1991, 08-05 Permit: 91002534 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 withpmvossmo In additionI 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= 91002534 ISSUED PERMIT DATE= O8/O5/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SI TE STREET= 10912 E 18TH AVE PARCEL4= 28542-4185
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
*** SEE NOTE ***
PLAT4= 002 393 PLAT NAME= %KYVI ' ACRES i %T ADD
BLOCK= � LOT= 5 ZONE= AG%UB DI%T4=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W= 70
4 OF BLDGJ= i 4 DWELLINGS= i WATER DIET =
OWNER= MORSE PHONE=
STREET= 1O912 E 18TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEONARD PHONE NUMBER= 509 926 8964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= H & S CONSTRUCTION PHONE= 509 926 8964
STREET= i18i7 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
08/05/9i 5290 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 .00
------------- ------------
50.00 50,00 5O.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB A%-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 (45"-8OOO)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR N %T D TO THE SEWER MAIN
********* CALL FOR INSPECTION 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- ipE30ngs
— —
Utilities------_- -- Double Plumbing._
-- ULM
Other
THIS SPACE FOR COMMERCIAL PLANS rR:AC IN:0,CERTIFFIOATEOFOCCUPANtY ONL`*******************x*********•
Date received for C/O processing: Flans.puiled for final processing} -----
,
Temporary C/O issued... • �_--. Certificate;.of Occupancy issued:
Office file review by
Date ..:. ,. ,
Fired insp tingled by Date:
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: ---- _-------_.___ . Date:
Date:------__.___-----_._.-__------____
Plans returned Received by:
No response from owner/contractor-plans destroyed: ----__-----___._--