1991, 06-18 Permit: 91002820 SewerSPOKANE COUNTYPEPARTMENT 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 Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state o(,local law regulatingtonstruCtion, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 91.002820 ISSUED PERMIT DATE= 06/18/91 PAGE= 01
**************************** PERMIT INFORMATION ****4**********************
SITE STREET= 12608 E 4T1 -t .AVE PARCEL:= 22542--1309
ADDRESS= SPOKANE WA 9921.6
PERMIT USE= SEWER CONNECTION - 8801
*** SEE NOTE ***
PLATO= 000162 PLAT NAME= BAUMANN'S SUB -
BLOCK= LOT= ZONE= AGSUB DIST;=
AREA= 00000000 F/A= F WIDTH= DEPTH= F.
0 OF BLDGS= 1 0 DWELLINGS= 1 WATER DIST =
OWNER= WR BRUCE ?HONE=
STREET= 12608 E 4.TH AVE,
ADDRESS= SPOKANE WA 99216
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT== -NA REAR= NA
**************•*************#* SEWER PERMIT+L•*****************************
CONTRACTOR= COURCHAINE CONSTRUCTION:
STREET= 16402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PHONE= 509 924 5485
PROCESSING FEE
SEWER CONNECTION
Y
1 '
10.00
40.00
•********•**********************3 PAYMENT SUMMARY•****************************
PAYMENT DATE RECEIPT: PAYMENT AMOUNT
06/18/91 3891 50.00
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID' AMOUNT OWING
SEWER PERMIT --- 50.00 50.00 1(00
T50._00 50.00 .00
PROCESSED BY: ,JULIE SHATTO
PRINTED BY: JULIE SHATTO
SEt4ER STUB AS -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
Tb LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000}
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********•
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU ********************************
Project
Address:
Dept:
SPECIAL CONDITION CHECKLIST
Dept. of Bldgs.
Date:
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Planning
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Special Insp. Final Report
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Date received for CIO VrOcietstsing.::,•,i.:!-•:
Temporary C/O issu4e
Date:
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Office file review by:
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FilPg11: 11* .'t * t A A. .4.* : 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.