1991, 05-24 Permit: 91002874 Sewer e
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
I 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 l��, LI1 J`L{ APPLICATION v2� ��
OWNER OR AGENT t C/� /%t DATE /
1
1
....
i'l:Li:.it::.i.: � #'�,,,,,! :t.»jt-- . 91002874 ISSUED PERMIT D!"!T#::..... 05. .24?91 {''!.:!tv#...:::: 01
********K******************* i•'!::.t':i'#,. E .#.i;e j••## :;r':{::! # .#.!..?i''1 *******K*:*******************
ADDRESS=iSPOKANE WA 99206
PEkmif USE= SEWER CONNECTION — NORTH KOKOMO
: .! v - 001396 ilti , NAME= < ; t
kM ..: I txI N::b BLOCK= ZONE=
..
0 DWELLINGS= iWIDTH= 100 DEPTH= 150 R/W= 70
OWNER=r=: Ml.:RAE; SHIRLEY•i F!"it,!r:J :. 509 9:.:2 4079
STREET= 'j , •i •i ! 21ST i::!`:r`#::.
ADDRESS= SPOKANE WA 99206
CONTACT NAME= :::i"j...t'=•., ::" f #!..:?'{A i::. PHONE NUMBER= -•;(.j:..: .y,:.... 4079
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= i"- A REAR= NA..
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CONTRACTOR= i.?ofNt::.j't PHONE=
ITEM EM r ESt.:R F !-ION QUANTITY FEE AMOUNT
PROCESSING FEE 10.00
r SEWER CONNECTION .40 . 3()
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PAYMENT DATE E RFt.:#::.?. t '9- PAYMENT AMOUNT
05/24/91'# 220 50 .00
9 TOTAL DUE= _ t•J!•J TOTAL PAID= 50.00
i"PERMIT. AMOUNT j
TYPE t.:. i::.E !'•!M t.f t.?i a , f••}#v!t.. i N.........`x j :j AMOUNT.....OWING.... ._i
! SEWER PERMIT "50.00 50.00 . 00
50.00 50.00 -----
.00
PROCESSED BY : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
SEWER • t.?. AS—BUILT J.rj j::(.?t'C M f•i # .j.f,J i;i :i:: AVAILABLE AT# i'.i:• COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR :..,;. APPLICANT is TO FIELD 2� LOCATE r:a!`•i t j CONFIRM -i..i i�.
ELEVATION AND POSITION OF SEWER
PRIOR TO ANY OTHER
EXCAVATION
• ! LOCATE
Or -TtBURIED
i . CABLES,
, 5! 5 : lry fyPIPING, A - ! : LINES, .f1 .
CALL BEFORE YOU DI _ k456-8000
SEWER
STUBS ARE 1 _ v
ECHECKED PRIOR .
'f' CONNECTION TO INSURE
THAT i HE i ARE CLEAR::.AR :`pt !.? UNOBSTRUCTED t,: THE SEWER #{t N
K******** CALL FOR;:; •�:'.. i•• •i•: i.i � PRIOR �i�; 'COVER " 2' )'i iA..i.i•.i•*:E*
*:k******* .':!{ HOUR NOTICE i.!.,#-, .t t,;,to.,) t,#t^-?J �J}:7i-�!-F'::}:.:i.-4F)!-.•1:
456-3604
.J!.�..x..x..Jl:•a:'R•'J=:P: *'>•.•jk.K..}i..j,..jl..u:.)t:*
1 R a : } ;rk : c 1 h 1 : :ah: : k : ,: { y: i74THANK Y i9J . iia. 1a. . . .i. . ... . ...:):.. .. ....x
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
_________ Road Plans/Improvements_ —_ — --------
----- Bonds
Planning___ _ s _ Bonds
Utilities Double Plumbing_
ULID
•
Other.___
•
—**********•' THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY 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:
Owner/contractor called regarding the return of plans: _ — __ Date: __
Plans returned: _____.--__ __— _ . Received by:_ _ _ ___— -- _-
No response from owner/contractor-plans destroyed: ____— _________