1991, 12-04 Permit App: 91008399 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
PROJECT NUMBER= 91008399 APPLICATION DATE= 12/04/91 PAGE= 01
****** THIS :CS NOT A PERMIT ******
PENALTIES WIL..L. BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 15005 E 16TH AVE:: PARCELO= 23544-1608
ADDRESS= VERADALE WA 99037
PERMIT USE= SEWER CONNECTION -- VERACREST (91 -S118)
*** SEE NOTE. ***
PLATO= 00275i Pi..AT NAME= VERA
BLOCK=: LOT= ZONE= SFR DI ST m==
AREA= F/A=f•/A= f WIDTH= DEPTH= R _::
M OF BLDGE= 4 DWELLINGS== i WATER DIST =
OWNER= JANKE, MARK PHONE=
STREET== 15005 E 16TH AVE
ADDRESS= VERADAL..E WA 99037
CONTACT NAME= ALWAYS ACTIVE -- RON SLOAN PHONE NUMBER=: 509 922 8500
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
***************************** SEWER PERMIT **************•*•***•**•****•******
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= PO BOX 141562
ADDRESS= SPOKANE WA 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 10. 00
SEWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50:.00
„00 50.00
50.00 .00 50.00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DOMITROVICH, ROBIN
SEWER STUB AS-BUILT INFORMATION IS AVAILABLE.. AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS 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 (456-8000)
SEWER STUBS ARE TO BE. CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL.. FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *•********************************
SPECIAL CONDITION CHECKLIST
Project
Address:
Dept. Date: Condition:
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other
Project # Use:
Special Insp. Final Report
Hydrant ( )
Lock Box
Init:
(in)
Appr:
(out)
RID/CRP
Easements
Road Plans/Improvements
Bortds
BOnds.
•
Double Plumbing
ULID
, •-•1
I t 1
******* ***** * ***"' r ""*'***4';-TH rs. SPACE FOR COMIcifERCIA4 CSJIOACIkINtlli;CERTIF16s,TECA:N066iii i=iissit4CYOtit..,Y4********************** *******
Date received for C/O`p4'cliCeSSing" P,Ia.nklpudiOr' finalProcessing"
Temporary C/O issuedCertificate of Occupancy issued:
Offidefife 'reVelk "
Filed insp finaled by'
Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed:
Received by
Date: