1991, 11-27 Permit: 91005213 Sewer SPOKANE COUNTY DEPARTMENTOF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
d in it u submittedu t to compilesaid 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= 910052i3 ISSUED PERMIT DATE= 11 /27/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 1ii22 E 18TH AVE PARCELO= 28542-2216
ADDRESS= SPOKANE WA 99206
PERMIT U%E= SEWER CONNECTION - NORTH KOKOMO
*** SEE NOTE ***
PLAT0= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 6 LOT= ZONE= 1.)11 .1r—
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 6 DWELLINGS= i WATER DIST =
OWNER= BABLOCK PHONE=
. STREET= 11122 E 10TH AVE
DDRE%%= SPOKANE WA 99206
CONTACT NAME= RON %LOAN PHONE NUMBER= 509 922 8500
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= PO BOX 141562
ADDRESS, %POKANE WA 99214
ITEM DE%CRIPTION QUANTITY FEE AMOUNT
�
PROCESSING FEE FEE Y 18.00
SEWER CONNECTION 40 . 00
******************************* PAyMENT %UMMARY ****************************
! '
PAYMENT DATE RECEIPT� PAYMENT AMOUNT
11 /13/91 8633 5O.00
11 /13/91 8633 50.00-
ii /27/9i 9068 5O.00
------------ |
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------SEWER PERMIT 5O.O8 50.00 .00
------------- ------------
50..00 50.00
5O.00 .00
PROCE%%ED BY : JULIE SHATTO
PRINTED BY : DOMITROVICH, ROBIN
SEWER STUB~ AS-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CON .IRM
� THE
��������� A.`-
� POSITION OF��EWER STUB PRIOR TO ANY OTHER
EXCAVATION
. I"N
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: 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
*******************************THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATEOF OCCUPANCY ONLY******************************
Date received for C/O processing:. Plans pulled for final.processing:
Temporary C/O issued: Certificate of Occupancy issued:
Office file review by: .Date:
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: