1991, 08-05 Permit: 91002533 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 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== 91002533 3 ISSUF.EI) PERMIT DATE= 08/05/91 :`AGE 01
*3i):kri3>:***3k****3r3i•3kii*•***3i•3i3t•*ri* PERMIT INFORMATION #**3i3b***Yi3i3?•*3i•*it•*#3i3! • 3i•#*3r*3i•*
SITE STREET.= i i i i S F 21ST AVE: PARCEL. : 28542-2611
ADDRESS= SPOKANE WA 99206
SE.
PERMIT SEWER CONNECTION -.. NORTH KOKOMO
3i•*3( E NOIE ***
PL.AT4^ 001393 PLAT NAME= KOKOMO TOWNSITE
E
BLOCK= 10 LOT= ZONE":'- AGEUB D1:S•r: = E=
AREA= 000000 00 F /A= F WIDTH= DEPTH= Ft:/W= 0
4 OF BLDGE= 1 x: DWELLINGS= i WATER DIST ::::
OWNER= O ' CONNOR PHONE=
STREET= Ill21ST AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEONARD -•• H S PHONE NUMBER= 50" 926 8964
BUILDING SETBACKS : FRONT:::: NA LEFT= NA RIGHT= NA REAR:'- NA
:R.*x•x3tx* :•*3i•*tt*3i•3iH3i•m•*#*3t***3i*** SEWER PERMIT ***3;•*3i•**3i#3i•*3i*3i**3i••M***:A*****•r:•
CONTRACTOR= H S CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 I VAI...L..F::YWA•Y` AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE 10.00
SEWER CONNECTION i 40.00
r i ri i rt*3 a t 3 3 i kL 3 7 3 3 c k i i t**3 k {ri* PAYMENT
SUMMARY a xnu a 3An** e
t*# { ( i i3h 3 E bk i uAi
PAYMENT DATE. RECEIPT4 PAYMENT AMOUNT
08/05/91 5294 50,00
TOTAL DUE.:::: .:00 i•OTAL.. F'AID'= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 ,00
50.00 50.00 . 00
PROCESSED BY : JULIE SHATTO
F'Fe.:1:NTEE:D BY : JULIE SHATTO
SEWER STUB AS—BUILT INFORMATION 1:S AVAILABLE AT. THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM .HE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS 4 F'°1.E'•'1.N..r , WATER 1...1.!`JE:.S, ECT.
CALL BEFORE: YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR (Fl CONNECTION TION T'I INSURE
URI
THAT THEY ARE CLEAR AND UNOBSTRUCTED F''i TiOTHE 'EWER MAIN
:,>:.****3i•3i•** CALL F•O R INSPECTION!' PRIOR TO COVER •x•3i.R 313':A• :3+..3i at
3i•3!•*3r3!•*3{•#* t 4 HOUR NOTICE REQUIRED Il 3k#3i•3t3k3r3k3E3t3{
......
�R••R•R•3[•3!•3L•h:3{•3{ 456-3604 3i•3t•3•:3i•Ni A•:n:it 34 3i•
*nx nr nx n? rif e 3 **3a3b#3fi3i r) 33 *3t 3THANK YU1J ! 1 ***3 ***A*3P**3 *3 ***3 ** `***33x
SPECIAL CONDITION CHECKLIST
Project
Address: ----____-- -- _ Project# —_ ______._______ Use:
Dept. Date: Condition: lnit: Appr:
(in) (out)
Dept. of Bldgs.
Special Insp.Final Report —___--
- Hydrant( )
Lock Box —_— — _ —
Engineer's_.----- __._. RID/CRP.
Easements
------_—___-- ----__.—�— Road Plans/Improvements
Planning Bonds:
•
UtilitiesDouble Plumbing
ULID
Other-__-______.__----
. .. .. . �
""`""""•'°•""°" """
°`" 'THIS SPACE FOR COMMERCIAL PLANS I'RACKiNfia;`GERTFFiG,4TEt7FOCC"l:iRA'NGl'ONLYpx ***************************
Date received for C/O processing` s :Plans putted tot'final processing. _ _
Temporary C/O issued.. _ . __ w_ Certificate of Occupancy issued:____ -----------------.--_--
Office file review by:
Filed insp..finated by ,.. _ .- — Date: :
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: . Date:
Plans returned: _.Received by:No response from owner/contractor-plans destroyed. --___--