1991, 04-05 Permit: 91001377 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 SkCounty to proceed with vmuossmn In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comth 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/apn nonu"oun/uvusenuontmsnonmnonnmv ls 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= 910O1377 I%%UED PERMIT DATE= 04/05/91 r.", O�
*****� ************* PERMITINFORMATION ****************************
%ITE %TREET= 1111115 111' 20T AVE ' PARC28542-231O
ADDRESS= SPOKANE WA 99206
PERMIT USE= %EWER CONNECTION - NORTH KOKOMO
*** %EE NOTE ***
� PLAT�= OOi 393 ' PLAT NAME= KOKOMO TOWNJITE
BL C K= 7 LOT= ZONE= AG%UB DI%TO=
AREA= OOOOOOOO F WIDTH= DEPTH=
LLIN�
�
� OF BLD�%= i �� DWE ^= i WATER DIST = -
OWNER= MACK LVI 6 RT PHONE=
%TREET= iiii5 E 2^TH AYE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEWIS - TOM STONE PHONE NUMBER= 509 928 7710
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA --
***************************** SEWER PERMIT ******************************
CONTRACTOR= TOM STONE EXCAVATING 1::'H;1\E= 509 928 7710
STREET= 1112 N MAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNi
------------------------- -------- ----------
PROCESSING FEE `' ' ^ `
SEWER CONNECTION ` i 40.0O
******************************* pAyMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
04/85/91 i845 50 .00-
TOTAL DUE= .00 TOTAL PAID= 5O. 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
------_----_--- ------------- ---------~--SEWER PERMIT PERMIT 50.00 50.00 .00
------------- ------------ -------------
5O. (•)O 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
%EWER %rUB A%-BUILT `NFORMATION I% A�AILABLE AT THE COUNTY
UTILITIE% DEPARTMENT (456-36O4) �
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
�
ExCAV*T7ON
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT .
CALL , BEF�}RE YOU DIG- (45o�8OOO)' ` `'� ' '
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO :INSURE
THAT THEY ARE -CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INDP-CTION PRIOR TQ COVER **********
********* 24 HOUR N[)TICE REQUIRED ********** ^ ' ` |
********* 456 36O4 **********
- '
******************************** THANK YOU *********************************•
' �
SPECIAL CONDITION CHECKLIST
Project
Address: Project#– _—_-- ---------__—_--Use:__--- -----------__-.-
Dept_ Date: Condition_ Init: Appr:
(in) (out)
Dept.of Bldgs.
_________________________ __-_. __ Special Insp,Final Report
-- — —
Lock Box — —
Engineers_______ -- --_-- -- RID/CRP ------_.___-- —.__---
_.________ — Easements --__-_-- —_-
„ __—__—_—_ — Road Plans/Improvements _._.__.
______________________ ___-- Bonds_� ____ _
Planning____._______. _ Bonds._
UtilitiesDouble Plumbing_____ ----- — -----____--
- ULID
Other —
"-----'•"""--*—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:___________—_ _____.__._—__._ _________ __. Certificate of Occupancy issued:
Office file review by: - ___________ Date:
Filed Insp finaled by: _______ Date:
Ninety days after C/O issuance:
Ownericontractor called regarding the return of plans: _.__ ________ ---_--_-- -__-_-- Date: __ ___ ._ _ ___
Received by:_____--
No response from owner/contractor-plans destroyed __ .. -- ---- -------