1991, 08-06 Permit: 91001806 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. BROADWAY AVENUE
SP1303
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 mvoou withpmuossmo In additionI have reaand 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 specif ied
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= 91O0i806 ISSUED PERMIT DATE= 08/06/9i PAGE= 01
**************************** pERMIT INFORMATION ****************************
SITE STREET= 11116 E 19TH AVE PARCE28542-23�6
ADDRESS= SPOKANE WA 99206
PERMIT U�E= -WER CONNECTION - NORTH KOKOMO
*** ELL NO | E ***
PLATO= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 7 LOT= ZONE= SFR DI%TI=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 4 DWELLINGS= i WATER DIST =
OWNER= HILL PHONE=
STREET= iiii6 E 19TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= RON %LOAN PHONE NUMBER= 509 922 85O8
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= PO BOX 141562
ADDRESS= SPOKANE WA 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE iO .00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
88/06/91 5381 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. O0 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB A%-BUILT INFORMATION I% 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 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: fnit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report_ _ —___--
-— — Hydrant( )
--- --- -- Lock Box
Engineer's----_--- �._ RID/CRP
Easements - _
-------- -- --- Road Plans/Improvements
Bonds
•
Planning__ Bonds — •
Double Plumbing_—___ • — —
ULID
Other - •
•
•
•
“*"w**•'•'****"'***'********•'--THIS SPACE FOR COMMERCIAL PLANS TRACKING;•GERTIFICATEOF.00CUPANCY ONLY`""`"'*****—"*""°"""""•
Date received for C/O processing. --- _ Plans puffed for final.processing:
Temporary C/O issued: Certificate of Occupancy issued.
Office file review by: _-_:._-- Date: •
Filed insp finaled by:—_____ _ ___ _ Date:: _
.::
Ninety days after CIO issuance: —_-_.-------_-----_.__
Owner./contractor called regarding the return of plans: . Date:---------__-----_---------.___-----___.
Plans returned: ____._.__------ Received by:
No response from owner/contractor-plans destroyed:---------------_—_-- __-_-___-_