1991, 03-25 Permit: 91001317 Sewer •
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SPOKANE COUNTY DEPARTMENT OF BUILDINGS )
W. 1303 BROADWAY AVENUE
/ �POKANE,WASH|NGTON 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 athorize Sx County to proceed with processing. In addition / »mmmamanuvnuorstanumo /wopscrmmnsou/newswTawor/us
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, as~warranty of conformance with the provisions of any state or local '
laws regulating construction
SIGNATURE OF erm APPLICATION _� ._�. �� __ �v /
OWNER ORAGENT -�-^~=��, f7-, DATE —� ~— ~^ / /
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PROJECT NUMBER= 91001317 ISSUED PERMIT DATE= 03/25/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 11221 E 17TH AVE PARCEL4= 28542-1824
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION FOR KOKOMO TOWN%ITE ,
*** SEE NOTE *** -
1
PLATO= 00i393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 2 LOT= 23 ZONE= UR 3.5 DI%T:11:= 1::-
AREA=
AREA= F/A= WIDTH= DEPTH= R/W=
0 OF BLDG%= i 0 DWELLINGS= i WATER DIET =
qww:R= OTRADOHEC KENMARIE PHONE= 509 534 6348
STREET= 11221 E 17TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= D & B EXCAVATING PHONE NUMBER= 509 467 8787
BUILDING SETBACKS : FRONT= NA LEFT= HA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= D & B EXCAVATING PHONE= 5O9 467 8787
STREET= POB 722 PL
ADDRESS= MEAD WA 99021
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y iO.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
03/25/91 1487 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50-.00 - 50.0O .00
. ------------- ------------ -------------
, ^
5O OO 50.00 .00
PROCESSED BY : JOHN LARSON
PRINTED BY : JOHN LARSON
SEWER STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
|
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLE%� GAS PIPING , WATER LINES, ECT ,
CALL BEFORE YOU DIG (45�-8OOO)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND ` UNOB%TRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER *** ******
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
************* ** *************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: _'__- _ _ ProjectUse: ___
Dept: Date: . Condition: |nit Appr:
} (in) (out)
. !
Dept of Bldgs \ /
Special Insp.Final Report
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Engineer's__ _ _-_ -_| RID/CRP
_--______- —_/ _-- --/ eEasements { '
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Road Plans/Improvements
Bonds
-- -- ---- -- -i --| -- -- - � ---' -- ! -----
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Planning__ __| __! __� Bonds
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Utilities. __| __- _-| __| Double Plumbing
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''~^^'^^-^^^^THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE opOCCUPANCY ONLY'```'''` ^^`~^~`~~~````
Date received for C/O procesino: Plans pulled for final procesing: __-__' _______- _____
Temporary C/O insuou:__--__ Certificate of Occupancy issued _______ __ ---__-----
0{nnro|rroviowhy: . oato:
Filed inopnna|ouby:_- —_____ __- ____-. umo:____'
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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:__________