1991, 03-28 Permit: 91000541 Sewer .
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
/oom/'mut/xuveoxammoom/onmm/uunnouono".otummutmomm,munonoonmmoumnunoouumntoo»vmoomvagentmoumnnooampermit/application is true
and correctand authorie SkCounty to proceed with processing. In umu I have read and understandm 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= 91000541 I%%UED PERMIT DATF= 03/:2!'.3/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 10816 E 21 %T AVE PARCEL4= 28542-2902
ADDRESS= SPOKANE WA 99204
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
*** %EEN8TE ***
PLAT4= 001393 PLAT NAME= KOKOMO T0 WNSITE
BLOOK= i3 LOT= 3 ZONE= AGSUB DI%T4=
AREA= F/A= F WIDTH= iOO DEPTH= 135 R/W=
4 OF BLDGJ= i 4 DWELLING%= i WATER DIET =
� .
OWNER= ALBONCA, BOB PHGNE= 5O9 926 8864
%TREET= 10816 E 2i %T AVE
ADDRESS= SPOKANE WA 99204
CONTACT NAME= LEONARD - H & % PHONE NUMBER= 509 9268964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ************************ *****
CTOR= H & % CONE TRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRE%%= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
� ' ------------------------- -------- ----------
{ PROCE%%ING FEE Y 10 ,00
%EWER CONNECTION
***** ************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
03/28/91 1629 50 OO
� ------------
TOTAL DUE= .QO TOTAL PAID= 50. 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
� --------------- ------------- ------------ -------------
%EWER PERMIT 50. O0 50.00 .00
------------- ------------ -------------
50.00 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
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]
.SEWER %TUB AS-BUILT� INFORMATION IS AVAILABLE AT THE COUNTY UTILITIES DEPARTMENT (456-3604)
LOCATE AND CONFIRM THE CONTRACTOR OR APPLICANT I% TO FIELD LO
ELEVATION AND PO%ITION OF ,...,EWER %TUB PRIOR TO ANY OTHER
EXCAVATION
` /
TO LOCATE BU�IED CA�LE� �A% PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG .. .456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR UNOBSTRUCTED TO THE .SEWER MAIN
�
********* CALL FOR IN%F��CTION PRIOR TO COVER ********** .,
********* 24 HOUR NOTICE �EQUIRED **********
********* 456-3604 ********** `
******************************** THANK YOU ********************* ***********
{
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SPECIAL CONDITION CHECKLIST
Project
Address: ___—_ Project#_ _Use._—__.
Dept Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs,
Special Insp. Final Report
- --__ _ Hydrant ( ) - —_ 1
Lock Box _ _______---�-- ---
Engineer's RID/CRP
Easements------ . . __________
— __ — Road Plans/Improvements
_______-- — —_ Bonds. —__- _-, _-_-
Planning_ —_ Bonds
•
Utilities. Double Plumbing_—_____—._____ __-
-__ U L I D_— — —
Other__------------ - _ ---
SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY
Date received for 0/0 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 0/0 issuance:
Owner/contractor called regarding the return of plans: -__.__ --.__ Date
Received by: __ _.
No response from owner/contractor-plans destroyed:___________ __— _