1991, 08-05 Permit: 91002530 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;aid 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= 91002530 ISSUED PERMIT DATE= 08/:05/91 PAGE= 01
*****ri**ii**#iE#a *k*it*n#***** PERMIT INf•f?RIIf .. . r ** • • .*#K)6 3t iia : ii}4i> * iieu
SITE STREET=: 2205 S VERCL.ER RD PARCEL4== 27542-2809
ADDRESS= SPOKANE WA 992.06
PERMIT USE= SEWER CONNECTION .... DRY 1..IINE ONLY
*** SEE NOTE **•*
Pt_AT,:=: 0012.23 FLAT NAME= HIu...cR:E::ST ACRES '.ND ADD
BLOCK= ~� LOT= 9 ZONE== A ; i.iB DIST 4= E.
AREA=A== !000;1 !00,0 F'/A= F I. T.I'TH-: DEPTH= E;.:,.W_:
',*: OF BI._DfYS=:: 1 re DWELLINGS= 1 WATER DIST =
OWNER= ALDERSON, MARCUS PHONE=
STREET= 2207 A: VERCLER RD
ADDRESS=:: SPOKANE WA 99206
CONTACT NAME= LEONARD f•IPH•fON NUMBER= E.... ,., .�;�, • l:f�'.-;4
BUILDING SETBACKS : FRONT:::: NA ,..LEFT= NA RIGHT:::: NA REAR-- NA
.}i•• -bi** •}k'P...H**•R.•**ii:k•PL•)l*$:7t .:p•.*3\*f•:k* SEWER .:I::R I .. •h•.p.-N:•*•}k•}LRP:*-P:-A'*Yi•)G--il•}l•A**it.it.A.:A..A*•}E***P:
CONTRACTOR= H & S CONSTRUCTION PHONE== 509 926 8964
STREET= j181f E:: vAI._L..E::Y'WAY AVE::
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING INS FEE Y' 10,00
SEWER CONNECTION 1 40.00
*R••}t•**•ii•'v:*.a:•k•ii••)e*•m;•ri••k•N:•ri•ii••a•n•-}!•r:•ii ir:*ri*a•ii•}G PAYMENT Rt..i"iI'f-?RT b:**3{•A:**i{•**iC.P:iC•b:•Ik'!k i{••P:*•A-A••R Jl h:*•!t:**
PAYMENT DATE RE:CI:"I PT : PAYMENT AMOUNT
08/05/91 5292 50,00
TOTAL DDUj i .00 TOTAL PAID=: 50.00
PERMIT TYPE FEE:. AMOUNT AMOUNT PAID AMOUNT OWING
;�•'E::WE::R PERMIT 50:00 5i"},00 .-00
50.00 50.00 :-{i0
PROCESSED D) BY : JULIE SHATTO
PRINTED BY : ..JUL..IF: SHATTO
SEWER STUB AS—BUILT INFORMATION f.S AVAILABLE I:I...AM,fI...E:: AT THE Ci,:COUNTY
UT .I.L..1. T•I ES DEPARTMENT T ( 456 -.h604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND
PRIOR CONFIRM
M
THE
ELEVATION 1r ' POSITION f = SEWER STUB T' ANY OTHER
EXCAVATION
TO LOCATE BURIED C:::AT:{I...ES, GAS PIPING, WATER LINES, ECT.
CAL..L_ BEFORE. YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED) PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CI....CLEAR
AND UNOBSTRUCTED TO THE SEWER MAIN
R••>,:•RRb:RRRR CALL FOR INSPECTION II..]:O TO COVER •r;RR.•r;R•R•;<:RRR
RRR•R•R*R9!J!• R4 HOUR NOTICE REQUIRED -iL•}L**RR'R*R•)L
.p,*.x..p.a,_.a.}t.*h; 456 ;g,,}!;/4 •n,•e,:.f;..i!••x:•u-h:•-N;•}i••h:
R•}+:••iL**•7LRRRRRRR -R*R*iL*RRRRii.) RN•RRRR THANK YOU ' 'X' ii•iki!-•i•:•ii•. •'n.•'it•**it•ii•**•'t!=X'r.'it•*****)i ii-)i•**ik•}i•
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
?t : f T
T
Engineers RID/CRP
77t,
Easements
Road PlonsiiirnpromMents',.- ;.; 7 7;
Bonds
(;:I • 11! ..j
•-! f t. ,
i . v
.
Planning ;171 Bonds • ;.•3
("; ; :..•
: ). i 3: 4
1 ,
1,;! •
Utilities Double-Pfurpldir}g T AO.
UUD """ "" " ""-"' """ • '"""""' """"
Itl
•
c.ri• 1 j -; T •
• •• • •• -- ••
Other
7".1 .
A ' , i••• . T A ii 1"
1 v. 41
045 •i
•"
0 T‘c. V!•..4
. • i./
I 0 "' 0 0 .117‘.1:73
f.if 7. (.3"i" T ." .. > " ::il... : 74 i I
,.; 7.; I i• Eis csi,i I (.1. 1-) :71
'.! .• i11 l II II II
*****"*""*****"******* ,:11:"Vt1 ,1".1-titsS64PACE FOR COMM eFf4ALPLA-14$TRACIKIN:"WCOIT(FlATEOF OCCUPANGY-0#1ti**•1(*******************"********
••••••••', •:•••• •:•••.• 4,•••
Owe.received for:OIXO:•pitiCessirt* :ps• ••;f:•,(•••st'• pidteitHdf finttitOtOcestirigt ;!.. i.
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: