1991, 03-18 Permit: 91001144 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
1 certify that I have examined this permit/application, state that the information contained in it ar d submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addoon, i i ale 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 `� -f7 % 4/'�G��`�J T APPLICATION
OWNER OR AGENT � � - DATE
PROJECT
NUMBER=
! Z i 1 Y S ISSUED PERMIT DATE= 0308/91 PAGE= t
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PERMIT If ..•O,• i"tF 1 i.i.i.. itv.
SITE STREET= .t •i 41 9 E:. 24TH AVEI"'ARCEi....,,._.. 2854 2-3830
ADDRESS= SPOKANE WA 99206
PERMIT t ;} . : = INSTALL NEWER CONNECTION i" O i" DUPLEX
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PLATO= O!J., ::._, PLAT NAME= KOKOMf::i T.i,iWI,7S I •t I::.
BLOCK= 24
ZONE= UR 3.5 DISTO=
AREA=: r: /A WI:i?T•U= DEPTH= j:,/W= 60
•,r OF .:{ ... ? G ,.1 --'• 0 DWELLINGS= 't WATER ..?I ! ....
OWNER= i iANSl...r1, if.A?...D..J P. F'!••it.JrNi::.:::: 509 926 .;...,:.•_'r
STREET= i0000 N MAMER RD
ADDRESS= SPOKANE WA 7906
CONTACT t`yAME:: = JACOBS EXCAVATING t:=HOi``%!::. NUMBER= 509 924 .;..355
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= A i,:...1:}E:::: NA
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SEWER PE::RMI-•t• 'ii :Ji .;,; •ii• ''r: •ii..R.:n: •n: •i+:.p:.�..y,..n..i,..y;.:n; •;i• ii• •ii• i,; .P_ .y;..i�: •'n: •i•: i4 �n: •ti �Ji•
CONTRACTOR= J f i C i.i B S EXCAVATING PHONE= t:i t� 9 924 ::'•..}5
STREET= 13420 E ,`. f";LTE,`. E:: A`Ji:::
ADDRESS- SPOKANE WA 9906
: f?%:.j •!+':j
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- -------------
PROCESSING
......—...........---..
SEWER CONNECTION I:ON •t50 . i;i ..;
.. J . P: •P: 'P: •n.• ;!• 7!: •N: ',t• 9k 9k lk •J!• dtr -ii• ';ti -!�i -;ti 'Ni 'ttr •P: •n: 'hi 'Pi •)i 'Pi -n: 'P.' N• •Jk
PAYMENT SUMMARY '1+: 'n• 1+..Jt n •li• •A• •h:• h:• '!+r 'Pr •;i• :i,; �j{• -j,; je; •j,j �.i,i •!ti •P::'�.• 9,i ;,i •pi �;ti ')i' in., •;i'
PAYMENT DATE I::. RC:...:E I t.. f 9: PAYMENT AMOUNT
50.00
f ii302
........ _.......................... _........
TOTAL
.i t..! ! F1 ... l...!.::.":: J TOTAL I''ri.i.,.: 5%00
PERMIT 'T`± PE.: FEE.: AMOUNT AMOUNT PAID Ai`'ii:ii.lNT OWING
...... ...—................................ — _.. _.. ------------ ..-_...._—»_.._.._-----._... ----
..- -- - — ......_ .
5&00 50.00 00
PROCESSED BY: JOHN LARSON
PRINTED BY: JOHN LARSON
SEWER STUB AN—BUILT INFORMATION IS AVAILABLE AT THE i::::OUNT,r:
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD OiFTEAND CONFIRM
TF'iE::
ELEVATION ANl,;, Pi1;':ETI::iN OF SEWEi :`.i'TUB PRIi..iR TO ANY i._iTHEE'.:
EXCAVATION
TO LOC;ATE:.! BURIED CATri._E::,aE YOU DIG , t:.r�; t::+I:j::+:ENi:;, WATER LINE, : ECT...
CALL —8000)
;aE::WE::Et STUBS ARE:: TO BE:: CHECKED PRIOR TO CONNECTION
4i.jisi•. Ljit,i. i}1t!,:•.JnA,; ..rpNt:•• •i:n!,i• i3•;rEti i�'At�:i �--;ni+:: .OtN
`ri•I,t• Oigini:• :•�,iN:•• a�i:' i;fi• ��i'• i:„i: '�iG:• i�•;ii
..iE
THATTHEYARECLEAR AND UNOBSTRUCTED TO THE iEW=R MAIN
CALL Et% INSPECTION I::tETO C,ViI
24 HOUR NO E!REQUIRED
56.h6)t.
... .. . .
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THANK
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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
Easements
- Road Plans/Improvements
Bonds
Planning _ _ Bonds
Utilities _ Double Plumbing
ULID
Other —
•
•
•
"******************************THIS SPACE FOR COMMERCIAL PLANS,TRACk ING,CERTIFICATE OFOCCUPANCY ONLY****************************
Date received for C/O processing: Plans pulled for final processing:
Temporary C/O 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:
Plans returned: _._-- ---. — . Received by:No response from owner/contractor-plans destroyed:__