1991, 06-18 Permit: 91002429 Sewer SPOKANE COUN1 )ARTMENT 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 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 APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 91002429 ISSUED PERMIT DATE= 06/18/91 PAGE= 0i
***********•***************** PERMIT INFORMATION ********************a>***
SITE STREET= 11020 E 2iST AVE PARCEL= 28542-3001
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — NORTH KOKOMO
*** SEE NOTE ***
PLAT= 001 393 PLAT NAME= KOKOMO TO_WNSI.TE
BLOCK= 14 LOT= ZONE= AGSUB DISTM=
AREA= 00000000 F''A= F' WIDTH= DEPTH= R:'W= 70
OF rL_DGS= i 4 DWELLINGS= i WATER DIST =
OWNER= MARKS PHONE=
STREET= 11020 E 21ST AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE PHONE:: NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT **********************4********
CONTRACTOR= COURCHAINE. CONSTRUCTION PHONE= 509 924 5485
STREET== i 6402 E VALLEYWAY
ADDRESS= VERADAL..E WA 99037
ITEM DESCRIPTION QUANTITY FEE:. AMOUNT
----------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
*•*•******•x****•*****•• *•**•***•****•* PAYMENT SUMMARY *****•*** *** *•**•*•*:*********•b:
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
06/18/91 3899 50.00
------------
TOTAL D1.1E__
.00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
-------------
SEWER PERMIT 50.00 5000 :00
50.00 50.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE. COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES4 GAS 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 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: !nit: Appr:
(in) (out)
Dept.of Bldgs,
— — Special Insp.Final Report
— — Hydrant( )
Lock Box_
—
;,;
Engineer's
Easements
— Road Plansllmprovements
Planning; • •=Bonds
Utilities___ Double Plumbing
— ULID
^
Other_ ; ,
•
•
•"'"'"""°'°""°*•,•THIS SPACE FOR COMMERCIAL PLANST 1ACKINGI CERTIFICATE OF OCCUPANCY ONLY" .......,,,....,:«<—.<.......
Date received for C/O processing: ••• • • 'i •ftan$=piufied for Sin 6:proceis ing : •
Temporary C/O issued{ CertyfiCate,3of O ccfpancyissued. ',
Office file review 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: