1992, 05-21 Permit App: 92003631 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 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
:l O iF t..'. i' NUMBER=ir'"1BE:.R:::: )'; 0;:!: 63 1 APPLICATION DATE=F:.:::: ;?::7 ::.. ! .,.. •A!sE:::: 01
')i'*)i•** THIS IS NOT A PERMIT 3t uai•r;*
PENALTIES WII...I... BE ASSESSED FOR OMM :NC:i:Nc; WORK WITHcii.r ._......., T
SITE STREET= _ ;`07 E. 22ND AVE PARCELO= .,..;•4i .... ;0ii
ADDRESS= VEREDALE WA 99037
PERMIT USc - SEWER CONNECTION . ti EFAcREi (92S-504)
F** ` EE NOTE
h**
PLATO=„:= iY03091 PLAT NAME== i:::i-iUFs:C::i..i ADD
BLOCK= i LOT= i ZONE= UR 3.5 DI S M::::
AREA= F:'/A= l:: WIDTH= DEPTH= R/W= 60
OF BLDGS = i
.n. DWELLINGS= I WATER ER. DIS' ....
OWNER= r HOM( SON , MIKE P HONE= 509 922 0248
TrEi':T:. 1470 E 22ND AVE
ADDRESS= VEREDAL.E WA 99037
CONTACT TACT NAME= TOM STONE EXCAVATION PHONE NUMBER= 509 928 7710
BUILDING D.I.Nir cE'iBACK., : FRONT=T::= N .`A LEFT=:-' i r(? RIGHT= N/A REAR= N/A
nxu} A n) ) u p* ix a i ;i *n k* i {*i ** k aSEWER IEFMT ` 'ii...) ) A**** l x** ;A jpxijp {PPPnn ;
CONTRACTOR= TOM
STONE EX` ?rTFa � PHONE= 509 928
7710
STREET= I::isi BOX. 14154
ADDRESS= SPOKANE WA 99214
ITEM DESCRIPTION QUANTITY FEE AiM!OUN .
PROCESSING FEE `•j• 10,400
SEWER CONNEi:TI.ON 'i 40.00
PERMIT v, FE FEE
AMOUNT A~CUTi PAID AMOUNT OWING
SEWER PERI.'! 50.00 50
50.00 .00 50,00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED ::t r : s?OrMI. ! Rt.+VI.C:H , ROBIN
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
z
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR TRra{:'T'_++t Cl !_: N- IS TO FIELD i...f.t!;:Ai!::. AND CONFIRM ; I..;!:::
ELEVATION AND POSITION OF SEWER }'TUB PRIOR TO ('tr3':' OTHER
EXCAVATION
TO LOCATE BURIED CABLES , GAS PIPING, WATER ER L.INE , ECT .
CALL BEFORE YOU DIG (456-8000)
T
SEWER ;�'i.+I:r ra F•.E:: i i:i BE CHECKED PRIOR TO f.;Cl!'-.1 N E::!"::"(']:C:i N 'T'i:t is it1.:�'t.i i:•,i::.
THAT THEY ARE CLEAR AND UNOBSTRUCTED i THESEWER MAIN
)i•)i•;,:•*)i'';•:'x•*;;: i:;AI...i.. 'r'OF'. INSPECTION F:'E::C:T]:f:iN P'Ri OR TO COVER u:'x'AA •A)i•hr.I•
ro r i ) *rn*r24 HOUR NOTICE "Ei 4=D JN *M* ) )
456.-3604
1t..A'.1t..P:.)L)i.:lR'1!:
)?•)+:)i.);.).:):.i(.N');'*) )i)i)i•)i•*••r.•*)*)t*N:)r)k n at)E)i•)E)i*)r THANK Y+..i%•{ 'N')t P•)i-)i'){')!•)t J!•)i:**N•)S')!')t)?•)i•)t)?'R•)i•)i-)i-)i'*)i)i•l-:i!•9r**