1991, 10-28 Permit: 91007186 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,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"41*-9/
PROJECT NUMBER= 91007186 ISSUED PERMIT DATE=±::.= 0/ ,.'8.": 1 PAGE=.. 01
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*•F:•}t•}!:A:•j,;•tt'*•A**9l•},:•}1.••jY*)!:*•R•}i**R:-}t 3i*)!* t-'I::.±'4 r'±.i. i .!.N 1"1. .!`�.f -± I C.N •l !t•A:•P:**7+:P:!!:1('•A:•P:•}t•A:•Y:•A:•P:)4'}f*:!!:i!:9!:-P:P:-P:*
SITE STREET= • 3•± 14 E VA4EYWIA`r AVE Pf;i' CEi...;,•..:: 15544-1613
ADDRESS= SPOKANE WA 99216
PERMIT USC.:::: c:FwfrR CONNECTION BASIN--C U.:l...., T. :.I} 86-2
}!N'* SEE NOTE *•;;:*
PLATO= 004046 PLAT NAME= SP- 41
BLOCK= LOT=«.. ,.> Zf.)N1::..... UR-3,5 I?7.E , .N.»_
AREA= 1 .
DEPTH= 90 r
Hf " _ ffi. tiDWELLINGS= WATER DIST . VERA
OWNER= PETERSON REMODELING
STREET= 4108 S MCDONALD IN
ADDRESS= SPOKANE WA 99206 -
CONTACT
}< ?tot6CON1 At»: r NAME= BRENT PETERSON PHONE NUMBER= 509 922 3130
BUILDING SETBACKS : FRONT=:::: NA LEFT= NA RIGHT= NA ("TEAR:::: NA
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9{-9t•ji;•Pi N•}!:9t Hr bt••lt•R••1{•�l•i4•A�?-H:�i'1{..A.:)L•§k)!')f,•){'}�i�i 9E i!i SEWER 1'�!::.i't'f"t,, 'R 9l••1k Ni•j!i•A'i!r:Pr.N.:P.fi..9G.R..}l.'A.:yi.Ni.}+r:pi.}j.)e.jf.pj.}i•*'Ai•j!i r!e.••1!i•Pi
CONTRACTOR= ( ~TE,zOV REMODELING
!.:..IOt`Je:.:.`:: 509 922 3.130
STREET= 4108 ,. Mi,`• :}f?N. =?i...i, LNAD )R'.E:SS:::: SPOKANE WA 9_:21 6
ITEM EN DEStnRIP ION QUANTITY t.. ::.::. AMOUNT
PROCESSING I N}GI•l:::E:: f` 10„00
SEWER CONNECTION ION i E:.. _}i}
.>e..lk J4•}t t!••P:41 9!:*if••A•*tl•?!:*fit•i!:9{•i¢./k.N.•9!:il•}l h:•A:ri it**J{ E'A Y`1"'!E:.±a ! .. t"±,'i 1-:•{'Y x•x:•r:•x•a..1i..1i*k•H.•Vit•-!!;•x n:•N:•r:•P:•i!:.j,..Y:31•-j!:** +•r:•P:*
PAYMENT DATE RE:-f::E:::E:PT :a: PAYMENT AMOUNT
10/28/91 8025 50.:00
TOTAL DUE= .00 TOTAL PAID= 0 .00
PERMIT TYPE ±"E::C:: AMOUNT AMOUNT! -'AID AMOUNT OWING
SEWER PERMIT 50,00 50,00
PROCESSED50,00 50, 00 ,00
PRINTED BY : JULIE SHATTO
± A : R : ± ;2AS—BUILT INFORMATION i. AVAILABLE i ! THE COUNTY
CONTRACTOR iR APPLICANT TS TO FIELD . !_ii_. .. AND CONFIRM THE
ELEVATION tJ } POSITION! F 3 { " SEWER STUB: f « ANY Y i � r {
EXCAVATION
TO LOCATE BURIED CABLES, 'i;,A:`:• PIPING , WATER LINES, ECT,
CALL BEFORE YOU DIG (456-0000)
SEWER I t.;B::: ~-i i•':E::: TO# cf E CHECKED PRIOR TO CONNECTION TO i N:`:•_..?•_•'±::.
THAT 1 E'1E::.Y ARE I'':1::. I LEf'1E"'` AND:t ?-tf}:,.1i i;. t ±•;i if.: ! t" I? TO THE SEWER MAIN
:1!• G'}k'Ai:{'}E•'tti•x•p• !.;•a±...L.. ;..t.i!'•. INSPECTION PRIOR TO COVER -j t!:y!i�ti•iui•j&�pi•}!;�t,�•pi
:!!t***i:•*t *j;. ,r HOUR i•_: ti 1 2.Y- REQUIRED **!t ii-iR i f:•! J•`.:Is•
*t ; t ; ?tj , 456-3604
,P . 3t ;4 Ji {RR14 NPry
**********************K* ******* THANK • *****K***************************
/?• ^ SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
permit/application,state that the information contained in it and submitted by me or my agent to compile said permit/application is true
kane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
gree to comply with same.All provisions of laws and ordinances governing this type of work will be complied with whether specified
e issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
the provisions ofany state or local law regulating construction,or as a warranty of conformance with the provisions of any state or local
1 0 -2 8 -9 1 ""L. cl ADATEICATION/ 0
z 6.479,
02 * * 10. 00
14 * * 40,00
* 50, 00
* 50,00
g * 0, 00 u
91007186 ISSUED PERMIT DATE= 10/28/91 F'Ai.Yf.::::: 0
802,5z
-......M.,...t•-x**** *4****** *****•x PERMIT INFORMATION x ** *********. .•x• • ••x•*.
SITE STREET= 13114 £ VALLEYWAY AVE PARC EL..O== 15544-1613
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION ••- BASIN-•C if.L-. I .D 86-2
*** SEE NOTE ***
PLATO= 004046 PLAT NAME= SP-341
BLOCK= LOT=- 3 ZONE= UR-3.5 DIST== F
AREA== F'/A= F WIDTH= 78 DEPTH= 90 F /W= 4()
;r OF E_{LDGS== „= DWELLINGS= 1 WATER DIST = VERA
OWNER= PETERSON REMODELING PHONE= 509 922 3130
STREET= 4108 S MCDONAI.D LN
ADDRESS=:: SPOKANE WA 99206 -
CONTACT NAME= BRENT PETERSON PHONE NUMBER= 509 922 3130
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR== NA
•x•* :•x*•x***** ******** k•x•*�t •**** SEWER PERMIT x x ate x x *�:�ix••x:a
, ,. . N P ONE= 509 922 3130
i
STREET= 4108 S Mi ONf. �.
ADDRESS= SPOKANE WA 992-16 -
ITEM DESCRIPTION QUANTITY FEE AMOUNT
-------------------------
PROCESSING FEE Y , 10.00
SEWER CONNECTION I 40.00
*•x** ••******atr:•*•x**aim****** •ac * PAYMENT SUMMARY ******* * * *. ******.y3 x
PAYMENT DATE RECEIF'Tm: PAYMENT AMOUNT
10/28/91 8025 50 .00
------------
TOTAL. DUE= .00 TOTAL. PAID= 0.(0
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 t00
50.00 ....._..._....-_...._..�50,00 .00
PROCESSED BY : WENDEL, GLORIA
PRINTED BY : JULIE SHATTO
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE::
ELEVATION AND POSITION OF SEWER STUB PRIOR •1O 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 INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
***•x ** C;ALL. FOR INSPECTION PRIOR TO COVER .x****x***;c•
***)i•***** 24 HOUR NOTICE REQUIRED * •*** •***.x.
ai 4 iE 3+ x 9k H 9{)F 456-3604 k 3i*hi k 3(>a:k x it
3 iv***3i**]t• k••x••)tk••X.ii•**3t•3i•** • ?ck i(*•aih* THANK YOu ****ii•***#**R•3b •iEu$i•}i•********•h...•x•)i••L:3
`�' SPOKANE COUNTY. PAYMENT VOUCHER
13 .864
�' ND
OD _
X DATE 3/70/99
NAME '�� REM0oE3.ING x-, I- Y % AGENCY
� xr ;j NAME ('11W F ?r cwr
I
ADDRESS 4108 S. McDONALD LANE ! .! AUDITORS STAMP
j ill
If1
SPOKANE, WA 99216 ,
�, fit{ 11 _„ I .
•; 1 r< ,�) k; , ririo
, ACCOUNT DISTRIBUTION,ORIGINATING ENTITY(ALL VOUCHER TYPES)
0 1099 REQ'D ID#
1 LitSE- I/ENt70R`f 04GAN-. B .,.. B
NO, INVOICE NUMBER FUND AGENCY OBJUB REV SUB JCB
RATION ACT OBJ : REPT 63
SOURCE REV NUMBER C¢TEG ACCT DESCRIPTION AMOUNT
i •
1 91-007182 406 030 0008 $!CIE 2210 03 REFUND
19.20
2 ii406 030 0008 2210 07
48.00
3 iiN20 675
4 4.50
406 0130 0008 'y • 2210 02 " 493.32
3700
5 91-007186 is
11.00 501.23
6 is401 436 0000 4241
DETAIL DESCRIPTION „ 32
•�"
1 1 - 6 REFUNDS ON PERMITS #91-0071 .&..9].-fY1na6 FOR 13114 EAST VALLEYWAY�AVE I, the undersigned do hereby TOTAL
PROJECT CANCELED PEROPIES OF PERMITS & LEITER ATTACHED certify under penalty of perjury •
C
that sufficient funds have been
1 $ 24.00 X 80% _ $ 19•
2 $ 24.00 X 80% = #91-007182 BLDG PERMIT budgeted
eted for this claim, the ma- TRAVEL CERTIFICATION
48.00 iiterials have been furnished, ser- I hereby certify under penalty of perjury
1 3 $ 4.50 X 10C% = 4.50 II vices rendered or labor performed that this is a true and correct claim for
4 $616.54 X 80% - 493.23 is as described herein or contracted necessary expenses incurred by me and
5 $ 10.00 X 8OX 8.00 #91-007186 for, that the claim is a just, due that no payment has been received by me
6 _ „ SEWER PERMIT and unpaid obligation against on account thereof.
' $ �.� X - •� Spokane County or fund agency
TOTAL $604.93 indicated above, that I am autho-
SIGNED
rized to authenticate and certify TITLE
INTRA-GOVERNMENTAL VOUCHER to said claim. DATE
SELLERS ACCOUNT DISTRIBUTION
z FUND 1- t«d1Cv 'ORGAN `sOs `ACTIVITY REVENREV UE' RPT.' OFFSET' ��``� �� EXAMINED and ALLOWED
izA1 oN ORG SOURCE gqc `z JOB NUMBER CAr Ci. r A E m N `
N \ CER IFI KIN DATE 19
sIGNE.
SELLER CERTIFICATION �� CHAIRMAN
I,hereby certify that the materials have been furnished,the services SIGNED
rendered or the labor performed as described herein or contracted TITLE OFFICE ADMINISTRATOR MEMBER
for,and that the claim is a just,due and unpaid obligation,and that TITLE
I am authorized to authenticate and certify to said claim. DATE DATE 3/20/92 MEMBER