1992, 11-10 Permit: 92009967 Sewer SPOKANE COUN DEPARTMENT OF BUILDINGS N
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
;..•!.,:t i.!i••t. , NUMBER- 92009967ISSUED PERMITDATE= 11 /10/92 P A
GE= 01
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SITE STREET= 10716 E 12TH AVE PARCEL4= 45213 ,9062
ADDRESS= SPOKANE WA 99206
PERMIT USE- SEWER CONNECTION — OLD ORCHARD (92E-1149 )
PLATO- 999999 PLAT NAME- RANGE 1
v
DWELLINGS=
OWNER- DANNER, TOMMY PHONE= 509 924 9524
STREET= 10716 E 12TH AVE
f-'t`.!Dt":1::.:..+.. •• +.:E"i.3it.AAI::. Wf.:i 99206
!'+.'!
CONTACT NAME= EXCAVATION PHONE ii3MB...R. . . 924 9524
BUILDING SETBACKS : i'`:,' h'i LEFT= ±•t i f^: RIGHT= N/A i
:!i.:!iK :!::i.ai.s'.:i.:i.:i...3i***f*fi'f*fi'**"±.*f*'fii±±ifif±i SEWER
PERMIT .....**'hif*i'i:?P:f*f*fi.:)±iPififkfbf*'f±if*f*.....Pi*ll*i±:'P:f*
CONTRACTOR- f - -f: T L NE CONSTRUCTION HO` i = ", 9 3 ) : 5485
STREET= 16402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM# " DESCRIPTION ,li ! } iY FEE AMOUNT
PROCESSING 10,00
. WER CONNECTION ; 40 .00
.. ...... .. .... ........ .... ...:::...........::... ':i.:!'.:(.......... •.•�. i,_�;•.�..,. .'��i I m H.f•�'I t``'' l±:it f±:fi:f±;:fi fi;u;f±:f(.:±i.:!i.:u.:p,ft fi.f±.f±;ft..;n;fi,•f±::!±::u:f!:f fi
r•
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
50 ,00
TOTAL11 /10/92 157
iuiAL DUE= , 00 !.5,:::•) 00
AMOUNT OWING
SEWER
..,_, PERMIT 50. 00 50,00 . 00
.. .. ..00 50. 00 ., is?':f
PROCESSED BY : ?.•!t.iM.#. # Rt.it'I}..:f'i; i-''.1..??7IN
PRINTED BY : r)II N t._f i'':I,#`5/.!. ..•#"}: ROBIN
SEWER. ;:• t t..?1:� AS—BUILT_ .l.#'`��i i i'•'�'I ��i T�.i.?{''� .�.>:: AVAILABLE ('•'t_j. ..t 'i 1::. COUNTY
UTILITIES DEPARTMENT (456-3604 )
CONTRACTOR
_ v : ; OR APPLICANT iS TO
FIELD ` - CA' LCONFIRM
" =
ELEVATION AND POSITION " SEWER
_ AV TiN
TO LOCATE BURIED CABLES , r("I:.:- PIPING , li:?(.'t # i::.!"•. LINES ,
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS
Ti, ; rR: TO
,t# CHECKED
P : . ` E ? PRIOR
" Ii ` TO CONNECTION
i1 ?
i
SiRi
. : , Tr ;t . ; " . CLEAR AND± N n . • : , O r' SEWER : AI!
YPfi* ii!9 :9CALL INSPECTION " 1r TOCOVER f *ffi3ffpf
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EPS PAYMENT DOCUMENT
pr i SPOKANE COUNTY AUDITOR Change Onier#
Dept
Bid DD
VENDOR: SHIP TO: ELL To: Blanket#
Cuut.CmAINE CONSTRUCTION
102 EAST VALLEYWAv RC#
VEi;.ADALE , wA 99037
1.71#
Vendor Contact/Tel Corn-ming Order
FOB: PO DATE: BLDG/ROOM: BUYER
ACCTG.PERIOD: DELIVERY DATE: WAREHOUSE:
DONALD Li LABRECOU-
COMMENTS', ENTERED BY' PURCHASING DIRECTOR
COMM LN# I DESCRIPTION
COMMODITY NO REF ACCT LINE QUANTITY UNIT UNIT PRICE I TOTAL PRICE
0.000000
10.00 X 80% . $8.00
-, 2009967
40.00 X 80% = $32.00 0.000000 .'30
TOTAL :.
. .
I
LINE NO. FUND 1 AGCY ORG SB ORG [ ACT OBI SB OBI REV SRC SB REV I RPT CAT BS ACCT 1 JOB NO. PAY THIS AMOUNT PIF
. _k,)
PAN D TOTAL : ,-'1 •O(''
RECEIVING CERTIFICATION PAYMENT CERTIFICATION TRAVEL CERTIFICATION
Materials noted in quantity /have been I,the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim,the I hereby certify under penalty of perjury that this
received in good condition or contracted for, materials have been furnished,services rendered or labor performed as described herein or contracted for,that the claim is is a true and correct claim for necessary expenses
a just,due and unpaid obligation against Spokane County or fund agency indicated above,that I am authorized to authenticate incurred by me and that no payment has been received
-
SIGNED\- 1='------S-- and cectify to said claim. by me on account thereof.
... ,___—
TITLE SIGNED '..."--- ‘,..._ ,.... .-...— TITLE SIGNED TITLE
, _
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DATE /7/ DATE DATE PAGE
DEPARTMENT 2