1989, 10-27 Permit App: 89004355 Sewer "..w '
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SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
1 I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct.In
addition,I have read and understand the INSPECTION REQUIREMENTS/NOTICE provisions included herein and agreeto 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 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 fATE
: { "t ! N :. :. •? } _ 1 S .::) % ! » _. 10/27/89 'er
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APPLICATION
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'.;.> SITE E 1::. ,:: F #",i:.�:._i :::: 12619 4::. 15THAVEF ¢-i 1.r:. PARCELO= '22546-1266
ADDRESS= SPOKANE WA 99216
PLHMI1 USE= SEWER CONNECTION — 8801
9t•4!:* ,::E i::. NOTE *.K 7j'
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PLAT4= 001345 PLAT NAME= JORGENE ADD
Ef'.»l'i.;1;:.... p... ZONE= ;. #.. i..1#;: 3J I: "'!:i:::::
AREA= 00000000 I"% h;:.:: ± WIDTH= DEPTH= R,. is::::
C) ±•i '#.E= :-' '}bi• L.' INGS ttt: 'i
t PHONE=_
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OWNER=OWNER= i'',±::.f.vi::.i":, ,.?!. E 509 926,i i_i8 ;±;;i
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(»;r`.:!1,}.. .:.,'. _ ' it•-,r?:' "?N F::. i it(4 c))9:.'.16
CONTACT NAME= SIMPSON SANITATION PHONE „1E lfil.... 50%
BUILDING SETBACKS : tR; . NA LEFT= NA RIGHT= NA REAR= NA
..r ?: a: ! ? : . : „: n %7 : : rj] : jj: : } SEWER :# " " . S : :qfjjr : jFAyjj }.?j. F9ii :j: i: :!. !iij
N .ir:.:::: `• ; ,•' ' !.ii-•,E EANITATION I''I'11..ii`?'t::.:::: 50+ 926 4781
„s ITEM i::.M %i::.E{ R 3.P ! i.=..=.} QUANTITY i'!...t... AMOUNT
1 PROCEESING FEE 10 ,00
SEWER CONNECTION 40 .. . ..
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PERMIT Z I ± t'±::. 1-LE ('f E'#;.. I :'-i E`I t.7 1NT �,..,:3:... AMOUNT OWIN::;
EEWER PERMIT 50.00 .00 50.00
50.00 ..0':j 50.00
PROCESSED BY : JULIE
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PRINTED BY ...ii: i....i.#::. ,:::-A I I U
.. ' EWER :; i i.!?:f AE—BUILT INFORMATION .. COUNTY
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CONTRACTOR : APPLICANT Ia TOFIELD LOCATE r ND CONFIRM
THE
• ELEVATION AND POSITION OF SEWER STUB P`#'{..i.1."R TO ('#':1•p OTHER
j.. LOCATE , � .it "_# iPIPING,S s ? ` WATER L. k
: ; , ECT ,
C:Ai...... BEF:(::ORE::, YOU DIG (456—8000)
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i SEWER STUBS ARI::. TO BE CHECKED PRIOR i . CONNECTION F t•. .,.I`'i::• i':: :.
THAT F P'i1::.s r ICLEAR AND UNOBSTRUCTED , " ' SEWER I"4("{.i.P`•:
'." 'ti''ii";!;'i,: ,: ,;'i::a; h''t::Iu.... FOR
,• , , :._•1 .1 I #.•;li`J PRIOR COVERi'-ir::..t:!±:i::3!;•i 'p
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. .....,....,.:,.:,j.:j.:,. 24 HOUR##t#': NO'{' I"`E REQUIRED
;Pr:kiR it'f i!!.s?..jl:}t*
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JOB ADDRESS: E i 2( (Q /5T11
SUBDIVISION: LOT : BLOCK:
OWNER: Q '
PHONE: ewe e 87O
ADDRESS:
CONTRACTOR: . 1) ♦ +I J,Tk7 I wit) PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: