1991, 08-27 Permit App: 91005255 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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
= 1005255 AP i. .:i.. .:`.i DATE= 08/27/9i/9 PAA;:"::. t.i`i
...... THIS IS N i;'•t r:; PERMIT :!i ii tr it ii•*WITHOUT
t,' . : ' sE , .• r,r•• WORK •i PERMIT
SITE S I rt :.E ! = 13105 E::. 9TH H AVE "`r:a t`t.........,1--•• 22544-0823
ADDRESS= SPOKANE WA 99216
v y�
PERMIT USE= SEWER CONNECTION! _.+..!!`•� DRY LINE i.i!'`l....?
**9t• ::i i::.I::. N t.! 1 I::. H•f*.•9k
PLATO= 002404 PLAT NAME= +:!i"t ME R ! o-'i A D jj TO (n1OO ,j;,j A r;'t! PARK
•+ r ....
BLOCK= LOT= LONE= UNNN 0, :,. K ,_
H;,,i, . t;1 t'j 4/!::t'1 1.1 C1 t.1 F/..= - DEPTH=
50
BLDG
S='.'1 x.I...._tv:.s.... ,!- DWELLINGS= 'I WATER I::. -. , ....
OWNER= STACK , JAMES PHONE=
STREET= 13.105 E 9TH AVE
ADDRESS= SPOKANE WA 992.16
CJNIACT NAME= Ti
+ ?. » PHONE
NUMBER=
^9 i if 6760
BUILDING SETBACK : F.-iON :: -LY. NA RIGHT NA REAR= "
i i ) k: u *1A: i Y k*11t h Ji1 !7 ; ; t i . . +ER PERMIT
FRMI , A1 +1i t r: i i ; k {) t k t.1tt bP*
*) { l t E
CONSTRUCTION
CONTRACTOR= TLC PHONE::: ..?t:9 .:a2 1' r', f60
r
Ti;i:
STREET= i ;:; ii i 12TH AVE
ADDRESS= SPOKANE WA .99216
ITEM )CSCRITI » N QUANTITY F Er AMOUNT
:: t cIy
I''1•il�t_:1..._:>>.I.1�ts FEE!':. ( 'l i:1 t;1t;/
SEWER CONNECTION 4, .. i::t i i
PERMIT TYPE i::E AMOUNT i i AMOUNT PA-i.t: AMOUNT OWING
SEWER t. F"•'.:.RI"1i. i 50,00
!,;1,1::1'•f:1 .ti:/0 50. 00
50.00 .00 50.00
PROCESSED B , . JULIE 4 1«!f•'i s I t.:
PRINTED BY : •..I1..!I. .1:I.:. SIH€ i TO
_
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE (3 THE I::. +..: .14.#I`•-i I 'z
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR
tN VihCTOtO APPLICANT . S TO FIELD iI ? LOCATE x
, - � �D
CONFIRM • #
ELEVATION
t.:#I'4 i? POSITION i::i i�• ,..,.:.i, r' STUB PRIOR `'r OTHER
, r
EXCAVATION
TO LOCATE BI . D CABLES, GAS PIPING, WA ELINES, ECT,
't:
C r•#5...,._ BEFORE YOU ._r a.is 456—!:.3000.
SEWER STUBS ARETO BE CHECKED " ti1tR . CONNECTION
ON'E ,_ IO1T f
INSURE
THAT '1I-il:::'v` ARE CLEAR AND UNOBSTRUCTED TO III':' SEWER MAIN
u:•1 1 •n h 1i>: }! h. CALL FOR i c .,. .SP1::.C! .I.>..:fN PRIOR TO COVER •r:*1+:•n•n:•x a•*x hi•
.1r yr•r.•*•r•*is 24 3'1 O .! '; !! ! .I.t.t-. REQUIRED •1+::;:9�!t!`:K�94 9t.1;Ft•
„, .
'R•'!+&�N:�:•-Pi h,;;1,;•j;•j{ i}Ci.^}...- 1�}!.!4 •Pj'P•i+:i;k;+i:`+i•1G:ni•i!i*
1 : , n* ttr t1p9 ' t} .4 . ; ?^ ltj *jjjiiiiTHANK YO; t : ix1 e
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