1991, 12-18 Permit: 91005627 SewerSPOKANE COUNTY DEPARTMENT OV 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 w(II 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= 91005627 ISSUED. PERMIT
*1******3i•3r ii*****iE*** **3i*
*3E PERMIT
INFORMATION
SITE STRCET- 11804 E. 4TH AVE
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION -- 8801
*** SEE NOTE **3E
PL.. ••
BLOCK=
AREA==
:; OF BLDGS=
'OWNER=
STREET=
, ADDRESS=
00 038 PLAT NAME=
1 L_OT=
00000000 F/ A==
1 w DWELLINGS=
L_OWRY
11004 E 4TH AVE
SPOKANE. WA 99206
CONTACT NAME= TLC
BUILDING SETBACKS' FRONT== NA
******3e**.h.******* •1E**33..x_.1.*3t•*•X*
DATE 12/18/91 PAGE== 0i
*3e3E3i *********#*3i **•**********
PARCELn°= 21541- 1512
ALDORNA HOMES ADD
1 LONE= AGSUB
F WIDTH=
1 WATER DIST
LEFT= NA
SEWER PERMIT
PHONE=
DT.ST:== F
DEPTH= R/W=
P) -HONE NUMBER== 909 927
RIGHT= NA REAR?; NA
6 760
***3e**ie*3434***;3****.1*3*3* **3e**3
CONTRACTOR= TLC CONSTRUCTION PHONE= 509 927 6760
STREET= 13016 E 1'2TH AVE
ADDRESS= SPOKANE WA 99216,
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 10.00
SEWER CONNECTION 1 40.00
*****3i********ii****at..u.3t.*;t.3i..x..;i..**..*3t. PAYMENT SUMMARY *****3I3{'3k 3k m*********
PAYMENT DATE
12/18/91
TOTAL DUE=
PERMIT TYPE
SEWER PERMIT
PROCESSED
PRINTED
BY:
BY:
RECEIPT:
9533
.00 TOTAL PAID=
PAYMENT AMOUNT
50.00
50.00
FEE AMOUNT AMOUNT PA'1D AMOUNT OWING
50.00 50.00 .00
510.00 50.00. .00
JULIE SHAJTQ
DOMITROVItI-i, ROBIN
SEWER STUB AS -BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD L_OCATE::'AND CONFIRM THE
ELEVATION AND POSITION 01- SEWER STUB PRIOR 'TO ANY OTHER
EXCAVATION
TC) LOCATE BURIED CABLES, ‘AS PIPINGS WATER LINES, ECT.
CALL.. BEFORE YOU D.I•Gr,(45.6--E3000)
SEWER STUBS ARE:: TO BE CHECKED PRIOR TO CONNECTION PO INSUR'
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO TETE SEWER MAIN
**X**3E**X CALL_ FOR INSPECTION PRIOR TO COVER **vE***34'***
********* 24 HOUR NOTICE REQUIRED **********
*****3e3i•** 456-3604 **3e1i•1ii4**3Qie
*3E3e*x*3i3f*#r3E3ti#3i'3i3e3i3s)f*3f#3e****3i)E3.*3E THANK YOU****3F3e***ii1r#3F3i1e*1e3i***34****s..
x*34
******
Project
Address:
Dept:
SPECIAL CONDITION CHECKLIST
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other
Date:
Condition:
Project # Use.
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
Init:
(in)
Appr:
(out)
THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing: Plans pulled far 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.