1991, 02-15 Permit: 90006974 Sewer SPOKANE COUNTY DEPAR' T 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 authorize Spokane County 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 APPLICATION
OWNER OR AGENT DATE
.._
-t•�{{.tt••S. i {•-J{fit•:{;.: .. ' ',;-;; 'DATE= j:,2 •{ '+ _
01
ISSUED iFT) F:i:-c;MTT
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SITE STREET= .10924 22NO AVE ..j.•;{"•.{..:{••{ _.. 2H542-3. 9
ADDRESS= SPOKANE yes.(•:{i'•tE::. W/: 99206
PERMIT USE= SEWER CONNECTION — NORTH KOKOMO
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00.1797 PLAT NAME= KOK0m0 TowNTTF
BLOCK= LOT= 7ONE= AGSuB
OWNER— ?.} Nr::•
-
i.
ADDRESS=. SPOKANE
WA 99206_
CONTACT NAME= E tt•E''- .E. t t i i•, ._ I: j '�H i,i;`4;::: c.J i .. .. _.. ...
797
BUILDING SETBACKS : FRONT= NA i:-
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CONTRACTOR= E F�`'lt 1,E'i x!!i�i F•t D ,.t_ PHONE= 5l,,,t:, 924 5595
STREET= P0-,BOX 141557
ADDRESS= 'E`i; i:A ,} iiA 99214
ITEM DESCRIPTION Qi A TITY FEE AMOUNT
;_{NT
PROCESSING FEE 10.00
SEWER CONNECTION 40, 00
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pAymE:f....tT i}A..'.{.' ... PAYMENT AMOUNT
02/15/91 707 50.00
TOTAL DUE= .00 TOTAL PAID= 50, 00_
PERMIT TYPE FEE AMOUNT AMOUNT PAT -f*r.WIHNT owTNi,SEWER PERMIT 50.00 50.00 .00
50, 00
50.00 ..0
PROCESSED BY : jULTE SHATTO
PRINTED BY.: jULTE SHATTO
AVAILABLE
r gEWER STUB AS-BUILT INFORMATION TS
UTILITIES DEPARTMENT (456-7604)
CONTRACTOR OR APPLICANT Is TO FIELD LOCATE AND CONFIRM.E.RM H •
ELEVATION AN;-; POSITION OF SEWER STuB PRIOR TO ANY OTHER
_ EXCAVATION
t.} LOCATE BURIED 4./ k..f{at,..."..,.. 'GAS PIPING, WATER LINES, .. ..
CALL BEFORE YOU DIG (456-8000)
- SEWER :.: S Fs,'i::: i'-!. .... TO BF CHECKED PRIOR TO CONNECTION TO INSURE
E{t ?_. i t t?::.i 1 +"i.: 5 e:irlC (..;� { t{P.fF j;S I t. I I9; ;i t ! I{
tl 1?•i+:'P:K 9+.ti 74R CALL FOR iINSPECTION PRIOR TO COVER *********.k
3f•3P*A*3f•#3t�#•-.- '..-;"! HOUR i i E"•: N{.f i-:4 { F. REQUIRED
...jt; ; n t•')'i g! g i! -
9 . :; 3 ;;;• r ff - Jt . : t9 * :t :: : : : _. . . THANK. Mq1 :*_* i : a ::a..: gjj 4* r: *3 i ****it:..: } : i 3 „ ,.
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SPECIAL CONDITION CHECKLIST
Project
Address: -.____-_—________ Project# ____-- —Use:_____________-_
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
------ Special Insp,Final Report__.—. —_ v T__—_—_ _ _______
--- ------- — — Hydrant( )
—___ -- ___ —____ __ Lock Box_ __.- -- _ ___._
Engineer's_-- — RID/CRP ____
-__- _--___ _ Easements..___ __—_--
____.____--- __ — —. __ Road Plans/Improvements
— Bonds_ — — — — -- -- -----
Planning — — Bonds. —_ -- —_
Utilities__^ Double Plumbing —__--
- _ ULID
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:____________ ___.________ ___
Plans returned: _ — _—__ _ —__ _— — . Received by: —_--_____________ _______
No response from owner/contractor-plans destroyed:__.___—.-_______ ___ — ___—____.___ —____