1991, 03-28 Permit: 91000506 Sewer 2 ' m — � _� ~ °
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
3U
N� 13BROA0V�AYAVENUE
/ �POKANE.WASH|NGT0NS92GD
(589)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/applicationis true
and correctand authorize Spokane County to proceed with processing. In addition, I have read u 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= 91000506 I%%UED PERMIT DATE= 03/28/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= ii2ii E 23RD AVE PARCEL0= 28542-3215
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — NORTH KOKOMO
*** %EE NOTE ***
PLATw= OOi393 PLAT NAME= KOKOMO TOWN%ITE '
BLOCK= 18 LOT= ZONE= AG%UB DI%T4= F
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OE BLDG%= i 0 DWELLINGS= i WATER DIET =
OWNFR= HLUBOKY PHONE=
%TRELT= ii2ii E 2RD AVE
ADDRE%%= %POKANE WA 99206
CONTACT NAME= LEONARD — H & % PHONE NUMBER= 509 926 8964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
•
CONTRACTOR= H & S CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
---------....--------------- -------- ----------
PROCE%%ING FEE 10.00
SEWER CONNECTION 1 40.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
03/28/9i i619 50^00
. ------------
TOTAL DUE= .00 TOTAL !::'AID= 5O.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50.00 .00
, ------------- ------------ -------------
5O.00 50.00 .00
PROCE%%ED BY : JULIE %HATTO
PRINTED 3Y : JULIE %HATTO
SEWER STUB A%—BUILT INFORMATION I% AVAILABLE AT THE COUNTY
. UTILITIE% DEPARTMENT (456-36O4)
.
CON T R OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PO%ITION OF %EWER %TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES,. GA% PIPING, WATER LINES, ECT,
CALL BEFORE YOU DIG (456-8000)
%EWER STUBS ARE TO BE HE KE PRIORO
TO CO��ECTI � TO 7N%�—E
THAT lit ARE CLE ~UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR I EPECTION PRIOR TO CO;ER **********
********* 24 HOUR NOTICE REQUIRED **********'
********* 456-3604 **********
, ******************************** THANK YOU *********************************
,
,
^
SPECIAL CONDITION CHECKLIST
Project
Address: -- -- - �_w-- Project# Use:
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 __ —__ _.
Planning—_-._ Bonds.-----____.
Utilities _ _ Double Plumbing
--- _ U L I D_ ---- — --
-- ------ ----Oth er_____-- -- ---------�_ _
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY
Date received for 0/0 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 C/O issuance:
Owner/contractor called regarding the return of plans: __ ._._.____ _ _—_. Date ____ . __.____ _
Received by: ____________________
No response from owner/contractor-plans destroyed. _ _— —