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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