1991, 06-18 Permit: 91002564 Sewer SPOKANE COI 4TY 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
PROJECT NUMBER= 9100 564 ISSUED PERMIT DATE= 06/18/91 PAGE== 01
**** *•***•*********•*********• PERMIT INFORMATION ** •• • •*• • ***a ir* • * • * * • •
SITE STREET= 11408 E 23RD AVE PARCEL_r= 28542--38i 2
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION -- NORTH KOKOMO
** SEE NOTE ***
PLATO= 001393 PL..AT NAME= KOKOMO TOWNSITE
BLOCK= 24 LOT= ZONE= AGSUB DIST4=
_= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
0 OF BLDGS= 0 DWELLINGS= i WATER DIST =
OWNER= KRAUSE:. PHONE=
STREET= 11408 E 23RD AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT:- NA LEFT:-: NA RIGHT= NA REAR:- NA
*•******•x :*•x •**n• **** • :** • :* SEWER PERMIT ******•x*** •****• ** x; •********
CONTRACTOR= COURCHr•"a:ENE CONSTRUCTION PHONE= 509 924 5495
STREET= 16402 E:: V'AI...L..EYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE: Y 10.00
SEWER CONNECTION i 40.400
*** *•********* • :*k*** •***** •*** PAYMENT SUMMARY ************•;k•;i••*******•u*•;****
PAYMENT DATE RECEIPT : PAYMENT AMOUNT
06/18/91 3890 50.00
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE:. FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 .00
50.00 50.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JUL..].E:. SHATTO
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 O1=• SEWER STUD PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
* ** *) ** CAL.L.. FOR INSPECTION PRIOR TO COVER ***x**A***
#•**•YE•k#ic** 24 HOUR NOTICE REQUIRED **********
******* 456-3604 **•x•****•xri•*
********x*********************** THANK YOU *3e **** *** * ***
SPECIAL CONDITION CHECKLIST
Project
Address: _ — .. _ Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp. Final Report _
Hydrant( }
Lock Box
Engineer's_—__— _ RID/CRP
iff
Road Plans/Improvements
Planning_ Bonds
Utilities — Double Plumbing
U L!D
Other a — ..
i•
*"*"• `••{'****tHISSPACE FOR COMMERCIAL PLLANSTRAGClIVQ'C;ERTIF#BATE' 1FOCCI)PANQYONLY.* ***—*"***********"**—•,•
Date received for CIO pir®ce$sing= Alans pulled:#o�finai'processing
Temporary C/O issued_ *•ifi" Occupancyissue:' -- —
Office file review by _ . _ Data
Filed insp finaled by: ___ -_ . Date:
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: -----__________. Date:—
Plans returned: _.. Received by:
No response from owner/contractor-plans destroyed:_—__