1992, 12-03 Permit: 92010616 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BI1OADWAY 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 rovisions 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
SITE ETREET- 12522 E 24TH AVE PARCEL4- 4527 „ 260:".3
ADDRESE- EPOKANE WA 99206
PLATO- 00'122C PLAT NAME- HILLCREET ACREE 6TH ADD
BLOCK- LOT- ZONE- EFR
AREA- 00011950 E/A- F WIDTH- DEPTH=
OF BLDCE- DWELLING = 1 WATER DIET =
OWNER= WAILHS , NORMAN PHONE=
ADDRESE- EPOKANE WA 99216
PHONE NUMBER=
BUILDINO SETBACKS : i-RuNi = N/A LE - i = N/A N/ A REAR- N/A
CONTRACTOR= OWNER PHONE-
ITEM DEEORIPTION QUANTITY FFE
HRucEEEINu ;- EL
EEWER CONNECTION 40 , 00
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
TOTAL DUE- , 00 TOT 50 ,00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
50, 00 50 ,00
PROCEEEED BY :
................................................
v:...iv:
ITROVICH , ROBINDEFAMENI ( 456-.:3 )
i : v.: i... LOCATE