1991, 05-14 Permit: 91002568 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 t to o 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 /•‘''
PROJECT NUMBER= 91002568 ISSUED PERMIT DATE= 05/14/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 11012 E 18TH AVE PARCELt= 28542-4i02
ADDRESS= SPOKANE WA 99206
PERMIT USE= INSTALL SEWER CONNECTION / NORTH KOKOMO
*** SEE NOTE ***
PLATt= 002393 PLAT NAME= SKYVIEW ACRES 1 %T ADD
BLOCK= i LOT= 2 ZONE= UR 3.5 DI%T4=
AREA= F/A= WIDTH= DEPTH= R/W= 70
t OF BLDG%= t DWELLINGS= i WATER DIST =
OWNER= MIETEREK , ARNOLD PHONE= 509 926 8802
STREET= 11012 E 18TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= ARNOLD MI%TEREK PHONE NUMBER= 509 926 8802
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
----------
PROCESSING FEE Y 10.00
SEWER CONNECTION 1 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
05/14/91 2850 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 5O.00 5O.00 ,OO
50.00 50.00 .00
PROCESSED BY : JOHN LARSON
PRINTED BY : JOHN LARSON
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 CABLUL 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: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special insp.Final Report
Hydrant( )
Lock Box
. • .
• i • i • ii . . . . .
Engineer's
Easements
Road Plans/Improvements
,' •
Bonds • •
. •
Planning -. ... ,;; j . : Bonclg.
. . .
%.•",
• • •
•
ULID
Other.
THtS SPACit FORtOMM CERTIFICATE 6FOCOOPAKICYONtY-!-*******--"*********"****—
. -; . • : c-• • :
Date received for C/O pirOgessiingiiil: • -• .PianSipulieiiiiioi final processingY
Temporary C/O issued: Certificate of Occupancy issued:
Filed insp finaled by: —. Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: Date:
Plans returned: Received by:
No response from owner/contractor-plans destroyed: