1991, 03-28 Permit: 91000508 Sewer SPOKANE COUNTY DEPARTMENTOF 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 mnoeu 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
PROJECT NUMBER= 91000508 ISSUED PERMIT DATE= 03/28/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 11219 E 25TH AVE pARCEL4= 28543-26O8
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - NORTH KOKOMO
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= LOT= ZONE= AG%UB DI%T4=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
41' OF BLDGJ= i 4 DWELLING%= i WATER DIST =
OWNER= JEREMIAH DAN PHONE=
TREET= -i 12i 9 E 25TH AVE
ADDRE%%= SPOKANE WA 99206
CONTACT NAME= LEONARD - H & % PHONE NUMBER= 569 926 8964
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= H % CONETRUCTION PHONE= 509 926 8964
%TREET= 11817 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DE%CRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PRUCE%%ING FEE Y 10.00
%EWFR CONNECTION i 40.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENTAMOUNT
03/28/91 1621 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------SEWER PERMIT PERMIT 50 .0O 50.00 .00
------------- ------------
50, 00 50,00 5O.00 . .00
• PROCESSED BY : JULIE %HATTO
�
PRINT�D BY : JULIE %HATTO
� .
SEWER ETUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER •
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS RE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR` IN%PECTI N 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 ---
Engineers _____ ------_-_--- __-. RID/CRP -------_-_-- —__. _
_________________ _d___________ .__. 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 hie review by: . Date: __.__._..
Filed insp finaled by:__.__ _______-______---_-__ Date:
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: ___ -_.__-___-__ .-_----.____. Date _
Received by
i ans ret u me . ----- -----_-------------- __--- --- ---- ---
No response from owner/contractor-plans destroyed: