1991, 05-02 Permit: 91001675 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
PRUjECI
NUMBER=
: z1tr , 4 .1gqS $ h} 3 ) G, : : t ? PERMIT ` J , ' A, .i , ***************** **:k*** **
SITE , ::i..F.. .... 11314. it 18TH A V :'A 3•t::..._ .'r.-" 28542• ..
ADDRESE= SPOKANE WA 99206
:.I°MI USE: SEWER CONNECTION .... NORTH K`::IK O
_}*j:. i SEE NOTE y
PLATO= 001393 PLAT NAME= KOKOMO TOWNETTE
BLOCK= 5 LOT= ZONE= EFR
AREA= 00000000 F/A= F
'.,I f•. i.{i ill. . :::: -" NL..:::: `WA WATER DIST ..... ....
OWNER= ( , 1 _ S Y ;
PHONE=. . 1 ,
t4 } , 11314 ( S
ADDRESE= SPOKANE WA 99206
CONTACT .:''.',:::'.... JIM
y - -iNPHONE
NUMBER= . . a . 6077 BUILDING E . ,. .: : • FRONT= LEFT= ( RIGHT=
REAR=
tr; . *: 3Ayx: :1 :fi * k x. k k ¢ $i•Pi i SEWER .. eI : . r .:; n ( ?. ; k :* :P :% ': ..ii :3 . ` : f..4.R
77
CONTRACTOR= J.R. ....1. ...2..t• AVE r-:t:
ADDRESS= EPOKANE WA 99206
ITEM DEECRIPTION QUANTITY REF AMOHNT
PROCESEING FEE
9 .tt ik? t 9at: t 4s F :. .., s R : :1 'i:. . : 1k { k `'' 3t• SUMMARY * , . : : .HR% k ay (1 aN (: _ N : *:
PAYMENT DATE
... L
T4 PAYMENT AMOUNT
05:' ......./91 2512 50 ,00
PERMIT TYPE
FEE AMOUNT
AMOUNT PAID AMOUNT OWING
V1
SEWER PERMIT 50,00 50-00 .
50.00 50,00 ,00
PROCESSED BY-: JULIE E.HATTO
PRINTED BY : JULIE EHATTU
SEWER ETUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
II
CONTRACTOR rR APPLICANT FIELD
. ELr . ic - - ; AND
ir '
ELEVATION AND POSIIION OF ,..EWER STUB
PRIOR TO
ANY OTHER
EXCAVATION
TO LOCATE BURIED i•..t:•i E t_.?::.,.` GAE PIPING, LINES , ECT ,
flAil M:7E:ORE YOU DIG '(.456—8000)
`1::.W1"i'°: Z: It«t�f, (••} �:i::. ti,. (,t. i.;tt �`E•::;},i.,l•t, �•1,: ,t.`+}j•Mf..; "1'i'}•; ,, ,•; i`a;.ii,
THAT
THEY i' L:.Y {ittt: CLEAR t..AR !••}r4 t1 UNOBSTRUCTED Ti.l THE EEWER MAIN
;;.:,:.:..:x..%;..*.:n,* CALL FOR R .i#'# L..t. 1 .1.i..iN PRIOR TO COVER **n•n**a• *ik
.3...17 4F .'.., ?--:,,.I t„!R [`.°TICE . ..... . .!.1°,1.. .. ..
'/a.::'R:'a•`7 i :7'1:. 456-3604 37'9i'17'P:'Pr ik :'lti:n:'.h
7*: 77..17..;.,.7..7:7 7 71 :*9 . r7 7 r ! : : c: a : : : : z t *THANK; , . : 1 .::.;..1 :i*r *39k**YJr d7* 47 17*i . : ?P:k :
I
SPECIAL CONDITION CHECKLIST
Project
Address- Project #______..__._—._.____ Use -
Dept:
Dept. of Bldgs.
Engineer's
Date: Condition:
Planning
Utilities
Other_
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
—*********'"******"'********THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing: _._ _ —_— . Plans pulled for final processing'
Temporary C/O issued:__..
Office file review by Date:
Filed insp finaled by: ________ Date'
Certificate of Occupancy issued:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:...__._.___ Received by'
No response from owner/contractor - plans destroyed:
Date: