1991, 02-12 Permit: 91000228 Sewer �
' ,
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
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 uum I have read u understandm 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= 91000228 DATE= 0~/12/91 PAGE= 01
` I%%UED PERMIT
****************** ******** PERMIT INFORMATION * **************************
%ITE %TREET= 202 % %TEEN RD PARCFLO= 2454i -90i4
ADDRESS= VERADALE WA 99037
PERMIT USE= SEWER CONNECTION - GOOD SAMARITAN EXTENSION
** %EE 'NOTE ***
PL = 999999 PLAT NAME= RANGE
BLOCK= LOT= ZONE= AGRI DI%TO=
AREA= OOOOOOOi i.7/A= A WIDTH= DEPTH= R/W=
OF BLDG%= 0 DWELLINGS= i
OWNER= ' E , PATRIEK PHONE=
STREET= 202 % %TEEN RD
ADDRESS= VERADALE WA 99037
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***** ********************** JEWER PERMIT ******************************
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
STREET= i6402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
� ------------_------_----- -------- ---------=
PROCESSING FEE 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT %UMMARY **************** ***********
� - .
rAYMENT DATF RECEIPTO PAYMENT AMmUNT
O2/i2/9i 6i6 50.00
------------ `
TOTAL DUE= . 00 TOTAL PAID= 50.�O
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- -------~_---- ---_--------
.
SEWER PERMIT 50.08 50.00 .00
------------- ------------
•
50,00 50 .00 ^OO
PROCESSED BY : WENDEL GLORIA
PRINTED BY : JULlE ^HATTO
%' -` STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-36O4)
f-nNTPArTnR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
AND PC%ITION GF %EWE� %r;B PRIOR �G (-INT GTHER
EXCAVATION�
� - -- - - - - - -'— - -- -- - -
TO 'LOCATEliPTED • wATER • LINE% ECT.
CALL BEFORE YOU DIG (456-8000)
SEWER ST E TO BE CHECKED PRIOR TO - CONNECTION TO INSURE
THAT THEY ARE CLEAR AND %TRU T D TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR **********
********* 456-36O4 **********
******************************** THANK YOU *********************************
� -
1 |
SPECIAL CONDITION CHECKLIST
Project
Address: Project# — Use: —
Dept: Date: Condition: Init: 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____
U L I D
Other v —
"*******"'**"*****************THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY 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: