1991, 04-25 Permit: 91002040 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/applicati6n is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
prpvisions 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 Issdance 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 Ipw 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= 91002040 APPLICATION DATE== 04/25/91 PAGE= F)i
)e*e3efl THIS IS NOT A PERMIT **3e**
PENALTIES W]a_L_ I;tE ASSESSED FOR COMMENCING WORK WITHOUT *=t PERMIT
SITE STRE T= 12720 E 4TH AVE PARCEi..4= 2254,2--1121.
ADDRESS= SPOKANE WA *9216
PIRMIT USE= SEWER CONNECTION NORTH KOKOMO'
3*** SEE NOTE #3Eje
PLATO= 0001 62 PLAT NAME-: BAUMANN' S SLiB
BLOCK== 1 LOT= 1 ZONE:::- AGSUB Id T: == F
AREA= 00000000 ETA= F WIDTH= 140 DEPTH= 95 R/W=:
x
OF BLDGS= 4 DWELLINGS= 1 WATER I>IST =
OWNER= ROGE:RS,, H Ff PHONi:'::::
STREET= 12720 E 4TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= J & S CONSTRUCTION PHONE NUMBER= 209 687 1878
BUILDING SETBACKS: FRONT== NA LEFT= NA RIGHT== NA REAR NA
'P:3e3E3*3E)**%3e3e#3*3**'X3e.)*..X.3(..1l.•*3E3****X'3E3r SEWER PERMIT
3t:.X..)it3***W*•)*.*•••*X•*fr***#•) 3E .u*•$#3***
CONTRACTOR= J RVCONSTRUCTION PHONE=: `208 687 1878
E
STRET=:: 6155E:: HAYDEN AVE
ADDRESS= RATHDRUM ID, 83858
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 10.00
SEWER CONNECTION 1 40.00
PERMIT TYPE:: FEE AMOUNT AMOUNT MID AMOUNT OWING
SEWER PERMIT 50.00 .00 50.00
50.00 .07 .?0.00
PROCESSED BY: FORRY, JEFF
PRINTED BY: JOHN LARSON
SEWER STUB AS --BUILT INFORMATION IS A'VAII...A'BI._E:. 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, ECT.
CALL_. BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONN.E:CTiON TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
3*3:•x;t•ai3E** * CALL FOR INSPECT J:ON, PR7:OR TO COVER 1E3e3Ex•3i3E3***
3e)e)e X3E3*** 24 HOUR NOTICE REQUIRED )*3*)e3E*** *3*3e
)E** *x3*3***, 456-;3604 3i3iu..X..r:lE3Eu3E3E
*###3E3Eie3E3*3*)*3e**3e3*3e E 3*3e3E3e* ******** THANK YOU 'X3
3e3e3E 3r ***'**********R************
SPECIAL CONDITION CHECKLIST
Project
Address: Project # Use:
Dept:
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other
Date:
Condition:
Special Insp. Final Report
Hydrant( )
Lock Box .
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
'nit:
(in)
Appr:
(out)
THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing: Plans pulled for 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.
Plans returned: Received by:
No response from owner/contractor - plans destroyed:
Date.