1991, 11-27 Permit: 91005647 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 correctand authorize SkCounty to proceed withnmommmn In additionI 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= 91005647 ISSUED PERMIT DATE= 11 /27/91 PAGE= Oi
** ************************* PERMIT INFORMATION ****************************
SITE STREET= 109i4 E 22ND AVE PARCE|4= 28542-3330
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — NORTH KOKGMG
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWNSTTF
BLOCK= LOT= ZONE= AG%UBDI%T4=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= i 4 DWELLINGS= i WATER DIST =
OWNER= YAJKO PHONE=
STREET= 1O914 E 22ND AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= RON SLOAN PHONE HUMBER= 509 922 8500
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= PO BOX 141562
ADDRESS= SPOKANE WA 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE
FEE Y ` 10 ,00
SEWER CONNECTION 40.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
11 /27/91 9068 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
�
` --- •--------- ----- — — |
SEWER PERMIT ,00
5O OO 5O OO^ ^
------------- ------------ -------------
50.00 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : DOMITROVICH, ROBIN
SEWERSTUB AS—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 ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR IN%PECTION PRIOR TO COVER **********
' ********* 24 HOUR NOTICE REQUIRED **********
�
o ********* 456-36O4 **********
******************************** THANK YOU *************** *****************
SPECIAL CONDITION CHECKLIST
Project
Address: _-____- ___ _ Project# Use:
Dept: Date: Condition: mit: Appr:
| / /
(in) ! (out)
------------ -( —
Dept.of Bldgs.
__-_____ Special InspFinal Report
/ ! | Hydrant ( )
-- ----------- Lock
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------- i ----------- -- «c Box
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Engineer's __ | _ RID/CRP
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-- ___ / _- Easements
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_____ __ -. ____ _ __ nouoPmnaxmpm,omemv _-_ -_
| | Bonds
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Pl*nning onnvm- i
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Utilities oovN*pvwnbing
ULID
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~'` ^^'''^^~~THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE opOCCUPANCY ONLY``'`~`` ^~`~~^'^'~'`^
_
Date received for C/O processing: Plans pulled for final procesinO:___ ___ - __'
Temporary C/O CnrtxicmomOoovpanoyinsvoo:_-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: ___ --
p*nsrvmmou: _____ _______ Received by: _______ ______
No response from owner/contractor plans destroyed: __-_ -___' -'_