1991, 08-01 Permit: 91003554 SewerSPOKANE COUNT" PARTMENT 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= 91 003 a.54
ISSUED PERMIT DATE= 08/01 /91 PAGE= t')i
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SITE: STREET= i0r1:3 E:: 19TH AVE::
ADDRESS= SPOKANE WA 99266
PERMIT USE= SEWER CONNECTION .... NORTH KOKOMO
>i•,t SEE NOTE i *•>t
28542-4310
PLATt= 002393 PLAT NAME= SKYVIEW ACRES 1 T ADD
BLOCK= 3 LOT= 8 ZONE= AGSUB DIET:„::::: F_
AREA= x:;0000000 F /Et= F WIDTH= DEPTH= R / W-:
0 OF S:t i... D (Y = i : DWELLINGS= i WATER DIST :_:
OWNER= E::VANS , C'F..ARK.
STREET= 10713 E 19TH AVE
ADDRESS= .SPOKANE WA 99206
F'FioNE::==
(CONTACT NAME= JIM NIELSON PHONE NUMBER== 509 924 60??
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= Nf'`•!
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CONTRACTOR:::: J.R. II CONSTRUCTION
STREET= 10504 E:: VAI._LE::YWA Y AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION
PROCESSING FEE
SEWER CONNECTION
PHONE.=:: 509 924 607.
€ UANTITY FEE AMOUNT
Y 10:.00
40,00
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PAYMENT SATE RECEIPT* PAYMENT AMOUNT
08/01/9i 5236 50,00
TOTAL DUE= .00 TOTAL PAID= 50,00
PERMIT TYPE:: FEE. AMOUNT AMOUNT PAID AMOUNT OWING
SEWER F':FN.IT 50,00 50.00 .00
50,00 50,00 .00
PROCESSED BY: JULIE SF•IA T•T0
1 F INTE::D BY: JULIE .HATTCI
SEWER STUB AS—BUILT INFORMATION 1:S AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-_.:604)
CONTRACTOR OR APPLICANT IS ..fO FIE::i...S) LOCATE AND CONFIRM THE
ELEVATION AND i='("t;:SITION OF —EWER STUB PRIOR TO ANY (rl111
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER i....I.NE+S, ECT.,
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO C:ONNE.CTiON in INSt.IRE::
THAT THEY ARE=. CLEAR AF AND UNOBSTRUCTED D TO THE SEWER MAIN
* i• * •x x •»: * * CALL FOR R 1:N PE::C'•T1:ON PRIOR T O COVER "!l' '!i 'p. ,t ')(• •lE * •1R• •1{ •lt•
*****H:•* •* :'4 HOUR NOTICE REQUIRED n:ii-*ii-*est*•ik*
.».:!l P: -P: * •A: i4 * Y: 456-3604 .. •k * •»:. * }f• •»: -'n: * *
t * hijtit 9 t i i * i * t i i * 6 , * * * k )* * t * » i) THANK you *nxm n*,3r3)E iy,r t ir r *!irir *r**
*ii
SPECIAL CONDITION CHECKLIST
Project
Address: Project# _ Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept. of Bldgs.
Special Insp.Final Report—_.__.
— — Hydrant( )
— Lock Box — — — - _________
Engineer's — RID/CRP
Easements_ _ __-- — _—_.— — —__--__
--. _ Road Plans/Improvements --. —_
Bonds
Planning__ _ _ Bonds
Utilities_ _ Double Plumbing -- — ___.
— a ULID
Other
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY**""*************""*"""
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: _______-__. Date:
Plans returned: —___-- Received by:_—____-__ .__.- --.------ --------_--- ----___---
No response from owner/contractor- plans destroyed: