1990, 09-14 Permit App: 90004601 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY-AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
1 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
FkujECI
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4/90 PAGE= 01
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SITE:.. I.. ....
ADDREEE= SPOKANE WA 99216
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PERMIT UEE= SEWER CONNECTION — 8201BLOCK=
SPOKANE
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CONTACT NAME= LEWIS . TOM STONEPHONE NUMBER= 509 928 7710
BUILDING SETBACKS : FR. N . NA LEFT=. \A RIGHT= t ` ( s - NA
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CONTRACTOR:. TOM STONE EXCAVATING PHONE.. 509 928 7710
STREET= '1 •1 I•'i _!'f f i I'i I^I+.M Yt`f J
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PROCE
SING FEE 10,00
..{;,11-#_. .:CONNECTION 40 ,00
PERMIT TYPE i r !. :•z#'#i, '_[ JT AMOUNT Pt... AMOUNT•I:,l OWING
.. .. ....'. PERMIT I ..s0 .:00 , ?•10 50 , 00
50.00 , 00 F0,00
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TOPIC = GENERAL DEPT = BUILDING
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:t.t INCLUDES `'iiu # 'I 2024 WOODLAWN
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1 L,l�t AS-B i'# t�S:�i;I�r's�ia•:iT AVAILABLE COUNTY; ,..:
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.456
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SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION . ;
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THAT THEY ARE CLEAR AND UNOBETRUCTED TO THE 1 . ( -t MAIN
. ..:k.*uI . x^ CALL FOR iS: ErPRIOR i - COVER xa9 *pR tir
24 HOUR NOTICE REP.UTRED 7t•3t'?t 9k f 4F.i•9i'9t.`i
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1-4-39-net0--C-Lti
SS: J� 1
JOB ADDRE � 7
SUBDIVISION:
24 1 LOT: BLOCK:
OWNER: r . -1 ( I PHONE:� t�
ADDRESS:
CONTRACTOR: S `--'-
ADDRESS: l o' �--T / l
LICENSE #: / 1 / XI , 7 l�
7 c7
INSPECTION DATE:
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TYPE OF OCCUPANCY: