1991, 02-15 Permit: 91000556 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 athorize SkCounty 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 'A Awn APPLICATION 2
OWNER OR AGENT DATE
PROJECT NUMBER= 91000556 DATE= 02/15/9i PAGE.- 01 [
'ISSUED PERMIT
PERMIT INFORMATION ****************************
SITE STREET= i0720 E 22ND AVE PARCE = 28542-34O4
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH
*** SEE NOTE-***
PLA II:= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= LOT= ZONE= AGJUB
AREA= 00000000 F/A= F WIDTH= DEPTH=
:11 OF BDWELLlNi".;%=
OWNER= KOON%, JEFF PHONE= 5O9922 4620
STREET= 10720 E 22ND AVE
ADDRESS- SPOKANE WA 99206
CONTACT NAME= JEFF KOON% NUMBER= 509
�
BUILDING SETBACKS : FRONT= NA LEFT= HA RIGHT= NA REAR= NA
(
***************************** SEWER PERMIT ******************************
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION QUANTITY FEE AMO;NT
------------------------- -------- ----------
PROCESSING FEE Y 10 .00
SEWER CONNECTION i 40. 00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPPAYMENT AMO\tNT
2/i5/9i 697 50 .00
-----------
TOTAL DUE= .00 TOTAL PAID= 50.00
� -
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
( --------------- ------------- ------------ -------------
SEWER PERMIT 50.00 50.00 .00
------------- ------------ -------------
50.00 - 50.00 .00
PROCE%%ED BY : JULIESHAT TO
PRINTEI) BY ' JyL HATTO
• { SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UIE% -DEP ARTMENT /476-36O4)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING' WATER LINE%, ECT.
- CALL BEFORE-YOU DI(;., (456-8000)
SEWER STUBS ARE TO BE CHECKEDO TO CONNECTION TO Iw ||RF
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FORIN%PECTION PRIOR TO COVER **********
********* 24 HOURNOTICE REQUIRED **********
********* 456- 6O4 **********
******************************** THANK you ****)i:** ****************** * ***
` ^
•
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 Plumbing
U L I D
Other — — -- — -- —
*'*THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing: _ — — Plans pulled for final processing: _________—__ ________
Temporary 0/0 issued:__—_ Certificate of Occupancy issued:_____ ____—__—________.____.
Office file review by: _—___ ______ Date:
Filed insp finaled 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:_____ —____—__ —_