1990, 03-23 Permit: 90000817 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
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
p0 +C1f ( !_ 9000001 '7 If1 0:3/77.7 '
'l'i PAGE= oi :
7JrZy} jj *? 7 : 7fc: 9 : 7 : : : M :Y: : PERMIT ItiCRM" rilv 9999 !4tJ "*
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SITE S {f'1 t:.i::. ; '':: 12625 1... 12TH i.a :E P A 1_4= 22543-9i`I .y.<.y
PERMIT USE= ,..!tilt::::S: CONNECTION '••• ::::01
•x** S E E NOTE ii•i3:ii'
RANGE
!''l...i•�1 I •x. _ 999999 t'L..f•�t T NAME=
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_ N' ` GRID Ii ; :
AREA= ( ' co - WIDTH= DEPTH=: !..
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OWNER= I..iAlRR?:ILJ's„ : li'iI":Et'j`~f Y PHONE=
ADDRESS= P O K N E W,i A I 992 t ...
CONTACT Ni"YME:::: !; EOfNA#:i;D .... H _ PHONE NUMBER= 509 `%...... 0964
BUILDING SETBACKS : FRONT= NA LEFT== lidA R..Lxl"jT:r.. ItF•, R,::.A:;,=,..... NA
******K********** *********** SEWER I• ER1`'t t N**')t*'1.'bi'Pi***3.''p;*i„i'ni !;*i`- *1.),i s,.'* 'A••hi•Hi?,:;i3;
CONTRACTOR= L.# r:- .11 CONSTRUCTION PHONE= 509 926 8964
,:.;TREI.....T= 11817 I::. %'i-;I...I...E::'t f it i•``t''Y' AVE
E
ADDRESS= SI`l::i lC(1 f'-v E:: WA 99206•
CTEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESS10.00
:::'EWER Cf::NNEC�.�..I.�:1NNG FEE - i 40,00
a ;A (D {: +* !P ! ! ;5ii* t ! ! ! {: „*P*„; 3PAYMENT SUMMARY ; l$ iifii & .„ 3 P .i .ipjlP ) 3 ; i„ i .
l ' ; N T D i _, i . II : f 8PAYMENT
i::Er•`if:tf,Ij•vT
03/23/90 } n... :.} 50.00
•
TOTAL Ail... !JI_ft:.-:: :J,:J TOTAL PAID= 50.00
PERMIT FEE AMOUNT " 'fl ' _ PAID A 1 Ci T OWING
i f
„
SEWER PERMIT . ; 50.00 00
50.„()0 50 :.OO
PROCESSED BY :: ,.3U1...IL:. -,::t'ifji i t t.i
PRINTED BY : JULIE SHATTO
SEWER : :.: AS—BUILT INFORMATION IS
AVAILABLEEAT HECOUNTY
UTILITIES DEPARTMENT r456 "3604e
CONTRACTOR OR APPLICANT IS TO FIEL.:0 LOCATE AND CONFIRM THE
t`I..EVFYT .I.t.li••': Ai' i:? POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO i I t. t.: t 1::. BURIED CABLES, 1 Y t, . PIPING, WATER L. .I.'r=):::,.> ; ECT .
r
CALL BEFORE YOU
SEWER STUBS ARE:: TOi E C: i1 EDPRIOR .n:7 CONNECTION TO INSURE
THAT ; t';;::.Y • i•:EI•:.{::. CLEAR AND i.tNflB T Rf.fC:T 1.-:T? TO THE •t.l:_fi,#1_'i MAIN
•.,.3,.k n N.!!J•.r.o. FOR INSPECTION PRIOR TO COVER •ti 3i•*•i.•:;:?, n u);3r
iA ty724 1ti RNOTICE REQUIRED 4
lPr 1 , 73 ) 9
.... ............ .. 456—'3604
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