1991, 06-18 Permit: 91002904 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= 91002904 ISSUED PERMIT DATE= 06/18/91 PAGE= 01
******************* •******** PERMIT INFORMATION ***•*********** : • •air*• •; * •* • •
SITE STREET= 11208 E 18TH AVE PARCEL 4= 28542-2215
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION -• NORTH KOKOMO
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 6 LOT= ZONE.--: AGSUB DIS T m- F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
OF BLDGS:= 1 ; DWELLINGS= 1 WATER DIST =
OWNER= KIMBALL, T M PHONE=
STREET= 11208 E 18TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
•******* *****•x**** .*****•x*** SEWER PERMIT * ac**•>t•x :* •**• ***• **** •• * ** R•x
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE=: 509 924 545
STREET= 1 6402 E VAL.LEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE. `r' 10.00
SEWER CONNECTION 1 40.00
*3***•********* •*************•x** PAYMENT SUMMARY **k• *********************•**u•
PAYMENT DATE RECEIPT:: PAYMENT AMOUNT
06/18/91 3893 50.00
____________
TOTAL DUE= x00 TOTAL.. PAID= 50.00
PERMIT TYPE: FEE AMOUNT AMOUNT PAID AMOUNT OWING
_
SEWER PERMIT____.. _.____.._.__.__50.00
��.4:f0 _.. 50.00 .00
50400 50.00 _00
PROCESSED BY : JUL.IE. SHA f TO
PRINTED BY : JULIE SHA('7O
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 (450-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
k*****•x** CAL.L. FOR INSPECTION PRIOR TO COVER *•x*****x**
aear • • •* ** 24 HOUR NOTICE REQUIRED ******* * e
•hay******* 456-3604 *****•;kk:***
** ******* * •** ** ****** THANK YOU ***********• •******3E********3*•***3•
SPECIAL CONDITION CHECKLIST
Project
Address: . Project# Use:
Dept: Date: • Condition:
Init. Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant(- - - )
Lock Box
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Engineer'sRID/CRP „ ;
Easement
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Road Plans/Improvements
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Utilities - Double Plumbing t
ULID
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**"--"**"*".******—*******THIS SPACE FOR COMMERCIAL PLAN :Ttj,wt.iQ; Ri-rF-to-'7‘1(.,2;F•oppypAN:0),o.p.ia4Y
•:si : •. . k A ; ;;;
Date received for C/O prOce$Singir".!„i;:. 'If'Ir.!.7-,.::••••.,IrS1
Temporary C/Ode!rt4fatof Occupancy issued
Office file review by: st::.•••,-;••.• ••• . Date. ••
foci: 4, . . ...• ••••: 4 it:
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: