1991, 11-27 Permit App: 91008244 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 Coty to proceed with processing. In addition, I have reao understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to com / th same.All provisions of laws and ordinances governing this of work willc*oumwoo with whetheru
herein or not.I understand that the issuance of this permit/apo nonanuunvouuoeovo"tmopoomnunpmvu/oo,nomooamoofnvnvvumyohuonnt 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
^d, �
_ |
PROJECT NUMBER= 91OO8244 �� _ __-_ DATE= 11 /27/91 PAC.;E= Oi
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
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- ,
SITE STREET= 604 S SUNDERLAND RD PARCEL4= 20542-i2O9
ADDRESS= SPOKANE WA 99206 ^
PERMIT USE- SEWER CONNECTION - UNIVERSITY HIGH 88-02 (9i -%82>
*** SEE NOTE ***
PLAT NAME= KELLOGG ARK SUB
LOCK= LOT= i ZONE= AG%UB DI%T4= E _
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= i 4 DWELLINGS= WATER DIST =
OWNER= FARNHAM, DE N PHONE=
STREET= 604 % SUNDERLAND RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= COURCHAINE EXCAVATION PHONE NUMBER= 509 924 5485
BUILDING %ETBACK% : FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
***************************** SEWER PERMIT ******************************
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
%TREET= 16402 E VALLEYWAY
ADDRESS= \/ERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y iO OO
^
SEWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 .00 50.00
------------- ------------ -------------
5O.00 .00 50 .00
PROCESSED DOMITROVICH, ROBIN
PRINTED BY : DOMITROVICH, ROBIN
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNT;
UTILITIES DEPARTMENT (456-3604 )
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF %EWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLE , GAS PIPING, WATER LINE% ECT
CALLBEFORE YO�~DIG ( 45 -8OOO) ' ^ ^
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU ****************************** **
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: 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
ULID
Other
'**`***************************THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY 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: _— __