1991, 09-18 Permit App: 91005790 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
PrC . t , NUMBER= 91r0 _ 90 APPLICATION DA E= 09
: ! - > i PAGE= 01
* i EE N : ` t"t PERMIT ii'*li
PENALTIES WILL BE ASSESSED rI COMMENCING WORK WITHOUT = PERMIT
SITE STREET= %rs : 14 (H AVE
PARCEL4= 22544-2457
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION .... iul.�ii...t't":sil:::: ,
li'1?7E
SEE E NOTE .!P ii
PLATO= 002753 3'`3...AT NAME= VERA [ t[ j
BLOCK= 179 LOT=O 1 = A�(II�lE:::�: MFR jj��t!.{.ii i :N::::: �..
AREA={rAarrrrrrrrFt n_ 1Y
_ T t : _. ...I I r`th.:::: 400 OF :Si...r'�.t.t= 'S 'u' DWELLINGS=t t 1.NGS::: '1 WATER ER D1k1_ •-•
OWNER= t s c 1 ; PHONE=
3
AvE
ADDRESS= SPOKANE WA 99216
CONTACT
CNTA_ NAME= S] { +z SANITATION : friNUMBER= ..
9 926 4781
LU { LDING
(.:!�.:1`'i,«•t : FRONT:::: NA 1...Ei'-T NA RIGHT= NA REAR= NA
:`:•i::. 1 tai t
r:.'+::k•it:P:*. ...i?•it:F:•P:...R:3t;'%I:'P:'.`I:**it 1(!{Ik Jk*7t:)t•P: SEWER P E R M { *R•'h•*fi*.!:R'b:'14••i':•h::t•.'i 1h l•* ?.*}t 9k'1t.:ri.*•ii* !L••a:9t•
CONTRACTOR= SIMPSON SANITATION PHONE= 509
09 976 4781
7812 E BALDWIN AVE
ADDRESS= SPOKANE WA 99212
ITEM DESCRIPTION QUANTITY FEE:: AMOUNT
PROCESSING] NCY f'r 7 10.00
SEWER l'?_a l'�?!'•!e.:. .?.:E i j . 4t 0..0 0
PERMIT TYPE FEE AMOUNT AMOUNT PA]:I) AMOUNT OWING
SEWER PERMIT 50. 00 . t:t:i 50.00
::"" ri
50,00 .00 0.:00
PROCESSED BY : JULIE SHATTO
PRINTED B: JULIE
SHATTO T_,.O
SEWER STUB [aS....BUIE.. I INE'ORMAi i•ON IS ?e`" ATTHE COUNTY AVAILABLE
I
t t,.,. 456-3604
t ... r
?.i T•.I L..STIES t i 1::.I•.I..!ice:T l`I i::.N i 1 4 5 6_to,: 0:a)
CONTRACTOR OR APPLICANT IS TO FlEf...D LOCATE ANI) CONFIRM IRM t HE
ELEVATION ION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE E URIEf CABLES, i ♦ , PIPING, WATER 1INE4 ECT .
Cf•tLi... BEFORE YOU DIG (456-8000)
EI.4ER STUBS BEARE TO CHECKEDCHECKEDPRIORPRIORTO CONNECTION Ti isNSUi E
i— `
THAT THEY ARE CLEAR ttintD UNOBSTRUCTED TE::%? TO THE SEWER MAIN
CALL r,
;e H•�c it'ik fi:n:h:'!t i..:r••i i._L_ i�E.i E': �.t``;,:�E"E::C T I Ci N PRIOR TO COVER ''1c*•hr'br-'tE*fl'Jt:R.:p.
'P.'!?')I:)'j?')?'7?'*9t :•; HOUR NOTICE REQUIRED! 'Jk•R•),.1}•91'?k 4t it Jt•1l•
' ' t ;' ' -45,5-.3604 -ic'ik�/i'ii••......ri'ii
N'N:}L-91-31'i:'1:ik i�:
...'3' '.:,l.:.:•..�.:;•1'-.•1t:'l *'i 7!•*'l}k' THANK tv o u it:tt'•il'***1!•N•:�:)':Jt 7t•**:t•:1•:`:,t•;,l;*;•;t'•)£':!t tt**1t ji•;,F***
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