1991, 10-02 Permit: 91003955 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- 91003955 'ISSUED PERMIT DATE= 'if7)/(12/91 PAcE= ,2)1
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'..7REET- 11404 E 19TH AVE PARCFL0- 28542-2403
AnDRF :::: SPOKANE WA 99206
PERMIT U. - X41 i CONNECTION .... NORTH 1-.. .f... :t,
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BLOCK- LOT- ZONE= UR-3 , 5 DIST4=
OF BLDG'S= 0 DWELLINGS- i WATER DIST =
OWNER=::.... Hi!!-r C:NE. :=-t,T KEITH
STREET= 11404 ":. 19TH
ADDRESS- SPOKANE WA 99206
CONTACT NAME- DONNA COURCHATNE PHONE NUMBER=E 509 924 5485
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CONTRAuioR= COURCHATNE CONSTRUCTION PHONE- 509 924 5.45
STREET- 16402 E VALLEYWAY
VERADALE WA 99037
ITEM .,:.. :,1 R ±. T{.t...ti'•- QUANTITY _1..t.. AMOUNT
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PROCESSING FEE 10 , 00
SEWER CONNECTION 40 , 00
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DATE PAYMENT i:±j-•i i i:. •.1::...:i:: .l.t.. PAYMENT AMOUNT
10/02/91 7152 50 .00
•
PAID-
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
EF.: 'i'
{':)::i 50 ,00 0
PROCESSED 11 i.;v
' 1
PRINTED
SEWER ETUB_ AS—BUILT INFORMATION TS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT TS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OE SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING , WATER LINES, ECT ,
CALL.J"'!i...[_. B: ± ± c! YOU DIG (456-0000)
SEWER STUBSCHECKED PRIOR TO .i!'NNE. 'i TO INSURE
CLEARTHAT THEY ARE t
D UNOBSTRUCTED TO THE MAIN
b".`±:"P: :±±: CALL .FOR INSPECTION
PRIOR _
,..:. ,. ,. ,. 4 ,1 .11111±.
: NOTICE
:..i..:..::..:vi.S :a..: : Q S .0n.:..:: : i.: : jj. jvjy: THANK :.j :: :.. j :: :::: .. . . gi