1991, 08-01 Permit: 91004066 Sewer SPOKANE COUNTY DEPARTMENT 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= 91004066 I:CSUEI) PERMIT DATE= 08/01 !91 FACE= 01
***************•**3 *****3**** PERMIT INFORMATION ******************•**•********
SITE STREET= :3107 S SKIPWORTFi RD
I"'ARCEL4= 28543-•5607
ADDRESS= SPOKANE WA 99206
PERMIT USE=: SEWER CONNECTION -•• SOUTH KOKOMO
*** SEE NOTE ***
PLAT;:- 001393 PLAT NAME= KOKOMO TOWNSITE F.
BLOCK= 56 LOT= ZONE= UR--3.5 DIST::=
AREA= 00000000 F/A' F WIDTH= .100 DE PTH-: 130 R/W.:
DWELLINGS= 2 WATER DIST
OWNER= HATCHER, HAZEL. PHONE=
STREET=: 3107 S SKIPWORTH RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= FORD CONSTRUCTION
PHONE NUMBER= 509 924 6182
BUILDING SETBACKS : FRONT::- NA LEFT== NA RIGHT= NA REAR= NA
**x**x******************•**•*** SEWER PERMIT *******•;r*****x*******• ****** :*
CONTRACTOR= FORDS CONSTRUCTION PHONE== 509 924 6182
STREET= 9713 E 4TH AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING TFEk 'µ..__.._._• 10.00
SEWER CONNECTION i 40.00
*•k** :*** ********************** PAYMENT SUMMARY ****************************
PAYMENT DATE:. RECEIPT:` PAYMENT AMOUNT
08/01 /9i 5268 50.00
------------
TOTAL Dt.IE==
.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 : JULIE SHATTO
SEWER STUB AS-BUILT INFORMATION IS AVAIL..ABL.E. 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 **********
**********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: 'nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant )
Lock Box
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Engineer's RID/CRP
Easementsivi
- Road Plans/Improvements
Bonds ft'f
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Planning _Bonds
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******—*********"*******THIS SPACE FOR COMMERCIAL PLANS TRAPKIN.4i!P.ERTI:FPATEPOO.O.,10Alsifgf ONq..'": "*"*************************
(t •::'
Date received for C/O piocessing 3 Plansipthltedifoik fin41:,:pre0Wa4in4'..
Temporary C/O issuedi:; • qer,tqlciiistle of OMncSy issued „ „ 4 4 4
Office file review by: . Date: f 1(.;
kit; 4-4.,- A. PatP• :=!•. -•
• ---
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:
a
S P O K A N E _Al -- mit,-,ilitit;
DEPARTMENT OF BUILDINGS • A DIVISION OF THE PUBLIC WORKS DEPARTMENT
JAMES L.MANSON,C.B.O.,DIRECTOR DENNIS M.SCOTT,P.E.,DIRECTOR
INVOICE
DATED: July 10, 1991
TO: Fords Construction
North 1425 University Road
Spokane, Washington 99206
Please make checks payable and mail to:
1 SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
West 1303 Broadway Avenue
Spokane, Washington 99260
ATTN: Julie Shatto, Building Technician
REF: Sewer Connection Permit Application #91-4066
DATE PROPERTY ADDRESS FEE
07/10/91 South 3107 Skipworth Road $ 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 July 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