1991, 12-18 Permit: 91004957 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 Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or !opal law regulating construction, 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 00495 7
***************************3
ISSUED F'E:::A MIT DATE= i './16/91 PAGE= 01
PERMIT INFORMATION
SITE STREET= 13309 E 5TH AVE
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION — DRY LINE. ONLY
343434 SEE NOTE 343434
PLATO= 000970 PLAT NAME= GARY ADD
BLOCK= 2 LOT= 7 ZONE= AGRI
AREA= 00014000 F/A= F WIDTH=
OF EILDGS= 0 DWELLINGS= 1 WATER DIST
.*..*3434343434**313Fie#34R.*************
PARCEL;=== 22541-0207
OWNER= HANSEN, I FI
STREET= 13309 E 5TH AVE
ADDRESS== SPOKANE WA 99216
CONTACT NAME= TLC
BUILDING SETBACKS: FRONT== NA 'LEFT== NA
34.34343434343&343431.33**34.1i•.k..143F***3i**3F*34* SEWER PERMIT
DIST.a.._
DEPTH= R/W=
PHONE== 509 926 8233
PHONE NUMBER== 509 927 6760
RIGHT=== NA REAR= NA
34343434.34.343434343434343434.343434'H'343e3434343434'*3434343E
CONTRACTOR= TLC COA4STRUCTION &'HONE:= 509 927 6760
STREET= 13816 E 12TH AVE
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FETE 'i 10.00
SEWER CONNECTION 1 40.00
#343434.y.# 343434343434343434'ri•34#34343434#3434343434343434 SUMMARY.
PAYMENT ••1i�;434•�i43i•34�34�34�343434�3434�343r r4.ii..i43r 34��ir 1434 a�3r34**
PAYMENT DATE. RECEIPT:0 PAYMENT AMOUNT
12/18/9i 9533 50.00
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 ,00
50.00 50.00 .00
PROCESSED BY. JULIE_ SHATTO
PRINTED BY: DOMITROVICH, -ROEIIN
SEWER STUB -AS -BUILT INFORMATION IS AVAIL_ABI_.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 S'TUB,S ARE To BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
343134343434#3434 CALL. FOR INSPECTION PRIOR TO COVER ***3434#3434.1431
34#34343434##34 24 I-OLJR NOTICE REQUIRED' 3431.3434343434343434
34343431343343434 456-•3604 *3434.3434.3434343434
3E344343***3F3434343434* 34 34434.34 34 34 34 344 3E34343434343
THANK YOU 3434343434343434.34343434343434%34343434*3434343434343F3434343f34
C.•
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SPECIAL CONDITION CHECKLIST
Project.
Address: Project # Use'
s..
•
•
>a -
Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
vv
RID/CRP
* Easements •
Road Plans/Improvements
Bonds
•
Bonds a '� G•.. t. ,� .,;,
Init:
(in)
jr
!t
r1(A
Double Plumbing
ULID s
lci
a '..
Y;
r
8l'.
1r,
4'.
'
Appr:
(out)
_THIS SPACE FOR COMMERCIAL PLANS TRACKIN.Cz, CERTIFICATEpF?dCCUPANCY ONLY
{
Date received far CLO processing'
Temporary C/0 issued • - `" - Ceftifid'ate of Occupah6y'issuedt
Office file review by: Date:
Filed insp finaled by: - " Date:
Plans -pulled .for finalprocessing-
Ninety days after,C/O'issuance: r '3 -
•r t"
Owner/contractor called,rega'$dipgthe return of -plans •� " - Date;
Plans returned -a. t a :.'. Y' ... . 4CReceiJeil Ty: l c a.. it
i 4:kf�G2:A•n-t
No response from owner/contractor - plans destroyed'
M1 F 'v a..r N r. 'E 5 4 ., e • i L
Dept. of Bldgs.
Engineer's
Planning-
�-
•'
ter. -t 't..
.. 1. .
Utilities
Other.
... ,::..
>a -
Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
vv
RID/CRP
* Easements •
Road Plans/Improvements
Bonds
•
Bonds a '� G•.. t. ,� .,;,
Init:
(in)
jr
!t
r1(A
Double Plumbing
ULID s
lci
a '..
Y;
r
8l'.
1r,
4'.
'
Appr:
(out)
_THIS SPACE FOR COMMERCIAL PLANS TRACKIN.Cz, CERTIFICATEpF?dCCUPANCY ONLY
{
Date received far CLO processing'
Temporary C/0 issued • - `" - Ceftifid'ate of Occupah6y'issuedt
Office file review by: Date:
Filed insp finaled by: - " Date:
Plans -pulled .for finalprocessing-
Ninety days after,C/O'issuance: r '3 -
•r t"
Owner/contractor called,rega'$dipgthe return of -plans •� " - Date;
Plans returned -a. t a :.'. Y' ... . 4CReceiJeil Ty: l c a.. it
i 4:kf�G2:A•n-t
No response from owner/contractor - plans destroyed'
M1 F 'v a..r N r. 'E 5 4 ., e • i L