1991, 12-04 Permit: 91006329 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 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= 91006329 ISSUED PERMIT DATE 12/04/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET:: 13203 E 12TH AVE PARCELO= 22544-1223
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION - WOLFCREST
*** SEE NOTE ***
PLAT= 001670 PLAT NAME= MOORE 'S PARK SUB.TR. i 54, VERA
BLOCK= 2 LOT= 10 ZONE= AGRI DISTI= F
AREA= 00000000 F/A= F WIDTH= 90 DEPTH= 142 R/W= 45
OF BLDGS= : DWELLINGS= i WATER DIST =
OWNER= MENKE, RICHARD M PHONE= 509 924 0855
STREET= 13203 E 12TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** 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
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT PAYMENT AMOUNT
12/04/91 9184 50.00
TOTAL DUE= .00 TOTAL PAID= 5000
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT___ _- 50.00 50.00 .00
50,00 50.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : DOMITROVICH, ROBIN
SEWER STUB AS-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 LINE=S, ECT .
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION 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: Init: Appr:
(in) (out)
Dept.of Bldgs,
Special Insp,Final Report
Hydrant(
-- Lock Box
Engineers RID/CRP
easements C :-;..11 '1; Y.:: 0 t- tjLv
Road Plans/Improvements
Bonds
A!!" 'A••!, •!t• • . czt—P T );::114 T iv,
--4-4 1 (V.? ..;
IA A
ff.) c:7., ;,1;:".', J2,
4 4.4 y Af•
Planning , Bonds
7: A:A c) :::.71i.•!if16 I'!I I !!!:„! • I*4
;:;;;:114 0 t ::;; ; j fl
f 4 : 1 1 1 T I \ e 0 47. ,,i(4
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: 7.;;; 1-11 4v1 T."4 1.4.:)!:1 1_3 10-0 (.10
f. -!! !•, !:!! VI 7'; 1J : ?: ;.?.
Utilities Double Plumbing
; fsi .2; .7114 ** 11: It It
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Other
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THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF.,QQ.PUPANCY ONLY
iJ ; I..; Ij Il. : l 1'71
!AO I
Date received for.c/0,processing; „. Plgtas.,pulled.for final processing:
: !•."4
Temporary 0/0 issued: `;'.-7.1 i T '
Office file review,13.y:.
• ,; ..; ".! ; .; , 21 I
Filed insp finaled by: !Ti•.•''!” ••••'! I.; • 0 I 4!! Dif614 V!l.!!!! a 14(4
Ninety days after C/O issna,ride: , "•: !;!%;!..."i!', . !!!! , T ";:•1. .;!!!!': .!
!..! •'' !!!;::: :;!•!;11-..f.
Owner/contractor called regarding the return of plans: Date: •
Plans r6tuitiedL T ! : ..!!!-I!!"• •:!.!!!'::--!:.!!...!iRecia..6d
4 2 2No response kin 9.Wrter4opntcactor.,!.!ptqnslesitfoyed;;..... !"! I II I
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