1991, 07-09 Permit: 91002553 Sewer SPOKANE COUNTYDEPARTMENTOF 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 Sokane Conty to proceed with processing. In addition, / have read u 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= 91002553 ISSUED PERMIT DATE= 07/09/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 11312 E 17TH AVE PARCEL4= 28542-2017
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
*** SEE NOTE ***
PLAT4= 00i393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 4 LOT= ZONE= AGUB DI%TO=
AREA= 000O9750 F/A= F WIDTH= 75 DEPTH= 130 R/W=
4 OF BLDG'S= i 4 DWELLINGS= 1 WATER DIST =
OWNER= PARKHUR%T , RICHARD H PHONE=
STREET= 11312 E 17TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= TERRY COURCHAINE PHONE NUMBER= 509 927 6760
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= TLC CONSTRUCTIONPHONE= 509 927 6760
STREET= 13816 E 12TH AVE
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 10.00
SEWER CONNECTION i 4O.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
07/09/91 4526 50 00
TOTAL DUE=DUE= .00 TOTAL PAID= 5O.0O
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.08 50.00 .00
------------- ------------
50,00 50,00 5O.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE SHATTO
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)
SEWER STUBS RE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND B%TR C ED 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: Snit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Repor4�____v_._.
Hydrant( ) ___-- -------_—__--
Lock Box — — — -
Engineer's _---- _ RID/CRP __—
EasementS
Road Plans/improvements__
Planning -- - Ponds
Double Plumbing._--.
U L I D
Other - — . .
>..,..,_..x..,"THIS SPACE FOR COMMIERCIALPLANS TRACKING;CERTI I ATEC FOCCU•PANCYONO/
Date received for C/O procetq ng{`: ; Pans pulled..for tinaE:processirig —
Temporary CIO issued:____ _:_ --- Oertificate-a#Occupioricy ---------
Office file rev€ew by �. Date ._
Filed; insp finaled by: Date: — — —
Ninety days after C10 is muanee.
Owner/contractor called regarding the return of pians: -__-- Date
Plans rett.imed. ___-_ Received by.
No response from ownerlr:ontractor-plans destroyed -__--