1991, 07-08 Permit: 91000877 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
PROJECT NUMBER= 91000677 ISSUED PERMIT DATE" 07/08/9i PAGE=:: Oi
**************************** PERMIT INFORMATION ******************* :********
SITE:: STREET= 11220 E:: 25TH AVE: PAF;`CEE_.4"= 28543-3104
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION
** SEE NOTE ***
PLAT':= 001393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 31 LOT= ZONE=:: AGSUB DISTO= F
AREA= 00000000 F/A= F WIDTH= DEPTH= F,/W-..
m OF BLDGS= i 4 DWELLINGS= i WATER DIST =
OWNER= TAFF PHONE-:
STREET= 11220 E 25TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
** * xa** * : :*** ********** SEWER PERMIT Aar*# :******h******•x•*** :**x ***
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
STREET-: 16402 E VALL..EYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 1e0.00
SEWER CONNECTION i 40AO
e:,O
•****************************** PAYMENT SUMMARY *****•****** ***3•***** •3**•A•*
PAYMENT DATE. RECEIPT 4 PAYMENT AMOUNT
07/08/91 4471 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
---------------
SEWER PERMIT50.00 50.00 .00
50.00 50.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS 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 ARE TO BE.: CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
rid{***3i•.3u* CAL..L.. FOR INSPECTION PRIOR TO COVER A** ** •*
•******* 24 HOUR NOTICE. REQUIRED #ai*#E* 3t#**
R*x. x**** 456_-360 ******** *
*3f•3i****)r*****#iii-*##fir******** *** THANK YOU *****3t'JE3E**********R'}t'****3t*if P*****
SPECIAL CONDITIONCHECKLIST
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 Pians/Improvements
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..-_.... __._.._._..._.._..._.___.__._ .�.— _._.___._._ •. - i.. •.Utilities.--- - - Double Plpmbincg .71; , �{., .! .
----�.__. U L I D
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Other
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777 777,774-
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_,x._.<'—,....,,,._.*”*—= *.THISSPACEFORCOMMERCIALPLANSTRAGKII GfCERTFFICATE'OFOCCUPANCYONLY""t'
Date receivers for C/O proo sstngi Plans: su(ted:f> t final prQeestinc
Temporary C/O issu 0
.- --.- ---- --- -- � �---. ���ti,#3�#eof j4Ctspancy,isstied:
. _----
Office file review by :. , Date :,
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans ____.-- Date
Plans returned. ._._. Received by:
No response from ownericontractor-plans destroyer