1992, 09-21 Permit: 92007855 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 Soxuno County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
���|�'��'s����'�������ded �'�'and������������to '���with
���/'��All
���������rovisions 'laws~''~~`'''~''`~~ny subsequent inspection approvals or �/'work�����,'��l----�m�����lied i/ih������er specified
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= 92007855 ISSUED PERMIT DATF= 09/21 /92 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
%ITE STREET= 2608 % %KIPWORTH RD P 45283.3404
ADDRESS= %POKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KGKOMG (92%-949 )
*** EEE NOTE ***
PLAT0= 001393 PLAT NAME= KOKOMO TOWN%ITE
� F
BLOCK= 34 LOT=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 0 DWELLINGS= WATER DIET =
OWNER= HESE PHONE= 509 928 i076
%TREET= 2608 % %KIPWORTH RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= COURCHAINE EXCAVATION PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
***************************** SEWER PERMIT ***************** * *********
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 54G5
STREET= 16402 E VALLEYWAY
ADDRE%%= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCE%%ING FEE Y 10 ,00
%EWER CONNECTION i 40.80
***************************** PAYMENT SUMMARY ********************** *****
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
09/21 /92 7986 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.00 50.00 .00
------------- ------------
50.00 50. 00 5O. 0O .00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DOMITROVICH, ROBIN
SEWER %TUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% 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 IN%URE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
rnn TurPrrr7nu PPrnn rn rGvFP **********
SEWER/PLUMBING PERMIT APPLICATION FORM / _ ,L ,
INFORMATION WORKSF-+EET ( .K. -7` ` O 7
JOB STREET ADDRESS: - ° A C . e -.�_vz
'�� 4 c�
QAa> 1`�, 1
CITY/STATE/ZIP: 4:. ----,,,,v-2---0 - LE'. ea PARCEL NUMBER: 1
MAILING ADDRESS: .__1.. yam- f
OWNER: �kz-6a-- PHONE NUMBER: fes? e--- Z€' —7
(Street)
(Street) (City/state) (Zip) 1 .- -13- (9
CONTRACTOR:CloUe hiNE EXCAv .iioW LICENSE NUMBER: COLI ECC- .181 g..17
PHONE NUMBER: cta4-6035 r
MAILING ADDRESS: E. tro40:? UAUEYWAY AVE liee.ADA-LE t^/,4- 99037
(Street) (City/state) (Zip)
DESCRIPTION UN TCH =AMOUNT l 52 2v 5 Q T
SEWER CONNECTION X 50.00 = ±e) lon5t4 /
PLUMBING ALTERATIONS X 35.00 = ,3
U�CAPn
SUBTOTAL $ ,75- S.
EQUALS: TOTAL � �� V'2
PEMIT FEE DUE _$ g-"�_
1 At
� fSIGNATURE ,=.i e L('/��-�'`e� �,
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675