1991, 04-19 Permit: 91000636 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303BROADWAY 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 SkCounty to proceed with processing. In addition, I have read and understandme /wapscr/omneou/nsmswram/or/cs
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= 91000636 I%EUED PERMIT DATE= 04/19/91 PAGE= Oi
*********** **************** PERMIT INFORMATION *********** ****************
SITE %TREET= 14910 E 16TH AVE PARCEL4= 26541 -2803
ADDRE%%= VERADALE WA 99037
PERMIT U%E= SEWER CONNECTION
*** SEE NOTE ***
PLAT4= 003474 PLAT NAME= JAN ' S ADD
CI te. LuT. 3 ZONE=
A�EA= O�OOOOOO F/A= F WIDTH= iOO DEPTH= i35 R/W= 5O
4 OF BLDG%= i LINi WATER DIET = VERA
OWNER= ARMSTRONG , KEN PHONE= 5O9 927 4434
%TREET= 1018 % WARREN RD
ADDRE%%= VERADALE WA 99037
CONTACT NAME= KEN ARMSTRONG PHONE NUMBER= 509 927 4434
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** FERMIT ******************************
CONTRACTOR= UNKNOWN PHONE=
STREET= UNKNOWN
ADDRESS= UNKNOWN WA UNKNOWN
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCE%%ING FEE Y 10 . 00
SEWER CONNECTION i 40 . 00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPTPAYMENT AMOUNT
04/19/91 2179 50 .00
TOTAL DUE=DUE= . 00 TOTAL PAID= 50 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.00 50 . 00
------------- ------------
50,00 50 ,00 5O .00 . 00
PROCE%%ED BY : JULIE %HATTO
PRINTED BY : FORRY, JEFF
SEWER STUB A%—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIE% DEPARTMENT ( 456-36�4 >
CO TRA GR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATuN AND POSITION OF %EWFR %TUB P�IOR TO A�Y OTHER
�
EXCAVATION
TO LOCATE BURIED CABLES , GAS PIPING , WATER LINES : ECT .
CALL BEFORE YOU DI� ( 45 -8000)
%EWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO IN%URE
THAT THEY ARE CLEAR AND UNOB%TRUCTED TO THE EEWER MAIN
**** **** CALL FOR IN%PECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
**** ************************** THANK YOU *********************************
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 •
ULID
•
•
Other. ____— �.��. •
* "*"* ""— ***"*".. *—"THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY****'"*`*********** '**'******