1991, 08-06 Permit: 91002133 Sewer SPOKANE 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, 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
F F;CI:•iE:cT NUMBER== 91002133 ISSUED PERMIT DATE= 08/06/ • 01
It it)i•ti•ik!t it Ik P:)t P:P:•ii•91 ti•ii•ik it 3t it P:9i•*P:•ik Pi iE)k r'E R ri.F•( INFORMATION ai•*ik**k ik•ir*}t•ik 3i•*•}i-3t•**ik it ii-ik*ii•ii•r.•r:**
SITE STREET= 10811 E 25TH AVE PARCEL4= 28543-2822
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWE:R CONNECTION -" NORTH K:COKOMO
;tai SEE NOTE: **,t
PLAT4= 00.1393 PLAT NAME= KOK.OMO TOWNS I�E
BLOCK= > " LOT= _ ON ": AC ;I
r „ E{
T„ - �::•
AREA= 0000000 j F:;f:#:_: F WIDTH= DEPTH= 1,=:'r.,1::::
4OF
rID ;S_ 4 DWELLINGS= 1 WATER ia ,T
_
OWNER= NESiE PHONE=
STREET= 10511 25TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= RON SI..OAN PHONE NUMBER= 5 09 922 8500
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT:::: NA REAR= NA
P.•b:7k•it}i•it•ie•ji••jt P:R-*fi•it ii•ii••ii•)t Pc P:••jE yt u••jt•ji•P:*i!••n; SEWER PER ri.I.! A:•Ji'P:•N,'')t•k:P:''P:•Pi$i••it it ik lk N''A:4t•a:•V:•J!•?!..Jl-'/+:-)C•P:P:'f+:9k•P:'Jk
CONTRACTOR= ALWAYS; At.:'T I.'�E_ PHONE= 509 ` 2:? ::350:`i
STREET= PO BOX 141562
ADDRESS= Sl-C1KANEW A 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING I::'E::F:::: Y :, .Ji„j
SEWER CONNECTION 1 40...00
3t.j,..x.•)t P:•]t P:••ji•P:..•jt P:P:•..*P:•. P:P.**P:•A•P..ji..j,. .*** PAYMENT SUMMARY
! rifRY it Pt P.. jK i. pR..P : t t jt PPij
PAYMENT DATE RI=t::E:EPT:y PAYMENT AMOUNT
08/06/91 5375 50.00
TOTAL J 00 TOTAL PAID= 50: 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00
50.00 50.00 :.06
PROCESSED BY :i : 1i.1i_.:IF SHATTO
PRINTED BY : ..1U.1I._IE. ;ki"IA.(._i•-+::J
S'i..:WE::I'. STUB AS—BUILT INFORMATION IS AVAILABLE A7. Ti..HE:. COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPL.ICAN.T. ,. .. A AND CONFIRM THE
.I. �: t C7 FIELD 1...C1C::fi�'1::. 1 I 1 t1 i i-ii-.
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES: GAS PIPING, WATER LINES, F::c:...i. :.
CALL BEFORE. YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE t:'I...I:"Al'. AND UNOBSTRUCTED 1 I•ii THE SEWER MAIN
Yk 4k 3k.p.**.r:'•;k P: CALL FOR't° .S r•e:.!.: t J._J N PRIOR TO COVER *•it•it•ii•-a:*-Je*P.•P:
3t 9t P:•it 3'*ii-3t." 24 HOUR Nit 1 I:CE t:i I OUT RE)) I--ji-ii••Ii ii-ii• ' ri•ft P:
•jt :A•it*ii•.•*P:• 4~I6-••3604 *P:Vii'P:P:•jt•jt•ti•...
*»r*rt HrViN9 * t 3 t*rP9ae ;it t k i * rhht THANK� t Y . J rPii9a 3 t P� iiii � ir i � r r
c k it ir t r*J *
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-____-- ---
- Easements_ _i —
Road Plans/improvements —__--
--- Bonds
Planning _ W Bonds:—_
•
Utilities-- — Double Plumbing_ _ _
__._-- U L I D _
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 0/0 issuance:
Owner/contractor called regarding the return of plans: Date:-- -- ---------_.—__-
Plans returned: _______ — . Received by: ------------ ---____--No response from owner/contractor-plans destroyed: