1991, 03-28 Permit: 91000510 Sewer SPOKANE COUNTY DEPARTMENTOF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
/co,nfymat/oavoovummonm/^nmm/vunnxootwn.omtomotmo/"m,monunvuntmmoum.,onu^uumnmuuvmoonnvagentmoomvnooumn rmit/application is true
and correctand authorize Soka 000 nty to proceed with processing. In umu 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= 91000510 ISSUED PERMIT DATF= 03/28/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
,
%ITE STREET= 10821 E 22NDAVE PARCEL4= 28542-2912
ADDRESS= SPOKANE WA 99206
PERMIT ,USE= SEWER CONNECTION - NORTH KOKOMO
*** %EE NOTE ***
P T�= OOi393 PLAT NAME= KOKOMO T WN%ITE
BLOCK= 13 LOT= - ZONE= AG%UB DI%T4=
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= i 4 DWELLINGS= i WATER DIST =
OWNER= W LLIA %� M A PHONE=
- - ^
. '
STREET= 10821 E z2ND AVE - -
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEONARD - H & % PHONE NUMBER= 509 926 8964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= H & % CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRE%%= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCE%%ING FEE Y ' -10.00
%EWER CONNECTION 1 40.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPTO 1:::AYMENNT
03/28/91 1623 50.00
`
TOTAL DUE=DUE= . 00 TOTAL PAID= 50.00
PERMITTYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- -----_------ -------------
%EWER PERMIT 50.00 50.00 . 00
------------- ------------ ------------- .
50 .00 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% DEPARTMENT (456-36O4)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLEI, �� PIPING, WATER LINES, FC | ..
CALL BEFOREGAS; |YOU DIC (456-'(.3000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE C EAR ND UN B%TRUCTED It THE %E�ER 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: '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-
UL 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 C/O issued:_____-____._--________ ----------_-_-__._--- Certificate of Occupancy issued:_-___ --__-- --_.-_-___._
Office file review by: . Date:
Filed insp finaled by: _______ ---._ __.__ Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:__ —._ _...—______. Date:
_ Received by:__-- __ ____
No response from owner/contractor -plans destroyed: _-_--