1991, 08-05 Permit: 91002509 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 correctand authorize Sx 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= 91002509 ISSUED PERMIT DATE= 08/05/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 12905 E 12TH AVE PARCEL0= 22543-0829
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION - 8801
*** SEE NOTE ***
PLAT0= O02962 PLAT NAME= WOODWARD PARK ADD
BLOCK= 8 = 5 ZONE= AGSUB DI%T0=
AREA= 00000000 F/A= F WIDTH= iO3 DEPTH= 142 R/W= 55
0 OF BLDG%= i 0 DWELLINGS= i WATER DIET =
OWNER= WARD 0O ' REILLYL JOSEPH PHONE= 509 924 3623
STREET= 12905 E 12TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= LEONARD - H & S PHONE NUMBER= 509 926 8964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= H & CONSTRUCTION PHONE= 509 926 8964
STREET= ii817 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
08/05/91 529i 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.00 50.00 .00
------------- ------------
50.00 50.00 5O.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE %HATTO
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 (456-8000)
SEWER STUBS RE TO BE H TO CONNECTION TO INSURE
THAT THEY ARE CLEAR N %T D TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
4 1
*
SPECIAL CONDITION CHECKLIST
Project
Address: Project# _'Wme
Dept: Date: Condition: mit: Appr:
(in) (out)
Dept.of Bldg
Special nap. Final Report___
Hydrant( ) — — - -- -- --
Lock Box
Engineer's n0/CRP
Easements --
Road Plans/Improvements
Bonus
- — - -- -- ----- ---
- --' -- - --- -- ----
r|unning____ _ _ _' Bonds
} -- --- - -- --
____
__
--' - --! -- -- -- --' -----� ----- ---- - --- --------
-- - -- ----| — --- - -- -- ------� -- -- — ------
ummoa -_ Double Plumbing _
uL|o
_ ______
Other
------ - — - --'
__'
'^`^~~^~```'~``~^^^`^^`~`~TH|SSpACspOnCOwmsnQALpLxw3TRACK|wG.CsRTip|CATe0pOCCoPAwCYOwLv```~`~```^``'`^``^````'~````
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: - _ ____ __ _____--_ Duto: -----'
Plans returned: __ _-_ —____ ___ -__ _ Received by:
mnresponse from owner/contractor plans destroyed:____________-