1991, 03-13 Permit: 90005951 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 Sx County to proceed with processing. In addition, I have read and understandtma 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= 90005951 ISSUED PERMIT DATE= 03/13/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= iiiii E 17TH AVE PARCEL4= 28542-i820
ADDRESS= SPOKANE WA 99206
PERMIT USE SEWER CONNECTION - NORTH KOKOMO
*** SEE NOTE ***
PLAT4= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 2 LOT= ZONE= AG%UB DIJT4=
AREA,, OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 4 DWELLINGS= i WATER DIST =
OWNER= BENHAM ROBERT PHONE=
STREET= iiiii E 17TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEWIS - TOM STONE PHONE NUMBER= 509 926 89ii
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= TOM STONE EXCAVATING PHONE= 509 928 7718
STREET= 1112 N MAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCE%%ING FEE Y iO.00
SEWER CONNECTION i 40. 00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
03/13/91 1231 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER 1::'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 (456-3604 )
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
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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------_- ___ RID/CRP.. . ._ . ..
Easements
�.- -----,--- -- Road Plans/Improvements
Bonds
•
Planning__ . .Bonds
•
Utilities ___ _ Double Plpmbing
_-- -- U L(D
•
•
Other
*******"'*°'""****"******".***"*THIS SPACE FOR COMMERCIAL PLANS:TRACKI&G-,CERTIFICATE.OF OCCUPANCY ONLY* . *************""*********`**