1991, 10-31 Permit App: 91007429 Sewer SPOKANE 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 Sokano County to proceed with processing. In uom I have read u 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 local law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER onAGENT DATE
PR[�JECT HU !:1)O7429111111111111111111 DATE= i0/3 /9i PAQE ` O�
****** THIS I% NOT A PERMIT ******
PENALTIE% WILL BE A%%E%%ED FOR COMMENCING WORK WITHOUT A PE�MIT
--------------------------------------------------------------------SITE %TREET= i36i9 E 6TH AVE PARCEL�= 2254i -�634
ADDRESS= SPOKANE WA 99216
PERMIT U%E=
SEWER CONNECTION - SOUTH BLAKE
*** SEE NOTE ***
PLAT::; = 001669 PLAT NAME= MOORE ' % ADD
BLOCK= 2 LOT= 15 ZONE= AGRI
AREA= 00000000 F/A= F WIDTH= 89 DEPTH=
0 GF BLDG%= WATER DIST =
OWNER= CQRDNER WILLIAM J PHONE= 7942
STREET= 13619 E 6TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= H & % CONSTRUCTION - LEONARD PHONE NUMBER= 5�9 �26 3964
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
PERMIT ******************************
CONTRACTOR= H & % CONSTRUCTION PHONE= 509 926 8964
STREET= ii8i7 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM QUANTITY FEE AMOUNT
------------------------- -------- ----------
PRGCE%�IN� FEE Y i0 . O0
%EWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ _____________
SEWER PERMIT 50 . 00 .00 50 . 00
------------- ------------ -------------
5O .00 . 00 50 . 00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DGMITROVICH , ROBIN
%EWER
STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNT?
UTILITIES DEPARTMENT ( 456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER %TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES , 'GAS PIPING, WATER LINES , ECT .
CALL BEFORE YOU DIG ( 450-80OO )
SEWER STUBS ARE TO BE TG 'INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **** *** *
********* 24 HOUR NOTICE REQUIRED **********
********* 456-36O4 **********
******************************** THANK YOU *********************************
JOB ADDRESS: 6 , 1 3(0 9 I v v
SUBDIVISION: 005L//_(Z93/ LOT: /5 BLOCK: a
OWNER: /LLi AyL1 001a) \l
PHONE:
ADDRESS:
CONTRACTOR: 7�! CI00 5`7
PHONE:
ADDRESS:
LICENSE t :
INSPECTION DATE:
TYPE OF OCCUPANCY: