1990, 09-26 Permit App: 90004903 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 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 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 OR AGENT DATE
PROJECT NUMBER= l
d0` r7i3 DATE= 09/26/90 PAGE= t'1.1
APPLICATION
a F F't • •-.,:T I i N :..f.�.! .f .... t i f i r t r r
•)+:it-)+:'A:•P•JL•:R•t(-:+t-7+:1h lt''!t•it•1±:it•!}.ri-y!.7'•:1:.:e(•}i-ik li-j¢;+i••1t•j±;ji• ¢•!1'1"I....I.t.:f^t 1 ... .. ry ik 9:7:9:•i:•R X�:••):It 9:}t•9:)!•h:1{If•)'.jF.9!•')�9t):P•A•SE):9t:h.H•i+:.)i..A:
SITE ETREET= 12906 E 9TH AVE PARCEL4= 22543-0439
hl;.. ;.?i'{:I::.�k,.. SPOKANE WA 99206
PERMIT USE= EEWER CONNECTION — 0001
FLA-10= ?_ 296:
PLAT !'?Ai`1E:.:::: lsl(:i,..±:..,.;:(.:,,i.1 PARK (•i 17,,{1
BLOCK= 4 5
AREA= k - ?; ; ?. a 1 :� : LWIDTH= a?EP••i•L.Il: i::= -i_•i-:: 50
•±,- t.11•• BLDGE= 0 DWELLINGS= i
OWNER= MILLER? fl & iti I::I..It!.•I1::.'::
J'ty.•i I::: 9TH AVE
ADDRI::.,:';:::: SP'`OKftNl::. WA 99206
CONTACT
NAME= LEONARD ^ PHONE NUMBER= 509 926 0964
7 FRONT= NA e'?fi RIGHT= t?f.:! REAR=( ... Nf.`.•i
')t•-H:•hi'Ai•l+i•R•')4••Pi 9i••7+:•-?+i.jl..At P••)t••)+r-jti?+i•R'•)+:ini-)C 3+:•R•b:*.jt..jt•A: } I t•• , PERMIT :+k N•'Pi-Ai-Pi i>:'!+i'Pi::+4 i±i•R•-P1'A'7+i•)t'A:i±++i•Pi inr'P:•Ni•P:••Pi•)k•P:-A:'P:•A:•A:'!h
CONTRACTOR= I . icNe _Ric - IorPHONE= 509 926 29 64
,> i 1":E:.E:: i:::: 11017 I: Vf-iI...I...I::.z I,it=1? AVE
ADDRESS= S , . 99206
f.':jT�1it��:�::.,.r,.:.... .��-�(��FA�ii� I-: (r.,A'•'i
ITEM DESCRIPTION QUANTITY ±
i` O( E "NG FEE
10,00
SEWER CONNECTION
i 40,00
±}:1
PERMIT TYPE E E E:.E AMOUNT i A tl..jUNI PAID AMOUNT T {. 1, ING
EEWER PERMIT 50.00 ,00 50,00
50 50, 00
PROCESSED „F1 .,.,._ SHAT
1 OF
PRINTED BY : JULIE SHATTO
. SEWER STUB I_iB f"ji,—is{U I:L..t INFORMATION 1.:`, AVAILABLE fS THECOUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR c:IR APPLICANT I TO FIELD LOCATE AND CONFIRM THE
ELEVATION I.tiAT'1:Ori Ai 1 POSITION OF
EXCAVATION
TO LOCATE E URa.E".o CABLES, GAS PIPING, WATER F:R L INES , ECT,
CALL BEFORE±R1::. !C:IU DIG (456-8000)
:::1::.i:sl G:.I't STUBS A•i R I::. TO i B h:. CHECKED PRIOR
TO CONNECTION TO INSURE
THAT
THEY iibE:. CLEAR AND UNOBSTRUCTED TO "T";Ii:_ SEWER Lir.l•c MAItr
/t•ia•A:•A:•A: ..n..A* CALL ,..i..i R INSPECTION PRIO11. TO COVER x****•n:u*A-
y{..j,.**•)±i i i ti•ji-•jr 24 1.-1(.)1;R r (I t .1.i.•I" R E t:{(.{I R i::.t? ***** *K
: ........A..}... 456-3604 ..•)t••)k.....•..•....•H:)+r
-,,. you :i:}.:•... {.:::(.••.:r.0 iE::P N):.+.1:}t. ). )L)E P)!)l3...-hr**)k•e•Ni
.... 1± 1 R)rJ J?1 9t 1: ,.....:... r. ............ .
"k 9t P:$t•t4 4t••JF 9t•-)b 7`.•9+i 9t•.Jk 9±.�9t•9t.i'r 9•`.9:)`:9:9k•):9 r i:.::::):•i i i i�i St 1 I'f{-•i 1'J it. Y tJ C.! .
•
JOB ADDRESS: I 3
SUBDIVISION: G�
1� �D
� 3 � LOT: 6 BLOCK:
OWNER: /
A L ) PHONE: 1
r
ADDRESS:
CONTRACTOR: /7 PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: