1990, 09-21 Permit App: 90004808 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= 90004808 DA'TE::: 09/21 /90 EAG' 01
IcATION
**113i**************** •ii**lelt*** APPLICATION **** elelk************ii•*ie** *****le •le
SITE:: STREET= 12407 E 14TH AVE F'AR:CE::L4= 22543-2307
ADDRESS=S::= SPOKANE WA 99216
PERMIT USE:-• SEWER CONNECTIO J '-' 8801
*** SEE NOTE ***
PL..ATM:w: 001392 PLAT NAME== K.OFMEHL. SUBDIVISION
BLOCK= I LOT= r' -2".ONE::= mE c:I.itr f:C;\TI:::::
yy
AREA= 00000000I /H:=: l::• WIDTH= DEPTH= 1:,/ Imo:
:. OFBLD
GS=GS'• I 0 DWELLINGS= •t
OWNER= HIC;t?IcHI , K & L.. PHONE=
STREET= 12407 E=. 14TH AVE
ADDRESS= SPOKANE WA 99216
1 1 / �' PHONE NUMBER=:: .`.?(:i ', 92A t: �64
CONTACT l�tA�f::::= L..E::':)t�r7F'.f• .... H & ...
rtt.):l.LD:ENG SETBACKS : FRONT= NA LEFT:::: NA RIC;HT:::: NA REAR= NA
9PPk ble le iAle e hlNk e PJe! *hPe e LSEWER ' :: ' . I 1 ******A** PPAe*****AAe 1e*.A.i
CONTRACTOR= H & S CONSTRUCTION PHONE= 509 926 8964
STREET= 11I:)1r I": VALLEYWAY r'A V E::
ADDRESS= SPOKANE WA 99206
QUANTITY FEE AMOUNT
DESCRIPTION�!
PROCESSING FEE T 10.00
SEWER CONNECTION 1 40,00
PERMIT .T.YPE:: F•E E AMOUNT AMOUNT PAID AMOUNT 1 W I N G
SEWER F'E::F{i''i:!:a• 50 s 01: .00 50 .00
50,00 .00 !.:50,00
PROCESSED BY : •..ihl...T E Sl•in T I II
PF;:!:i':C'f'E::T:, BY : ._)i..!1...IE S!••lATTC
SEWER STUB A,;'....T.:BU:t!...•T' INFORMATION TS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
)
CONTRACTOR OR APPLICANT IS TO EIE1i) LOCATE: AND CONFIRM THE
I::.I...E:.VAT .EC.)N AND POSITION OF `' r °
.E T:!:. J .F� ,.>l:::W I:::F? „::TUB !�'F�PRIOR!�� .T.C:) ANY J`r' C:)1 !•iE::R
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING , WATER ER 1...!.NE,.s , ECT .
!_:rii..!_. BEFORE-. YOU DIG (456---8000)
SEWER STUBS ARE. 1) BE C:l•IF.:CK.E:J.) PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR r''1l AND I.ii,iI•;;•. .,•T•Iz:I.il TI,_T•i TO THE SEWER I? I''ir='i:Ci•1
INSPECTION PRIOR TO COVER ..r.K..P:'P:'7L•*•A:•bi-p'
Pi**•N•****-;,i 24 HOUR NOTICE REQUIRED E). #*k**iL-***
********K 956x : " ' K*********
aA P n 1rhe 11 f L e 1i * c i * lrnl � nNW THANK YOU **1ee3leie9 . 1e3*lll . G* e I ) ellATe PP
SPECIAL CONDITION CHECKLIST
Project
Address: Project#—__ __ Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs. ^�—
_�_ Special Insp.Final Report
-----___ _ Hydrant( ) __.--
_------ �__-- Lock Box
Engiineer's _ RID/CRP
• Easements_
Road Plans/Improvements
Bonds
Planning •
Utilities T — Double Plumbing
ULID
Other
•
"—***************************THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY""****************************
Date received for CIO processing: —_ Plans pulled for final processing:---_---_---.-------.-----------_____ .___--
Temporary C/O issued.: _r _ Certificate of Occupancy
Office file review by: ____ •-_• — `Date. , • .
Filed insp finaled by. Date
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: -- -- ___.___.__.___.-__.__._-- Date:---------_-_____._____-----------_._____-
Plans returned: -____—.Received by: _ _-_-_--
No response from owner/contractor-plans destroyed:
JOB ADDRESS: _ 2/-/-1/1
Cl/
SUBDIVISION: ��� o / LOT: BLOCK:
OWNER: 1 ) /A J (� L PHONE:
ADDRESS:
CONTRACTOR: PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: