1990, 03-12 Permit App: 90000817 Sewer SPOKANE COUNTY DEPARITMENT OF BUILDING AND SAFETY
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.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
R€..1:.1E:.t.: ? NUMBER= 9000081 ;,('1- '?
90 PAGE= Oi
APPLICATION.
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SITE STREET= ... 12TH AVE ,'• ? •• I
34
ADDRESS= SPOKANE WA 99216
$'$..:Fti;:$:•i I.J5F:= SEWER i:`ONNECTi:i.ii:J .... 8804
PLATO=
_ fTr= : , 9999 PLAT
.fi NAi $ sRANGE
AREA= 00000000 $::',A:::: E WIDTH= DEPI L.$:::: $:;'
OWNER= $ ;F;:Ri'7i.ii'4, MERi A PHONE=
STREET=
ADDRESS=
SPOKANE a ,
•
16
BUILDINGCONTACT ! EOA.i:••RI) F•$ C' F HO . E NUMB :'R= 509 `926 8964
FRONT= ��J , NARIGHT.... JA; REAR= NA,.
:n:'P:.'N:P:)C•P:•P:i{..y!..}!?.}¢.i,:•!k•R:4k•i*•R•,C:k•P:9,:a4*to:.P.:4..1!r};* SEWER i',:..?,??.?. ? t:•Pr•1'i•}:Pr i!k•1:a:•i�:*h:•i:c:'i:*'i:•:L••i:{:•n:1:'i:•P::k::•t:::':•.:'P:
CONTRACTOR=
C # -FoCTCR_ H r CONSTRUCTION
N , Rt : $ 1iFFi ,E : ) 926 8964
STREET= 11847 .
,,..
A1)DRES4::r. ,`>i-'O$i,i..i€<'. LIrt 99206
ITEM• T)$:::Sis RIPfION QUANTITY FF•#:::F.E AMOUNT
PROCESSING FEt::' ,f: # 0,.0(;
SEWER i:::ON',iEi:;T I ON I 40 , 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT i:i,. . ;°'.:
SEWER PERMIT 50.00 00 50,00
50.00 .00 50.00
PROCESSED BY : JULIE ;HAT;.O
PRINTED BY : ...IULIE SHATTC:I
SEWER ;,..i•I..B AE—BUILT INFORMATION IS AVAILABLE AT T$..$$: COUNTY
UTILITIES DEPARTMENT (456....3604)
CONTRACTOR ORAPPLICANT IS i GO F"IE$_.E) LOCATE AND CONFIRM THE
ELEVATION AND`; POSITION OF SEWER STUB I''t'',.L.. TO f•i Ni OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
BEFORE- CALL YOU (456-8000)
SEWER . i it 5 ;iTO BECHECKED PRIOR € iCONNECTION tCINSURE
THAT THEY ARE CLEAR AND 3Ni : "Tiii " i ` : THE
SEWER MAIN
),..i;.*:u.:,k).•)*)L••R CALL F i:1 R .$:ie s P E::i::•.X.:$:C I f•J PRIOR E$�;__TO COVER .k i!:•ii•'a::: :
K******** ;•.:' HOUR NOTICE F=:$:::i i I..r $:Fi i::.D **x*******
.. .. !.•s ""d<"'`4 P:'t L'*'it)i:N•9:ri'i*P:
..........::............. ...... ...........: ........).)...).i.).) t •k•
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JOB ADDRESS: �" �� C C / 0 L'l
SUBDIVISION: "Q-:)"a-S Ilia (.-3�( / LOT : BLOCK:
OWNER: ill PHONE:
ADDRESS:
CONTRACTOR: r�
�'' PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: