1992, 07-09 Permit: 92005097 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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Pr,-:.OUECT NUMBER- 92005097 PFRMTT DATE- 07/09/,?2.
EEE NOTE
BLOCK= 25
AREA= 00000000 F/A= F WIDTH- DEPTH-
4 0E-
ADDREEE- EPOKANE WA 99206
OONTACT NAME- RON ELOAN PHONE NUMBER- 509 8500
SETBACKE : FRONT= NA LEFT= NA RIG-HT= NA REAR= NA
.. .t .. .. .. .: ., ! .: i. !! :,::}j.:q::q:3'.:;:ij.:i.j,::}/.:..::j.:;::;:t' gEwER EERmIT .... .. ,.r.a..1,..^....f'1}:::'1!:"Ai .. .. .... .. .. .. ..i
.. .. .. .. .. ....
•
ALWAYE ACTIVE PHONE= 509 922 8500
ETREET= PO BOX 141562
ADDREEE= EPOKANE WA 99214
Q.UANTTTY FEE AMOUNT
10 ,00
07/00/92 5275
5275
07/09/92 50 ,00
TOTAL DUE= , 00 TOTAL PAID-
i..;, i
uNi. AMOUNT PAID AMOUNT OWINC;
-------------
EEWER PERMIT 50,00 50, 00 ,00
50 , 00 50, 00 ,00
. jULIE ..I 1!; ..`.
PRINTED, i.i ,.f.
SEWER/PLUMBING PERMIT APPLICATION FORM
0.._, NFORMAt ION WORKSHEET
- .
-, -
JOB STREET ADDRESS: 5 2-40,„_? /
CITY/STATE/ZIP: -2
/‹; 76 PARCEL NUMBER: / 2- D.---? 5
...
...)
MAILING ADDRESS: , 'Y ) Y/3"‘-2
OWNER: PHONE NUMBER:
(Street) (City/state) (Zip) ej/
CONTRACTOR: ii-- /4-c 77/_/: - LICENSE NUMBER:
PHONE NUMER: /
MAILING ADDRESS: / / /v/y- 6 2 --A7-,?77 --,
, .
(Street) (City/state) (Zip) -,
._..:
X EACH
DESCRIPTION UNIT =AMOUNT / 'Ik
SEWER CONNECTION X 50.00=
_
PLUMBING ALTERATIONS X 35.00 = --t-J
SUBTOTAL $
__ ___
EQUALS: TOTAL
PEMIT FEE DUE =$
SIGNATURE
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675