1991, 11-27 Permit: 91005678 Sewer ~ ' ,
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
VK1303 BROADWAY AVENUE
' SPOKANE,WASHINGTON 99260
(509)456-3675
/oom/vmat/havooxammoum/npermmuvnnouuon.ututomutmvmm,muuonvontumoomnunuavom/ooubvmeonnvagentmovmnoonumpermit/application is true
and correctand authorize SkCounty to proceed with processing. In uom 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= 91005678 I%%UED PERMIT DATE.- 11 /27/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 11i21 E 22ND AVE PARCEL4= 28542-3110
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOHG
*** SEE NOTE ***
PLATO= 001 393 PLAT NAME= KOKOMOTOWN%ITE
BLOCK= i5 - LOT= ZONE= AGJUB DI%T4= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= i 41, BWELLING%= i WATER DIST =
OWNER- SCHMIDT PHONE=
`
STREET- 11121 E 22ND AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= RON %LOAN PHONE NUMBER= 509 922 8500
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET.. PO BOX i4i562
ADDRESS= SPOKANE WA 99214
| ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10,00
SEWER CONNECTION i 40.00
i
******************************* PAYMENT %UMMARY **************************** /
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
1i /27/91 9068 50. 00
------------
TOTAL DOE= .00 TOTAL PAID= 50 .00
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 : DOMITROVICH, ROBIN
SEWER STUB 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 PIPIN�, WATER LINES, ECT,
CALL BEFORE YOU DIG (456-8OOO)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
i ********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-36O4 **********
******************************** THANK YOU *********************************
/
i !
SPECIAL CONDITION CHECKLIST
Project
Address: _—_ _ _ Project# Use:
Dept: Date: Condition: Init: 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 C/O issued:._______ Certificate of Occupancy issued: v__ _
Office file review by: __ _ . Date: ____ •
Filed Insp finaled by:— — w —. 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: ________ --._--