1992, 05-29 Permit: 92003833 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 OWNER OR GENT " , DATE APPLICATION
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ADDREES= SPOKANE WA 99216
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AREA= 00000000 F/A- F WIDTH- DEPTH=
OWNER= BERGHEIM ,
ETREET- 13420 E 9TH AVE
ADDREFE- SPOKANE WA 99216
CONTACT NAME= RANDY BERGHEIM
'•S'+11::. NUMBER- .. _..BUILDING EETBACKE : FRONT= .. _ ..
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LEFT=
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CONTRACTOR- OWNER PHONE-
PROCESSING FEE 10 , 00
FEWER CONNECTION 1
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PAYMENT DATE RECEIRTT, PAYMENT AMOUNT
05/29/92 4031 '10 , 00
................................................
TOTALTOTAL DUE= ,00
PEHMii iYPE AMUUNi AMOUNT PAID AMOUNT OWING
EEWER PERMIT 50,00 50, 00 ,00
50,00 50 , 00 , 00
PRINTED BY : DOMITROVICH, ROBIN
UTILITIEE DEPARTMENT ( 456-3604 )
EXCAVATION
TO LOCATE BURIED CABLE , GAF PIPING , WATER LINEE , FOT,
FEWER STUBS ARE TO BE CHECKED PRIOR TO CONNEOTTO TO INSOPE
THEY APE C! FAR ANn HNOY:{:-::TRHflTrn Tn THE EEWER MAIN
,
OR INSPECTION PRIOR TO COVER
24 HOUR NOTICE .. is ..,: