1991, 12-18 Permit: 91007095 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, stthat the information contained iitand submitted u agent ocompile said permit/application Is
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 %yhether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certif icates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any Mate or Local lawtegthatinti construction, or as a warrapty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER VRAGENT DATE
PROJECT NUMBER= 91007095
ISSUED PERMIT DATE= 12/18/9' PAGE= 01
***************2************* PERMIT INFORMATION
%ItE STREET= 13518 E 5TH AVE
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION - ULID 903
*** SEE NOTE ***
*******A************'*******
^ PARCELO= 2254i^864i
`
PLATO= 801678 PLAT NAME=-MOORE'S PARK %UB"TR^154,VERA
BLOCK= 2 LOT= 7 ZONE= UR -3^5 DI TO= F
AREA= 88888888F/A= F WIDTH= DEPTH= R/W=
^
0 OF BLDGS= 1 0 DLLING%= 1 WATER DIET = VERA
,OWNER= BERGESON
.
STREET=. 13510 E 5TH AVE
ADDRESS= SPOKANE WA 99216
PHONE=
CONTACT NAME= TLC PHONE NUMBER= 509 927 6768
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
*****************************
SEWER PERMIT.
CONTRACTOR= TLC CONSTRUCTION
STREET= 13816 E 12TH'AVE
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION
PROCESSING FEE
SEWER CONNECTION
******************************* PAYMENT
PAYMENT DATE
12/18/91
TOTAL
DUE=
**********a*******************
QUANTITY
SUMMARY
PHONE= 509 927 6760
.FEE AMOUNT
10.00
48^88
****************t***********
RECEIPTO PAYMENT AMOUNT
9533 58,88
------------
^88 TOTAL PAID= 50^88
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--- ---- -------�~~~`~ -----
SEWER PERMIT PERMIT 58'48 58^80 ^88
--~------.-- --------�r-- -----�-------
58`88 58^80 ^88
PROCESSED BY: JULIE SHATTO
PRINTED BY: DOMITROVICH/ ROBIN
SEWER STUB A% -BUILT IWFOBMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (45G=3684)
CONTRACTOR OR APPLICANT if
TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION. OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCsiTE BURIED CABLES, GAS PIPING, WATER LINES, ECT'
CALL BEFORE YOU DIG (456^8080)
SrWER. STUBS RE 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 **********
********* 456-3684 **********
*************a****************** THANK YOU.******k**************************
1,
•SPECIAL•CONDITIOP4 CHECKLIST
Project
Address: Project # Use:
•
•
v..
__._.
Dept. of Bldgs.
Engineer's -. -,.
-. s..+.
o.....
..
•
Planning
Utilities
.
Dther. ...
..
....., ...
_��.
r
Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/ORP x'" `x •. .. p. x+#?er•:
Easements
.Road Plans/Improvements
Bonds .. ,..,, ... ,
u
Bonds
!nit:
(in)
Double Plumbing - •-'
ULID
v
•
Appr:
(out)
"THIS SPACEFOR COMMERCIAL PLAN?, TRACKING;6ERTIFICATE 9FOCCUPANCY`ONLY•
Date received for CIO processing:;•
Temporary C/O issued -
Office file review by:
••Plans canted for final processlrig.
Certificate of Occupancy issued- A
Filed insp finaled by: Date:`
Ninety days after C/O issuance - -...' ' • , ' 1 r q
Y r ' z` k
Owner/contractor'called regarding the return of plans: " r . - ,Dates •x
Plans returned: - Received by
-Noaesponse,from owner/coritractor,- plans destroyed: