1991, 11-27 Permit: 91005204 Sewer ,
SPOKANE COUNTY DEPARTMENTOF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
/vum,vmut/xuvooxammoumwnmm/uunnnvuoon.atammuuhemm,munonoonta/n^omnunuuuummoou'movn"vagentmvnmvnaanmn rmit/application is true
and correct, and authorize Spokane Conty to proceed with processing. In additionI 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= 91005204 ISSUED PERMIT DATE= ; i /27/91 PAGE= 01 '
**************************** PERMIT INFORMATION ****************************
SITE STREET= 1i009 E 25TH AVE PARCFLO= 28543-2723
ADDRESS= SPOKANE WA 99206
� ^ _
PERMIT USE= %EWER CONNECTION - NORTH xOKOMG
*** SEE -NOTE ***
PLATt= 001393 PLAT NAME= KOKOMO TOWH%ITE
BLOCK= 27 LOT= ZONE= AG%UB DIET.*=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= DWELLINGS= WATER DIET =
^ - -
OWNER= BAXTER %COTT PHONE= -
STREET= 11009 E 25TH AVE
ADDRE%%= SPOKANE WA 99206
CONTACT NAME= RON %LOAN PHONE NUMBER= 509 922 8500
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA '
***************************** SEWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500 -
STREET= PO BOX i41562
ADDRE%%= SPOKANE WA 99214
m
ITEM DE%CRIPTION QUANTITY FEE AMOUNT ^ � _
------------------------- -------- ---------- .
PROCESSING FEE Y 10 .,00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
1i /13/91 33 50.00
11 /13/91 8633 50.00-
11 /27/9i 9060 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 50 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50.00 .00
` ------------- ------------ ------------- '
50.00 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : DGMITROVICH, ROBIN
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PO%ITION OF %EWER STUB 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 IN%URE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: ___ _ . Project#_ — Use:__
Dept: Date: Condition: Init: 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 TRACKING,CERTIFICATE OF OCCUPANCY 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:_ ___-- _______________ ________________._______—__._.__