1991, 03-28 Permit: 91000500 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
/ovmfvmat/nuvooxummoummnmm/uupnocuoon.umtnmvtmomm,munonnontumoumxunuov»m.oeu»vmounn'agenu000mnnooump rmit/application is true
and correctand authorize SkCounty to proceed with processing. In oum I have read and understandm 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= 91000500 I%%UED PERMIT DATE= 03/28/91 PAGE= 01
**************************** PERMIT INFORMATION *** ************************
SITE STREET= i1005 E 22ND AVE PARCEL4= 28542-3014
ADDRESS= SPOKANE WA 99206
PERMIT U%E= SEWER CONNECTION - NORTH KOKOMO
***
EEE NOTE ***
P AT4= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK::. 14 LOT= ZONE= AG%UB DI%T4= F
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 4 DWELLINGS- i WATER DIET =
OWNER= BARBER, L E. PHONE=
STREET= 11 ()05 E 22ND AVE
ADDRESS= %POKANE 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 S CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRE%%= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y iO. 00
SEWER CONNECTION i 4000
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE PAYMENT AMOUNT
O3/28/9i 1615 50.00
------------
TOTAL DUE= OO TOTAL PAID= 5�.�O
^
PERMIT TYPE 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
%EWER STUB A%-BUILT INFORMATION I% AVAILABLE Al' 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, GA% PIPINGWATER LINE%,
CALL BEFORE YOU DI� (4';e:%—R000) '
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR :AND UNnETRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 ********** '
******************************** THANK YOU *********************************
� .
SPECIAL CONDITION CHECKLIST
Project
Address: Project# ----__—�_
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_____ w.__—_.___ _
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: -----