1991, 01-24 Permit: 90005950 SewerSPOKANE 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 Occupahcy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of any stateor local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PR0'JECT NUMBER= 90005950
**U*** PERMIT ;ENFOl MATION
SITE STREET= 11903 E 4TH AVE
ADDRESS= SPOKANE WA '99206
PERMIT USE= SEWER CONNECTION - 0801
3e** SEE NOTE 3e#3e
PLATO= 001839 .PLAT NAME:": COP. TR. 1--354
BLOCK 579- LOT=:: ZONE= A(:;SUII DIST:.= F
AREA= 0000000() F/A= F WIDTH= DEPTH= R/W=:
OF BL..DGS= 1 "4k DWELLINGS= 1
OWNER= TIFFANY, JAMES PHONE==
STREET:::: 11903 E 4TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS: FRONT= NA LEFT:'- NA RIGHT== NA REAR= NA
3(•3etea *)(**********•3E****3e i()e**4 *t(• SEWER PERMIT 1F**jrMisY(lirf#t(.ii.ii.#ri..h..1i1i•iFi(*f(•k#jrf{•iEYiii34
DATE. 01/24/91 PAGE= 01
ISSUED PERMIT
******3e**3e***4 Y******,****3***
PARCI:-L4'= 21541-1014
CONTRACTOR= COURCHAINE CONSTRUCT:CON
STREET== 16402 E VAI...1...1:"YWAY
ADDRESS:s, VERADAL_E. WA 99037
PHONE= 509 924 5485
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCE:SS'ItN'C; FEE Y 10.00
SEWER CONNECTION 1 40.00
3e#3(-**** e',* st•H•1E********** ***** PAYMENT SUMMARY****ft*.x..**fl********•*s****;t•tt•*
PAYMENT DATE RECEIPT:» PAYMENT AMOUNT
01/24/91 335 50.'00
TOTAL.. DUE= .00 TOTAL... PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAIL) AMOUNT (:OWING.;
SEWER PERMIT 50'400 50.00 .00
50,00 50.00 .00
PROCESSED BY: JOL.`EE SHATTO
PRINTED BY: JULIE SHATTO
SEWER STUB AE—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„ GAS PIPING, WATER -LINES, FC'T,
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS. ARE TO T:+E CHECKED PRIOR TO CONNECTION TO, INSURE
THAT THEY "ARE CLEAR AND UNOBSTRUCTED TO THE SEWER, MAIN
3ex3(3e#3e3e#3e CALL FOR -I:NSPEGTI:ON PRIOR TO COVER 3(•343F3e3eje3i#3eX
********3E 24 HOUR NOTICE REQUIRED 3e3e3ea(•3e3e3<x3e
)e3e3r****** 456-3604 ***no***
* ******** )eie34#3e*********
****)He* TI -TANK YOU ie#.H..*.*ie**** e***3e*3E:ie** ***********
t.'a
SPECIAL CONDITION CHECKLIST'
Project
Address. Project # Use:
•
ter..
............
f3
Dept. of Bldgs.
..
Engineer's
Planning
,
,
,
6,. i
Utilities
,.
..f
Other
-•
,
Condition:
Special Insp. Final Report
Hydrant ( )
Lock pox .... .. ,. ..,...
r
!nit:
()n)
RID/CRP
Easements • • '
Road Plans/Improvements "•- : r.
Bonds y
Bonds
4,
Double Plumbing
ULID '
c
14
Appr:
(out)
•
THISSPACE FOR 6OMMERCIAL PLANSTRAC(ING; CE4TIFICAT�(�FOCGUPANCYOtILY ,
Date received fbf C/O pr oGessinigt I � " { P(anprpf )leQf6r jmalprncessing•• ',
Temporary CIO issued w 4' , ' * ct ; - "i tCeitiflcate''of Obcupandy issued: • .+c '
r ,,. ., K , Date
Office file review by:. , , ,. , �.
Filed insp finaled by: Date•
'd ^; •z :,1 rx ii . •( l .�. !� d', .-* 4 ); : sf t it A .,
Ninely days after,C/O issuance:
Owner/contractor called regarding the return of plans: Date
Pians returned: Received by
No response frontownei/contractor -,plans destroyed.