1991, 04-22 Permit: 91001975 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 Sx County to m000u 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
F'ROJECT NUMBER=' 9iOOi97!5 I%%UED PERMIT DATE= 04/22/91 PAGE= Oi
INFORMATION ********************** *****
%ITE %TREET= 1820 % %KIPWORTH RD PARCEL4= 28542-2209
ADDRE%%= %POKANE WA 99206
PERMIT U%E= %EWER CONNECTION - NORTH KGMOMO
*** EEE NOTE ***
PLAT-0= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= LOT= ZONE= UR-3 . 5 DI%T4=
AREA= F/A= F WIDTH= iOO DEPTH= 140 R/W=
4 OF BLDG%= 0 DWELLINGS= i WATER DIET =
OWNER= MCLELiAN , WILLIAM & MARION PHONE= 509 924 1633
%TREET= 1820 % %xIPWORTH RD
ADDRE%%= %PGKANE WA 99206
CONTACT NAME= TOM WILLIAM% PHONE NUMBER= 509 926 i6: R
BUILDINC %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
******** ******************** %EWER PERMIT ******************************
CONTRACTOR= TRW BACKI-GE %ERVICE PHONE= 509 926 937�
%TREET= i1223 E 18TH AVE
ADDRE%%= %POKANE WA 99206-0000
ITEM DE%CRIPTION FEE AMOUNT
------------------------- -------- ----------
PROCE%%ING FEE Y 10. 00
%EWER CONNECTION i 40 . 00
*** ************ ************** PAYMENT %UMMARY ****************************
PAYMENT DATE PECEIPT,!!: PAYMENT AMOUNT
O4/22/9i 2224 50 .0O
TOTAL DUE=DUE= . 00 TOTAL PAID= 50. 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------- ---
%EWER PERMIT 50 . 00 50. 00 . 00
------------- ------------ -------------
5O.00 50 . 00 . O�
PROCE%%ED BY : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
%EWER %TUB A%- UILT INFORMAiION I% AVAILABLF HT ! Hi.-- COuNTY
UTILITIE% DEPARTMENT ( 456-3604 )
CONTRACTOR OR APPLICANT I% TO FIELD LOCATF AN� CONFI�M T��
ELEVATION AND PO%ITION OF %EWER ETi|B PRlOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLE% GA% PIPINGWATER LINE% FCT
| ' ' ^
CALL BEFORE YOU DIG ( 456-8000)
%EWER %TUB% ARE TG BE CHECKED FHIGR TO CONNECTION TO IN%URE
THAT THEY ARE CLEAR AND UNOB%TRUCTED TO THE SEWER MAIN
********* CALL FOR IN%PECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REUIRED **********
********* 456-3604 **»*******
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: ____ _ —__ _._Project#
Dept: Date: Condition: !nit: 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 OFOCCUPANCY 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:
- 4/- / -5
JOB ADDRESS / /v) 5') //:-2\46:3, r
SUBDIVISION li<G)4,,),/y),) Zz1/17 LOT:a2/42L24_ BLOCK
OlpINERPHONE /C 5 g"
ADDRESS - -9
CONTRACTOR Backhoe (Thomas R.. Williarn.s.IPHCNE 926-9378
ADDRESS E . 11223 Eighteenth—Spokane, ArA 99206
LICENSE #TRWBASI95NA
INSPECTION DATE Will call
TYPE OF OCCUPANCY