1991, 03-13 Permit: 91000604 Sewer _
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certifym t I h / d this permit/application,state thatthe information contained in it and submitted permit/application, by t to n said permit/application is true
withand 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 oe/mennw/mmmmunrmuteo,/mm/lawpmu/mmnvommmm/on.o,,muwvnuntymoo"mrmunvntheprovisionsof local
u"'"��"'
laws re " construction.
SIGNATURE OF
APPLICATION
OWNER OR AGENT o�Ts
PROJECT NUMBER= 91000604 ISSUED PERMIT DATE= 03/13/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 3120 % RAYMOND CIR PARCEL4= 29544-0906
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION
*** SEE NOTE ***
PLAT4= 000376 PLAT wAME= CHESTER PULS HEIGHTS
BLOCK= 4 LOT= 6 ZONE= AGRI DI%T4=
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W= 50
4 OF BLDG%= i 4 DWELLINGS= i WATER DIST =
OWNER= REPP, ALICE PHONE=
STREET= 3i20 % 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
***************************** SEWER PERMIT ******************************
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
STREET= 16482 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECE: PAYMENT AMOUNT
O3/i3/9i i203 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 5(),00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
SEWER PERMIT 50.00 50 .00 .00
------------ ------------ -------------
50.00 50 .00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB A%-BUILT INFORMATION I% 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
TO LOCATE BURIED CABLES, GAS 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: Project# _Use: _
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
Engineer's_ _ RID/CRP
Easements
Road Plans/Improvements
Bonds — --
Planning Bonds
Utilities — Double Plumbing
—
ULID --- — — —
Other__
*******************************THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY 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: __ _ ___ Date:
Plans returned: __ — Received by: —___
No response from owner/contractor-plans destroyed: _-------___-_--------------- -_-__--