1991, 11-25 Permit: 91007176 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 91007176 ISSUED PFRMIl" DAl'E= 11/21;/91 PAGE= 01
p x3t if* a xuxxx xxxurlx Rxxx
PERMIT INFORMATION-x*zxx���iE4R####ii 3E R##"r, #tF iiuxuri
SITE STREET= 10112 E STH AVF: PARCEL.:.= :0544-0545
ADDRESS SI'OKANF. WA 9921.6
PE::RMIT USE= SEWER CONNE:CIION -- I.11 IF) BB02
x it .SEE NOTE ***
PLAT '= CON'VRlPL..AT' NAME= CONVERTED CNTY DATA
RILOCP=: 1...0T=: ZONE:= LINK DIET»::= F.
AREA= 00000000 F/A= F WIDTI-I= DEL PTH= R/W==
OF BLDGS= 1 '- DWEL.I.INGE=: 10 WATER DIST =.
OWNER=: LEWIS, PHI:L.. PHONE== 509 32£3 1910
STREET=: 10112 E 9TH AVE.
ADDRE.S'S: SPOKANE WA 99216
CONTACI" NAME= STEVE -- CRISP CONST" - PH0NFI NUMBFR= 509 '534 1>0'r
BUILDING SETBACKS FRONT= NA LFF'r=:: N>5 RIGHT= NA REAR:: NA
rcn sxx slc x"xxnxx"" uu..x..0 u" xxxxxrrx;t SEWER PERMIT x..y..KIf it xx"N NMii. §..y..rt xx xx xxxxA ':e: xA
CONTRACTOR::= CRISP CONST RUCTTON TNC PHONE !:109`;34 1505
STREET= 3608 E 5TE1 AVE
ADDRESS':::: SPOKANE WA 99202
]:TEEM DES'CRIPT1:ON 4UANl"1:1"Y FEE f: AMOUNT
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
xxxx xuxxxxxxrrmxxxux;tuxxxx•xx-x+E PAYMENT SUMMARYx ax*x*iFx xxxxxnxxx rt. u. u..xuxx,F iFx
PAYMENT DATE RECF..:EF'T4 PAYMENT AMOUNT
1'1;25/91 8995 50.00
...........................
'TOTAL DUE::: .00 TOTAL PAID= .`.50.00
PERMITIYF'E FEE:: AMOUNT AMOUNT PAID AMOUNT OW1:NG
.... .... ._.--- _......... _._"_.... .... _.__._.. _..____._._._. ....____.___.__. _..rt_ ___.. .............---
SEWER PERMIT 50.00 .`:50. c.0 100
.. _....___........___..___ ... _...._____........ __.____...... .... .... .... ... .... ..___
50.00 50.007 .00
PROCE:S2iED BY: JULIE SHATTO
PRINTED BY. DOMIT'ROV'.T.CH, ROBIN
SEWER STUB AS—BUILT INFORMATION IS AVATLABILF. AT THE CnUNTY
UTILITIES. DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT 1:9 1'0 FIELD LOCATE AND CONFIRM THE/:
EL.EVAT.TON AND POSITION OF .3FWCR STUB PRIOR TO ANY orliFIR
17XCAVAI ION
TO I_CICATE BURIED CABL..EL.'i, GAS PIPING, WATER LINES, EC.T,
CAL..L.. BEFORF- YOU D:LG (45,6 8X000)
SEWER STUDS' ARE TO BE CIIE'CKED PRIOR 10 CONNF::CTInN TO 1'N9URE
THAT THEY ARE Cl EAR AND UiNOBETRUCTFD TO THE -SEWFR MAIN
CAI...I... FOR TN.SPE.CTION PRIOR TO COVER nx xxxxxrnx
uw ;tx �; at iix 24 HOUR NOTICE REQUIRED uua'it xxx rt xa
xxxxxnux 456-..3604 x;nxx karrxiF
ii i4 ii 3�: iiriiFM Rxi*x)h#iF 1f#u #ii 3F Tic#3i of ii ii-1i#kri THANK YOU iiiF x##ria nxx i}x;f ii ii irk#�kri-ri#k###�x kiiri#kri
Project
Address:
n<.m
SPECIAL CONDITION CHECKLIST
Date: , Condition:
THISSPACEFOR
Date received for C/O processing.
Temporary C/O issued.
Office file review by:
Filed insp finaled by:
Ninety days after C/O Issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed
PLANSTRACKING, CERTIFICATE OF OCCUPANCY ONLY
. Plans pulled for final processing:
—. Certificate of Occupancy issued:
Date:
Date:
Date:
. Received by:
n)
(out)
Special Insp. Final Report
Hydrant(
Lock Box
_
Rib/CRP
Easements
Toad Plans/Improvements ._
Bonds
Bonds
Double Plumbing
JLID
THISSPACEFOR
Date received for C/O processing.
Temporary C/O issued.
Office file review by:
Filed insp finaled by:
Ninety days after C/O Issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed
PLANSTRACKING, CERTIFICATE OF OCCUPANCY ONLY
. Plans pulled for final processing:
—. Certificate of Occupancy issued:
Date:
Date:
Date:
. Received by: