1991, 07-16 Permit: 91003611 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.
�� '1303 BROADWAY AVENUE
��SP0KAWASHINGTON 99260
1509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my t 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= 91003611 I%%UED PERMIT
nATF= 6/9i
**************************** PERMIT INFORMATION ****************************
BU
%ITE %TREE/= 2214 % %ONORA %T
ADDVERADALE WA 99037
rizxn1�
PARCELO= 25542-9048PTN
%EWER CONNECTION - RIDGEMONT E%T NO4 2ND
NOTE ***
PLATO= 004499 PLAT NAME=
BLOCK= i LOT=
AREA= F/A=
4:, OF BLDG%= 4:: DWELLINGS=
OWNER=
%TREET=
ADDRE%%=
MADDEN,
2214
VERADALE
LORA
NORA %T
WA 99037
RIDGFMONT FET NO4 2ND
3 ZONE= ;R-3.5 DI%Ta=
F WIDTH= 115 DEPTH= 201
WATER DIET = VERA
PHONE=
7 NAME= FRANK OR KEVIN PHONE NUMBER= 509
%ET'ACK%: FRONT= NA LEFT= NA RIGHT= NNA REAR= NA
*****************************
%EWER PERMIT
ON%TRUCTION
ITEM DESCRIPTION
---------------
PROCE%%ING FEE
%EWER CONNECTION
************************** PAYMENT
PAYMENT DATE
O7/i5/9i
TOTAL DUE=
PERMIT TYPE
SEWER PERM' PERMIT
PROCE
PRI
RECEI17;T�
FEE AMOUNT
-------------
5O.00
50,00
BY:
BY: WENDEL
BY: JULIE ^H*
'IA
9?4
******************************
QUANTITY
%UMMARY
PHONE=
FEE AMOUNT
i0„00
40,00 40.00
***************************
PAYMENT AMOUNT
50.OO
TOTAL PAID=
AMOUNT PAID
50,00
50,00 -----------
5O.00
SEWER %T'2... A% -BUILT INFORMATION
UTILITIE% DEPARTMENT (456-3604>
AMOUNT OWING
-------------
% AVAILABLE
.0O
-
------
.00
AT THE COUNTY
CONTRACTOR OR APPLICANT IE TO LOCATE AND CONFIRM THE
ELEVATION AND PO%ITION OF %EWER %TUG PRIOR TO ANY OTHER
EXCAVATION
TO LOC�
CALL BE/
CABLES
, 7456-
SEWER %TUB% ARE TO
THAT THEY ARE C
********* CAL
*********
*********
PIPING, WATER LECT.
CONNFCTION TO INJURE
THE %EWER MAIN
COVER **********
**********
**********
******************************* THANK YOu *********************************
Project
Address.
Dept:
SPECIAL CONDITION CHECKLIST
Dept. of Bldgs.
Engineer's __
Utilities
Other
Date:
Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
Uuo
Appr:
(out)
— ___ —_— _—__—_� ' _ ______________ ___
`~^^~`^```'``'``~'~`^^`~ THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OFOCCUPANCY ONLY '~`^```^^`~^~'^~`'``^~~`
Date received for C/O processing:
Temporary C/O issued. Certificate of Occupancy lssueu:__
Oftice file review by: _ Date: --_-
Filed inspnoaedby. Date.
Ninety days after CIO ssuance:
Owner/contractor called regarding the return of plans: . Date:
. Received by:
No response from owner/contractor plans destroyed: