1991, 03-13 Permit: 90005231 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify thatI have examined this permit/application, tate tht thinformation cont / d in it and submitted» t to compile said permit/application is trv
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
PROJECT NUMBER= 90085231 ISSUED PERMIT DATE= 03/13/91 PA6E= 0i
**************************** PERMIT INFORMATION ****************************
SITE STREET= 11122 E 22ND AVE PARCEL4= 28542-3203
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - KOKOMO
*** SEE NOTE ***
PLAT4= 00 1393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 18 LOT= ZONE= AGJUB DI%T4=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
.11, OF BLDGJ= i 4 DWELLING%= i WATER DIST =
OWNER= T OMMEN, MARK % PHONE=
STREET= iii22 E 22ND AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEWIS - TOM STONE PHONE NUMBER= 509 928 7710
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= HA
***************************** SEWER PERMIT ******************************
CONTRACTOR= TOM STONE EXCAVATING PHONE= 509 928 7710
STREET= 1ii2 N MAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 10,00
SEWER CONNECTION i 40. 00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
03/13/91 1220 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.00 50.00 . 00
------------- ------------
50,00 50,00 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
SEWER .STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILIIE% DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
77VATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING , WATER LINES, ECT.
CALL BEFORE YOU DIG- (4!:56-8000)
SEWER STUBS ARE TO BE H R TO CONNECTION TO INSURE
THAT THEY ARE CLEAR N %T | ED TO THE SEWER 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.
v__-- Special Insp.Final Report_
Hydrant( )
Lock Box -- --- --- �_ —
•
Engineer's -- __-- RID/CRP .
Easements
— -- Road Plans/Improvements --_-
- _ — Bonds _ —
Planning—_— — . Bonds.
•
Utilities. Double Plumbing
— — ULID — —
Other
` —""***°*`*""*`"THISSPACEFORCOMMERCIALPLANSTRACKING;CERTIFICATEOFOCCtJPANCY'ONLY""'*`***""**°********'"`"*"`"
Date received for C/O processing: .Plans pulled for final processing: - —� -----.__
Temporary C/O issued:.___ - Certificate of Occupancy issued' -_ _Office file review by: _ .T- s----- Date:
Filed insp finaled by:_ Date:
Ninety days after CIO issuance:
Owner/contractor called regarding the return of plans: __-- _— Date:
Plans returned: . Received by:
No response from owner/contractor-plans destroyed:__—_-- —._ ._ ------.-----------------_-__.---------------------_.__._