirfi;,; AUDITORS STAMP
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16402 EAST VALLEYWAY i „
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ADDRESS ( C' \it 'frh
SPOi<ANE• WA 99206 ' „�., I ivti,►I it!1,,. I,
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ACCOUNT DISTRIBUTION,ORIGINATING ENTITY(ALL VOUCHER TYPES) c ❑ 1099 REQ'D ID#
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.VENDO ,,,,. .f1/4 e.f aid i w• , ; ` .:A..,>G 'iEG.c t .a _..,s e. :+div, 4t s•t. ttt.t?} 10;s0*; r a'rtgl,. a:..i„t-
LINE ,s FUND; 'AGENCY .AGT QB t BJ SOURCE z' EV d {fi s NUMBER ,
NO; INVOICE NUMBER 0.• :;-::f,:..-:-.:',',': :' , 17ATION Y�i j,,...., ,° ,.t�.. 14. .? .t .....,r, � x Y.-,J a.+.e .a-.Y4'+�to .•::;w. •.a.-„,r•.v,rt„�b_'r.+•,:, .... e�s,,3R,t,t.,...,r2_.,...'s.,.
1 406 030 0008 •
2210 02 16.00
2 •
401 436 0000 4240 64.00
406 030 0008 2210 03 56.00
3 _ ,
•
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RIPTION
•
DETAIL DESC
. TOTAL ..136.00
1 & 2 PERMIT 92-008690 RR 3026 SOUTH RAYMDI) CIRCLE AND PERMIT #92-0092-007276 Icertfy the,under signepnad. do hereby of perjury
$10.00 X 80% = 8.00X.2• $ 16.00
FOR 2621 SOUTH HOUK'CT AS FOLLOWS: 4hat,sufficient funds have been •
• •budgeted:for this claim, the'ma= TRAVEL CERTIFICATION
$40.00 X 100% = 32.00 X 2 = 64•09 terialstave been furnished, ser- I hereby certify under penalty of perjury
'vices rendered or labor performed. : that this is a true•and correct claim for
PERMIT #92-007277 MR2621 SOUTH an( Cr AND #92-008597 FOR 12818 as described herein or contracted necessary expenses incurred by me and
23RD AVE AS FOL1l. S. • for that the'claim is.a just,-due: that'no payment has been received by. me
$35.00 X 80% = 28.00 X 2 = $56:00 • and unpaid obligation against • on account thereof.
PER COPIES OF PERMITS AND LEITER.ATTACHED. '. Spokane County or fund agency SIGNED
' . .•indicated above, that.I am autho TITLE
rized to authenticate and certify •
• INTRA-GOVERNMENTAL VOUCHER • • to said claim:.. PATE •
SELLERS ACCOUNT DISTRIBUTION EXAMINED and ALLOWED
Vii•eD r ;:,, zs 1 T `..d`:..=4}ia{S IaQEyENUE`�S.`AEVr�§r;IJOBSNU BEReg:. 2RTE'G .} 4+i'rR..,.BI.ES S .. ___•,•,•
FUND AGENCY 30•RGAN �:•,•• ,-,.:7, ACTIVITY ..t•w JFiCEi”r 7 M {+ EG ,, o' "� DATE 19
,.t: a .';......,-,c. ,,••--,••,,,90RG�. s-:+1 > .<... — SRC.• • •. . .-s, Ys ,»..... i...�CAT.. ...i�.?AccoUnir, •�
. c CERTIFICATION •
• \SIGNED \. CHAIRMAN
•
SELLER CERTIFICATION ICE ADMINISTRATOR '
I,hereby certify that the materials have been furnished,the services` SIGNED TITLE' • MEMBER
•
rendered or the labor performed as described herein or contracted TITLE 11/4/92
for,and that the claim is a just,due and unpaid obligation,and that DATE DATE MEMBER
I am authorized to authenticate and certify to said claim.