1991, 12-11 Permit App: 91008561 Sewer SPOKANE COUNTY DEPARTMENTOF 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 submittedu mm compile said permit/application permit/applicationis 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= 910O856iDATE= 12/11 /91 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
----------------------------------------------------------------------------
%ITE STREET= 133i9 E iiTH AVE PARCELO= 22544-1406
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION - WGLFCRE%T (91 -%i34)
*** SEE NOTE ***
PLAT4= 000973 PLAT NAME= GEORGE ' S SUB
BLOCK= i LOT= 4 ZONE= AGRI DI%T0=
AREA= OOOOOOOO F/A= F WIDTH= iii DEPTH= 143 R/W= 50
0 OF BLDG%= i 4 DWELLINGS= iO WATER DIST = VERA
OWNER= COLLETTE/ RON PHONE= 509 927 9371
%TREET= i33l9 ! ! IM AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= COURCHAINE EXCAVATION PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
***************************** SEWER PERMIT ******************************
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
STREET= 16402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- --------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
SEWER PERMIT 50 00 .00 50 .O0
------------- ------------ -------------
50.00 . 00 50.00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DOMITROVICH, ROBIN
SEWER STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES , GAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8O�0)
SEWER STUBSARE BE CHECKED R TOCON ECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
•
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept,of Bldgs.
Special Insp.Final Report -----_-_--
____ Hydrant( ) -
- — — Lock Box
Engineer's _ RID/CRP
Easements
• Road Plates/ImfSroJerfients
Bonds
Planning_ — Bonds__ _ _� —
•
Utilities __ Double Plumbing
— ULID — ,—_
Other
•
"------"--"--.THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY """"""" """'"'
Date received for C/O processing: __ Plans pulled for final processing:
Temporary C/O issued:__— . Certificate of Occupancy issued:
Office file review by: _ —__— _ . Date:
Filed insp finaled by: —_____—__ ._._._ _ . Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: Date:
Plans returned• --_----_____-- --__._-- Received by:
No response from owner/contractor-plans destroyed:_--_