1989, 09-20 Permit: 89003454 Sewer 4
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
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addition,I have read and REQUIREMENTS/NOTICE provisions included hereo agree to comply withm^ e.All provisionsm/uwx
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 onAGENT DATE
PROJECT NUMBER= 89003454 DATE= 09/20/89 PAGE= Oi
REVISED FEE%
**************************** PERMIT INFORMATION * **************************
SITE STREET= 12619 E 16TH AVE PARCEL4= 22543-1419
ADDRESS= %POKANE WA 99216
PERMIT USE= SEWER CONNECTION — 8801
PLAT4= 001345 PLAT NAME= JORGEN% ADD
{ BLOCK= i LOT= 17 ZONE= AG%UB DI%T4=
AREA= 00000000 F/A= F WIDTH= 105 DEPTH= 140 R/W=
4 OF BLDG%= 4 DWELLINGS= i
OWNER= PETERSON, GORDON PHONE=
%TREET= 12619 E 16TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= LEONARD — H & % PHONE NUMBER= 509 926 8964
}
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= H & % CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRESS= %POKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ---------
PROCE%%ING FEE Y .10.00
{
SEWER CONNECTION i 40 .00
******************************* PAYMENT SUMMARY ******************* *******
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
09/19/89 4284 50.00
09/20/89 4284 50.00-
09/20/89 43i5 50.00
� ------------
TOTAL DUE= .00 TOTAL PAID= 50 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50.00 .00
------------- ------------
•
50.00 50.00 ^OO
PROCE%JED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
******************************** THANK YOU *********************************
SPOKANE COUNTY DEOARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
certify�� �� examined thispermit andommmmm information conm/ ed in it and submittedu me or my agentmovmpiwoomnonmn/mmounouonon In
addltion,I have read and understand the INSPECTION REQUIREMENTS/NOTICE provisions included hereiu 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 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= 89003454 DATE= 09/19/89 PAGE= Oi
ISSUED PERMIT
**************************** PERMIT INFORMATION ***** **** *********** ** *
[
SITE STREET= 12619 E i6TH AVE PARCELt= 22543-i419
ADDRE%%= %POKANE WA 99216
PERMIT USE- SEWER CONNECTION - 8801
*** EEE NOTE ***
PLATt= 001345 PLAT NAME= JORGEN% ADD
BLOCK= i LOT= 17 ZONE= AG%UB DI%TO=
AREA= 00000000 F/A= F WIDTH= 105 DEPTH= 140 R/W=
0 OF BLDGJ= 0 DWELLINGS= i
OWNER= PETERSON, GORDON PHONE=
%TREET= 12619 E 16TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= LEONARD - H & % PHONE NUMBER= 509 92S 8964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
************ ***** **** **** SEWER PERMIT ********************* **** **
CONTRACTOR= H & S CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCE% EE Y 10.00
SEWER CONNECTION 40 .00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
09/19/89 4284 50.00
TOTAL DUF=DUE= .00 TOTAL PAID= 50 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50. 00 50.00 .00
------------- ------------ -------------
5O. 00 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
SEWER %TUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING' WATER LINES, ECT .
CALL BEFORE YOU DIG (456-8080)
VIMIll h. 4111111111111161
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
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 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 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 HATE
PROJECT .. 89003454 DATE=
9/89 ?--,?._.F......
r', ?
02ISSUED PERMIT
i
SEWER JCUj ? -} TO Y _ CHECKED ? { LtjjTO CONNECTION
. INSURE
THAT
THEY
E i-.f.,'?::' :}...? " - AN D UNOBSTRUCTED
t _ C ? THE SEWER M^ 4d
::* CALL FOR INSPECTION PRIOR T , COVER *
456—l... : .... r
, ..},.. ;t g . yf . , ..tt :: . „ § : : } f : : y , . : } : THANK you - ; ..l .. :: ; LM.: � ; ! ,f .jt . :ti :
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