1991, 03-28 Permit: 91000540 Sewer 4 -
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
/uom,vmut/ouvenxummoom/onmm/uonnu0000n.omtvmatmomm,mm/vnconmmoumnonuouumxmovvmoomywwntmoomvnooumpermit/application/otmo
and correct, and authorize Spokane County to mov*u with processing. In additionI have reaand 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= 9i000540 ISSUED PERMIT DATE= O3/28/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 10806 E 21 %T AVE PARCEL4= 28542-2903
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
*** SEE NOTE ***
PLATO= 001 390 PLAT NAME= KNOB HILL ADD
BLOCK= 13 LOT= 'ZONE= %UB DI%TO= F
AREA= 00013000 F/ = F WIDTH= iOO DEPTH= 130 R/W= 70
OF BLDc%= 0 DWELLINGS= 1 WATER DIET =
OWNER= FRIEND GEORGEE PHONE=
�
STREET= .10806c 21 %T AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEONARD - H & % PHONE NUMBER= 509 926 8964
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= H & % CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
•
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40 . 00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
/ 03/28/91 1628 5O.O0
------------
TOTAL DUE= ^OO TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT CiWI:�
------ --------- - ----- ------------ ---- - --------
%EWER PERMIT 50 00 50.00 . 00
------------- ------------
50 ,00 50,00 5O.00 . 00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
SEWER STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEpARTMENT (456- 604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLEE, GA% PIPING' WATER LINES, ECT .
CALL BEFORE YOU DIG 56-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
*K******a CALL FOR INSPECTION PRIGR TO COVER ********** - .
NOTICE REQUIRED 456-.3604
********* 456-36O4 ********** '
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: — -_____.__________-__ Project#- Use:
Dept: Date: Condition: init: Appr:
(in) (out)
__
Dept. Bldgs. — ----__
Special lnsp,Final Report
_- __-.- ._______.__ __.__.___.___.____-- -- Hydrant ( ) .__.____ _.____.__..___ _--
Lock Box._.__-- __
RID/CRP
----_-_-- Easements ----------------_.__----_`__. .__ _______ __________
— -- ------___--- Road Plans/Improvements .___--.___--
_ Bonds
PlanningBonds
Utilities____ _..__.____ Double Plumbing__
ULID__--
Other._
"""""""""" *""""THIS SPACE FOR COMMERCIAL PLANSTRACKING,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 finaied by: _ Date:------______.__--
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: Date
Received by
No response from owner/contractor-plans destroyed _-_--