1991, 08-05 Permit: 91002532 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE.WASHVNGTON 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 Sx County to proceed with nmvossmu 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= 91002532 ISSUED PERMIT DATE= 08/05/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= iiii4 E 26TH AVE PARCELO= 28543-3413
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - SOUTH KOKOMO
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO WNSITE
BLOCK= LOT= ZONE= AGJUB DI%T4= F
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W= 70
4 OF BLDG%= i 4 DWELLINGS= i WATER DIST =
OWNER= SMITH, B A PHONE=
STREET= iiii4 E 26TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEONARD - H & S PHONE NUMBER= 509 926 0964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= H & % CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
----------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
08/05/91 5288 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.00 50.00 .00
------------- ------------
50,00 50.00 5O.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB A%-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
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: ___.__. _ Project# __ _Use:.___. ---
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept..of Bldgs.
Special Insp.Final Report
Hydrant( )
----.___-- Lock Box
:
Engineer's — RID/CRP _ _
Easementsi___— _ --
�— Road Plans/Improvements __-
Bonds •.:
Planning ,Boobs.: i
Utilities-______-_-- Double Plumbing
U L I D
Other . . _ • :
. j y.:
""*"`" "' THIS SPACE FOR COMMERCIAL PLANSTf a4OKIN ;CERTIFICATEOPOC'CO ANC'fC?(VL'!*,„<
Date received for C/0rocesssn
p g: _ _-= � - _ ' Plans:putted:fair
Temporary 0/0 Cai#if.
icafe
of QcG.up�n�y,issued:____
Office file review by: __ . Date:
F:ii:ec(hasp finaled b _. f a- ___ ._: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:__._