1991, 03-13 Permit: 90006323 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 Ska County to proceed with processing. In addition, I have reaand understandmo /wspsormwnsoumswswTmwnr/os
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= 90006323 I%%UED PERMIT DATE= 03/i3/91 PAGE= Oi
**** *********************** PERMIT INFORMATION ****************************
SITE STREET= 11206 E 22ND AVE PARCELO= 28542-3202
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
�
*** SEE NOTE ***
P I...A T4= O0i393 PLAT NAME= KOKOMO T WN%ITE
BLOCK= LOT= ZONE= %FR DI%T4=
AREA= F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= i 4 DWELLINGS= i WATER DIET =
OWNER= GRIFFITH GEORGE PHONE= 509 924 2449
STREET= 11206 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= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= TOM STONE EXCAVATING PHONE= 509 928 7710
STREET= 1112 N MAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 10.00
SEWER CONNECTION 1 40.0�
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
03/13/9i 1235 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 5O.00 . 00
PROCE%%ED BY : JULIE %HATT
PRINTED BY : JULIE %HATTO
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-36O4)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF %EWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING , WATER LINES, ECT,
CALL BEFORE YOU DIG (456-8000)
SEWER ETUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO IN%;RE
THAT THEY ARE CLEAR ND UNOBETRUCTED TO THE %EWER 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: Init: Appr:
(in) (out)
Dept.of Bldgs. -- -- ----- ---..__.—___ --_—_---
- Special Insp.Final Report
—__-- Hydrant ( )
-- Lock Box _
Engineer's____.___ RID/CRP.
Easements_
Road Plans/Improvements
Bonds
Planning___ __ __ Bunds-_ .
Utilities___---__—_-- _---- Double Plumbing
ULID
Other,.
•
•
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY ONLY************..**`"*k****"****
Date received for C/O processing' --- — Plans putted for final processing: —_.-- —_--
Temporary C/O issued.:. • .; .Certificate of Occupancy issued:_-- --
Office file review by — Date:
Filed insp healed 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: