1991, 08-07 Permit: 91004820 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 correcand authorize Sx County to proceed withpmvessmo 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 constructio .
SIGNATURE OF APPLICATION
PROJECT NUMBER= 91004820 I%%UED PERMIT DATE= O8/O7/9i PA1,E= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= i0721 E 26TH AVE PARCEL4= 28543-2925
ADDRESS= %POKANE WA 99206
PERMIT WE= :<:EWER CONNECTION - NORTH KOKOMO
*** SEE NO ` E ***
PLAT4= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= LOT= ZONE= UR-3.5 DI%T4=
AREA= F/A= F WIDTH= 81 DEPTH= 130 R/W=
4 OF BLDG%= 4 DWELLINGS= i WATER DIST =
OWNER= FORNEY, GARRY PHONE=
%TREET= 10721 E 26TH AVE
ADDRESS= SPOKANE WA 99286
CONTACT NAME= RAY SHORT PHONE NUMBER= 509 928 2471
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= MOUNTAIN WE%T MECHANICAL PHONE= 509 928 2471
STREET= 9116 E SPRAGUE AVE
ADDRE%%= %POKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10.08
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
08/07/91 5415 5O. 00
TOTAL DUE=DUE= .00 TOTAL PAID= 50 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ _____________
SEWER PERMIT 50.00 50.00 .00
------------- ------------ -------------
5O.O0 50.00 .00
PROCE%%ED BY : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
SEWER STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PO%ITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BUR 3:ED CABLE%� GAE PIPING, WATER LINES , FCT.
CALL BEFORE YOU DIG (456-8000)
%EWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
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 It _Use:_
Dept: Date: Condition: snit: 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__ ._ _.---- ----__ w_ __. Double Plumbing__
ULID
Other_.____..____.— —
•
•
•
""""" `°"• —*""*"*— "—THISSPACEFORCOMMERCIAL_PLANSTRACKING,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: v. 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:_� -- _ -------____-----------_ »----_- _--