1991, 12-04 Permit: 91006761 SewerSPOKANE 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, 1 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
ATE_
PRt. JE::t::T NUMBER= cri 00c,'•r6i ISSUED PERMIT DATE= i2/04/9i is A` E= Oi
PERMIT • l_R t H I _! N
SITE E ;} REE:. t== i i 3i i E. 24TH AVE f"AR t::.L = 28542-3828
ADDRESS= SF'Ok:r"rNE WA 99206
PERMIT USE= SEWER CONNECTION -- NORTH KOKOMO
PLATO= 001393 93 PLAT• NAME= KOKOMO T'OWN,y is T'E::
BLOCK= 24 LOT= ZONE:.:::: AfxRI DIST:„"'.:::: F
ARE::A-:;t,!t}f)0�' 00 F'A'Aµ: F• WIDTH=DE PTHC R /W=
0 OF BLDGS= i a• DWELLINGS= T.NGS= ► DIST
OWNER= i''t7:l..LER is=i..ONE=:
STREET= 'i i 3i i E: 24TH AVE:.
ADDRESS= SPOKANE: WA 99206
CONTACT NAME= DONNA CCIURCHAINE:: PHONE NUMBER= 509 924 5485
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
31. . •R. •bl- !4 )k •P: 'R ' . :,i....F: it- -!�: •H: ?P: •P:.b..:N..M• n' b: : 9r,. '1{ -1k 'b:SEWER PERMIT
.N..n..A: il..A .A..P: •M .n. 'A..t!• bt �t -b: P: k •lt 'h: �i' 'F: �: •�+: P: ;i' �: -/t -li: 9k •P: T:
CONTRACTOR= COURCHAINEr 4:ONST"RI.Jt::TION PHONE= 509 924 548!5 -
STREET=
. 8!5-
4TF'EE::T== i6402 E:: VAL.L_E::YWAY
ADDRESS= VERADALE WA 99037
ITEM M DE::iSC;R7:PTION QUANTITY FEE AMOUNT
SEWER CONNECTION i 40.00
31• �: R:.u. ..A..k !i• b: it 'P.:• 'N: ii• R: 1+: •N:.'�..r. 9!• .p: R..�• •P: 'b: 'b:• P: H: iE �:• •k '�:
PAYMENT
AT ME-Nf SE. tr" 1MARY )k 3i• '11: 9l 'N: A: -It' ')l' •P: -yi• R- •P: '14 •A:' •1l 'n: 'ti' '!t 'A. Vii' •jt' j�; '!i- .p::��..P: •)+: •P:
PAYMENT DATE RECEIPT:"w PAYMENT AMOUNT
12/04/9i 9i8i 50.00
-------------
TOTAL. DUE= .00 0 TOTrus... !=AID= 50 00
0
PERMIT TYPE: F"E::E:: AMOUNT r~ -}MOUNT PAID AMOUNT OWING
SEWER PERMIT 50,00 50.0t)
50.00 50.00 .00
PROCESSED BY: JULIE EHATTO
PRINTED BY: DOMI:TRO IC H, Ft:t:lBIN
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456._3604)
CONTRACTOR OR APPLICANT CANT I S TO FIELD D i_ OC AT•E: AND CONFIRM T HE:
ELEVATION AND POSITION OF SEWER STUB F'C::iOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT,.
CALL BEFORE YOU .DIG (456-800 0)
)
SEWER STUBS ARE TO BE:: CHECKED PRIOR OR T O CONNECTION TO INSURE:
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
ti JS h:Ain3('3iN:ii•
CALL FOR INSPECTION PRIOR TO COVER
!i iiHRai 'r'•
24 HOUR NOTICE= RE'QUIRI:'i',
al• :p� it i�: •li• i�: ii• 'P:
456-3604
•}+ •ii h: -it ;u: 3i• �• k �: 'h:•
THANK YOU .... �: it ii• 3+:• 3r -� �r ii• ii •M• N• ii k it k• �• �i a- it n p• n• �E :A• �• 3+• •'r,'• i� •»- »• m• •r.• -n
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept,of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
2),i • • ;',*; ,
ir 4.ff.; *•)Y f(' (.; ; : ..'4 :h
Engineer's 4 .
I)
Easements
Road Pla0sY401p1PvementsE:;IC:is; ••• ; )•)'• •, . *.*
Bonds :;:e; : );:•••));••:4)
ty... :5%.?;;
.„5 ..5
••• '•42,-)._
• •••• ;.. • • • • ,
f 1.•.0;
Planning Bonds 7 r;.„
i; i f i " : k-f Ai!,
;vs') •••' •••••:,;s1 ;;;; :•;! ! ; . \5i; ;-; ; 1 •
y v. .5t 1: .v• " :( *:
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Utilities • ":••"::' Double PtOrtbirag •.;
ULID
Y"
Other : EE r
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TH4-8. .FAPf.if0 ! c!4*FTWIP.,!+7;e•PFiCP,PcUPANPY,ONLY,!"-r************************—
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-- —
Date received for 0/0 prcfc'es4ing:•;- ;::;-.4-!:f) ; ; ;• • ' T fir4lit;;O:cit06.4ingi:;7,A E");-• ; T
Temporary C/O issued: accUparicy'iS‘stibd: • .." •• '
Office file revieW'bEY2-) LIL. i 7 7. 1•••••:i
Filed insp finaled by: '‘ '' `...; i .•
T
;!..„1,1z •"7 i 1 i • •Eit $i;•-
••• 41: :•Sa; :,1.; .k.;
Ninety days after C/O.iss •eivance:
-•• E(••;f:-Divrier/tdrifrabt-ci't catledii-egFirdingk-the:r4tdefi 1"-1"4'. at&
Plans returned: Received by:
No response from owner/contractor-plans destroyed: