1991, 12-18 Permit: 91005628 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 authorizeo ka e Conty to proceed withvmoessmo In additionI have reaonuunoommnomo /mapsuTmwnsoumsmsmTS/wor/us
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= 9i005628 ISSUED PERMIT DATE= 12/18/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
%ITE %TREET= i1311 E 20TH AVE PARCELO= 28542-2410
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= LOT= ZONE= AG%UB DI%Tt=
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i WATER DIST =
OWNER= NEL%EN K L PHONE=
STREET= ii3ii E 20TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= TLC PHONE NUMBER= 509 927 6760
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= TLC CONSTRUCTION PHONE= 509 927 6760
STREET= 138i6 E i2TH AVE
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y iO.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
i2/i8/9i 9533 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 58.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.80 50 .00 .00
------------- ------------ _------------
50.00 50.00 .00 •
PROCESSED BY : JULIE %HATTG
PRINTED BY : DOMITROVICH, ROBIN
SEWER STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PG%ITI3NOF EEWER ETUT.: PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES , FCT ,
CALL BEFORE YOU DIG (456-8000)
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: Init: , Appr:
(in) (out)
Dept,of Bldgs.
Special Insp.Final Report__
Hydrant ( )
Lock Box
Engineer's___ _._.__ RID/CRP
Easements w —.
Road Plans/Improvements
Bonds
Planning---- Bonds
Utilities________ v_.________ __ Double Plumbing
_ a.
UL I D
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:_________.____.w — .Certificate of Occupancy issued:—.
Office file review by: ______ _._ _ . Date:
Filed insp finaled by:__
-------____.____.___-__.__._-- _-_. Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:_._--______.____ Date:
Plans returned: ___ �__ __._.__ ._. ._ Received by:
No response from owner/contractor-plans destroyed: