1992, 12-09 Permit: 92010801 Sewer SPOKANE COUNTY DEPARTMENT QF BUILDING AND SAFETY
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 conforman with the provisions of any state or local
laws regulating construction. �•
SIGNATURE OF
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, �� ,�^ ;-� �t Wr` DATE
e 9 �J „
OWNER OR AGENT �' , / ���lll/// r� C
PROJECT NUMBER= 92010801 ISSUED PERMIT DATE= i2/09/92 AGF::::: 01
ic*nn3is t* t t 3r i *ri h 3 *3i **ur#hp1R MI. INFORMATION ****• :• *) *) ? m a *ria ir ri**iu i :Jr
SITE ,S IF'E::E-I•-: 12824 E:: 25TH AVE: F'AF'.C:;Ei...::. 4 '7'7...: -._. :.. :
ADDRESS= SPOKANE WA 99216
PERMIT USE=: SEWER CONNECTION H:I:I...i...i::F E::S T (92S-1217)
2,
3'** SEE NOTE ** •
PLAT4= 00-1223 PLAT NAME= HI1...I...C::F t:ST ACRES 2r:i1:j ADD
BLOCK= kJ LOT= ,, ZONE= AGSUB ,-.. ..r 4.... ,...
ARIA=: F'/A= F WIDTH= DEPTH= Ri'I.tl=::
4F OF Bi._DGS=:: I 0 DWELLINGS= I WATER DIST ::_
OWNER-: GAYLARD, C;ERRr PHONE::::
STREET= 12824 E 25TH AV
ADDRESS= SPOKANE:: WA 9216
CONTACT NAME= TRIPLE S CONSTRUCTION PHONE NUMBER= 509 927 82SA
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
at•i+:•�•at�:**�>:•�:•*•x•�••ir a�:�:•�:•�•�:•�•�•*�•at••�•*•x•** SEWER PERMIT *****************K:************
CONTRACTOR=F;At::'T'C3F;•w: TC;:CF'i...E S CONTRACTING PHONE= 509 927 8256
STREET= 11322 i-. BROADWAY AVE::
ADDRESS= SPOKANE WA 99206
ITEM iF; :F3FTI O rQUANTITY FEE AMOUNT
--------
PROCESSING FEE Y 10. 00
SEWER CONNECTION a 40.00
.. . `- n, `ti '•r *9t•3t'Jt 3 t''7t i'.•N:'i+i'Pill'N it iii•N:•:3•Ik'P:1t i++i a.1t P•Pi It;t 9f'
9r 9l if••ii�:•�ll ik•li•ii•i'i�:it�•�it•It�•li li•�•�•��i�:it�•ri•��•it r•`ht Y•r'E::±`�T' ,..I.1 r•i r't t•'•t t Y
PAYMENT DATE RECEIPT::: PAYMENT AMOUNT
i2/09/92 1110 50 .00
TOTAL.. DUE= .00 TOTAL PAID== 50.00
PERMIT TYPE:: FEE AMOUNT AMOUNT PAID AMOUNT OWING
,
_
EWER
PERMIT 50.00 50.,00 ., 00
PROCESSED BY : DOMITROV'ICH , ROBIN
PRINTED BY : DOMIT`i OV3:C.H, ROBIN
t-.14I..:Ft STUB AS—BUILT INFORMATION IS AVAILABLE ATt •iI::. COUNTY
;....F _.I T I ES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO F'IEi...r LOCATE AND CONFIRM THE
E
ELEVATION r�i i�!I:j POSITION !.i 1- SEWER STUB t. i''i•;I`"I��; ANY OTHER
EXCAVATION
TO'""i LOCATELOCATEBURIEDBURIEDi:::r"tI:{i..'±:S, GAS PIPING , WATER LINES , ECT,
t
C.., BEFORE: YOU DIC (456-8000)
SEWER >:it wII:{`; f-t F;,::. TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY Y AI I..: CLEAR AND UNOBSTRUCTED "CO THE SEWER i MAIN
•jl it*l;:jl:1i P A 7!i CALL F i::l Ft INSPECTION PRIOR TO COVER ll•N:ll ji'.j;.ll ll ll ll ll
It ll It it'l;:It ll It 24 HOUR NOTIi::I..: REQUIRED ri it it k It It:Pi.j1.m:it
9k 9k 9t 9k 9k••A•P:N:.jh 456-3604 ****:***3c**
THANK i t••.•!1 1 if 1 +, fl f ! 1 h f )>• 1 FN 1 1 it 1 } !i+•!1
�)?•'JI It tn.it 7t:�'li It Jt it'!l ll!k A 7+i 7{•ll i+•l'jt'l+i ll ll It.J+i•j+i'Pi'Pi i4••P:9+:•!t YOU .
19::9:$t i:•Vi it:il}l:l:•j.l::.t:'l.::'):1:.:ii•l:9'i 9t 9:94'9:.:t:•P:94.90