1991, 07-10 Permit: 91003197 SewerSPOKANE COUNTY DEP?.I;TMENT 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. 1 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= 91003197 :rsSUf: D PERMIT DATE::: 07/10/9i PAGE= , •i
3i3i•* *•kiki{H:3:•*•k3i*3i**3i H3i•3i•3i•*3i•3i*•k3e F`E:F M.T. f IrelFORPIAT:I:oN x***•*. ***x***it•*****;1•**i>:****i~
SITE STREET:::: 11525 I= RIVERSIDE AVE PARCELH:= 16544_..0505
ADDRESS.:: SPOKANE WA 99206
PERMIT USE== SEWER CONNECTION -- B87-1
x•** SEE NOTE 3{**
PLATO= 001 835 PLAT NAME= OPP n TF . 1-354
BLOCK= LOT= ONE:::: COMM f 1ST 4= F
AREA- 00000000 F!`A=: F WIDTH= DEPTH=
OF BL.DGS=:: •i 4 DWELLINGS= i WATER DIST :-
F./W: 40
OWNER=:: PI_JRV T S PHONE=
STREET= 11525 E RIVERSIDE AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= BILI... .... SIMPSON SANITATION PHONE NUMBER= 509 926 478i
BUILDING SETBACKS: FRONT:- NA LEFT-: NA RIGHT= NA RE.AR:- NA
•k n:• •b: Ni & 3i ?t• 3i• ii * 3i 3t• 3i• * 3i ii •)t• * * •h:• * 3?• * 3i •* * *• *• SEWER PERMIT k 3k •h; it 3G * •b: •hi •k •k * * # ii 3i ii h: 3i• 3i * *• ii * 3i• * * •h:• * *
CONTRACTOR=:: SIHPSON SANITATION PHONE= 509 926 4781
STF E"E:"('�: (Ri'' r:: rtAI...DWIN W
ADDRESS:::: ,SPOKANE WA 99 i ,•_
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 10..00
SEWER CONNECTION i 40.00
3i• 3i 3e * 3i 3i• •N.• * a k ii .k. k• 34 ii• ii ]i 3i• 3i 3F 3v . * 3i• 3k ii• iti 3i 3i R A Y m E N T S U M H A R Y 3e 3<• h:• if,• •k: )'i 3e x • 3e 3i• 3i 3i 3i• 3>: 3i• 3i 3i• 3e ai 3e: ii• 3i it i+• •ii 3i 3i
PAYMENT DATE RECEIPT:I: PAYMENT AMOUNT
07/10/91 4570 50.00
TOTAL DUE::= .00 TOTAL PAID= 50.00
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: : Ji.JI...1.E:. SHATTO
SEWER STUB AS—BUILT INFORMATION Is AVAII...ABi...F:: AT THE: COUNTY
z.
UTILITIES DEPARTMENT Ml: NT ;4 >6--3604,
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE:: ANT) CONFIRM THE
ELEVATION AND POSITION Or= SEWED.'. STUB PRIOR TO ANY OTHE :iY°
EXCAVATION
TO LOCATE BI.JR1:E:D CABLES, GAS PIPING, WATER 1..1:NES, ECT,
CAI...I... BEFORE YOU DIG (456-8 000)
EWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MANN
**3i•3i•k3{•ii r:ii CAI...I.., FOR INSPECTION PRIOR TO COVER itp:3i•x3t3i•***3i•
ii-3rii•3rit3>:3i•3E3E 2.4 HOUR NOTICE REQUIRED 3t it•*3Eii:x*ii)t't
A.•**.R•A:**iti4• 451.••••3604 ri*3ti{•k**3{•i1••N.•
* 3i• ii 'r.• tr• 3i ii * i ..x it i4.3t it• 3i• 3i• 3' * 3i• 3>: 3r *• 3k 3i , ." 3e• 34.31 3i• ii x
THANK YOU
3i• 3i• 3i•) . 3(• * 3i . 3i• •p 3. •' i 3?• 3i• ii• . 3i• 3N ii• 3i• is• * it k * ii .) 3E 3 •k) * it•
Project
Address:
Dept:
4
SPECIAL CONDITION CHECKLIST
Project # Use:
Dept, of Bldgs.
Engineer's _.
Date: Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
!nit: Appr:
(in) I (out)
Planning Bonds
Utilities
Other
•
::+
Double Plumbing
ULID
•THIS SPACE FOR COMMCI
ERAL PLANS:TRACKING b;C
CERTIFATEiO'F OCG.UPANCY ONLY+"'*"""****""""k"'""""
•'- f�iens uiled �fe final. ro:teasin
Date received for CIO processing:• p
Temporary C/O issued,,.•n Certifrea.te f Qpcupanoy tssueif•`
Office file review by: Date
Filed. insp:firaaled,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:
Received by:
Date:
mw .If le C. I !
P O K A N �x _ ilii ii�fl artrz_
DEPARTMENT OF BUILDINGS
JAMES L. MANSON, C.B.O., DIRECTOR
•
A DIVISION OF THE PUBLIC WORKS DEPARTMENT
DENNIS M. SCOTT, P.E., DIRECTOR
INVOICE
DATED: June 10, 1991
TO: Simpson Sanitation
East 7812 Baldwin
Spokane, Washington 99212
Please make checks payable and mail to:
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
West 1303 Broadway Avenue
Spokane, Washington 99260
ATTN: Julie Shatto, Building Technician
REF: Sewer Connection Permit Application #91-3197
DATE PROPERTY ADDRESS FEE
06/10/91 East 11525 Riverside Avenue $ 50.00
Amount due and payable $ 50.00
Pursuant to your request for the above sewer connection permits, we
are issuing an authorization to proceed with construction, however
payment must be received prior to June 20, 1991. Failure to remit
this amount on or before this date will result in a double fee being
assessed.
Thank you for your prompt attention.
fh
CODE ENFORCEMENT DIVISION
WEST 1303 BROADWAY • SPOKANE, WASHINGTON 99260-0550 • (509) 456-3675
FAX (509) 456-4703