1992, 10-27 Permit: 92009406 Sewer SPOKANE COUNTY DEPARTMENT MENT 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
. .t;i.2.3;•:.i.: E NUMBER= 92009406 ISSUED E D I: E:.F'4M.?.T DATE= 10/27/92 ?'`AGE= 01
;y A.
*K************************** PERMIT ?t�?"t.�4??l•i ? ..1.1?`•F *****K**********************
SITE S , ::.ET = 12415 1::. 19TH AVE "`Aa'ti.: :.I...:,,:=:: 45272.2521
tAiDi_}RESS:::: SPOKANE WA 99216
PERMIT USE: :: ,kEIW::.i'°•', CONNECTION .... HILi._C,Ri::.::f! (92S-1117)
**N SEE NOTE ***
PLAT001222 PLAT I NniIF:.-= ..IIE...E..i.:i•I ci• ACRE::,' iST ADD
BLOCK= i LOT= 6 Z.i+'r1r.:::: .171-: D:i:'T ::::: F
r=tit:?I f4 :: F:IN=:: WIDTH.= DEPT •i:::: i ,''W=
OF B?._... .Y,.:.... ? tl' DWELLINGS= WATER DIST ::::
OWNER:::: WEILDER PHONE=:::
STREET= 12415 % 19TII AVE:.
ADDRESS= SPOKANE WA 99216
CONTACT NAME== H S CONS T i'=li TION :
_ P`His NE: NUMBER== 509 926,BUILDING SETBACKS : FRONT:::: N/A LEI_..? ..:: N/A RIGHT= N/A REAR= N/A ,,
BUILDING
SEWER*)***********)**********K****** t:.?'1 ''E'{? .. ? ,(•if:•ii••'ri 3i•K a?a*•}!:)k i,:x ii is*ai ii••n:x•i?••if::ll::i K'k:•ie K a•a•
CONTRACTOR= F'1 ,. s CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E: Vfil_?..i i Wry`?' AVE
ADDRESS= SPOKANE WA 99206
ITEM
DESCRIPTION QUANTITY FE
AMOUNT
----------
PROCESSING FE::E:: Y .10.00
SEWER CONNECTION 403.00
r.:f}Sr it'>e x ii rf:rf:*ri*it ra,i#}C'}i};.i{..k..};•ii•}{•h:*u k i+if:1i I`E l'i M E::N T SUMMARY ***K************************
PAYMENT DATE ?'E=CE..I.PT=1= PAYMENT AMOUNT
10/27/92 9536 50.00
------------
TOTAL DUE .00 TOTAL PAI D:::: 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID? AMOUNT OWING
SEWER PERMIT 50.:00 50:.00 .00
50,00 50,00 .00
PROCESSED B Y : DOMITROVICH, ROBIN
IN
PRINTED B,f • DOt'?ITF'.OV.T.?.: 'I, ROBIN
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT 456._3604)
CONTRACTOR OR APPLICANT AaNT :I:,`S TO FIELD LOCATE AND CONFIRM THE
ELEVATION.I.isN fIt i POSITION OF :•EWI::. ": STUB PRIOR R f ANY OTHER
EXCAVATION
TO LOCATE BURIED C r=A I:41...I ',, ?_Y A S PIPING, WATER LINES, ECT.
CALL. rtEF`ORE_ YOU DIG (456-8000)
Sf._WtE! STUBS UB=S ARE TO BE CHECKED PRIOR FOR. i O CONNECTION TO INSURE
THAT THEY fAi T"•:i... CLEAR AND itil d) UNOBSTRUCTED TO� ? !'?i:. SEWER MAIN
•rf:•}�ri§iii**** CALL FOR INSPECTIONt. PRIOR . O COVER :*•}i :••R•****u
***si:rit**at' 24 HOUR NOTICE REQUIRED ui•:•r:ii•3i Yi•# •r*
*K******* i 5 4 «u: 04 ..nk HA 3iN
; t
******************K************* TwNk YOU
?4•?k tit•}t 9k!l:fF tl•9i'!t)?':R•F•1;if:*!t.k.*i:.N..ik 9k 1!'*4k*•1?•N•k.:}t.):. ,.