1991, 04-15 Permit App: 91001827 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 Conty to proceed withpmoossmn In additionI have reaand 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= 91001827 APPLICATION DATE= 04/i5/9i PACE= 01
****** THIS I% NOT A PERMIT ******
PENALTIE% WILL BE A%%E%%ED FOR COMMENCING WORK WITHOUT A PERMIT
ITE STREET=JTREET= 614 S WOODRUFF RD PARCEL4= 20542-1403
ADDRESS= %POKANE WA 99206
PERMIT U%E= SEWER CONNECTION - U-HI
*** SEE NOTE ***
PLAT0= 002 208 PLAT NAME= RETTI ADD
BLOCK= T = 3 ZONE= AG%UB DI%T4= E
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W= 50
0 OF BLDGS= i 0 DWELLINGS= i WATER DIST =
OWNER= SWANSON, PAULA PHONE=
%TREET= 614 % WOODRUFF RD
ADDRE%%= SPOKANE WA 99206
CONTACT NAME= TOM STONE PHONE NUMBER= 509 928 7710
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= TOM STONE EXCAVATING PHONE= 509 928 7710
STREET= ii12 N MAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
` ------------------------- --------
PROCESSING FEE FEE Y 10.00
SEWER CONNECTION i 40 .00
`
- - PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
` --------------- ------------- ------------
EEWER PERMIT PERMIT 50.00 .00 50.00
------------- ------------
50.00 . 00. 0O 50.00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
SEWER STUB A%-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 TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GA% PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
%EWER %TUB% ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR IN%PECT ON PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-36O4 **********
******************************** THANK YOU *********************************
_ _ __~ __' ~
SPECIAL CONDITION CHECKLIST
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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: