1991, 12-19 Permit: 91007943 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify thatI have examinedms permit/application,state that the infoon contained iit and submitted» t to ile 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
�R�JECT NI%%UED PERMIT DATE= i2/19/9i
**************************** PERMIT INFGRMATIGN ****************************
J�TE :":-:TR:. ET= i1125 E 26TH AVE PARCEL4= 2543-3i20
ADDREE%= %POKANE WA 99206
PERMIT U%E= JEWER CONNECTION - %OUTH KOKOMO ( 91 -%62)
NOTE ***
PLAT4::= 001393 PLAT NAME= KGKUMO TOWN%ITE (COPY IN PRINT
BLOCK= 3� LOT= 18 ZONE= AGSUB F
AREA= 000{ 2000 F/A= F WIDTH= DEPTH=
4 OF 3LDC;J= DwATER DI%7
OWNER= TAFF JR, PAUL PHONE= 589 924 550
STREET- iii25 E 26TH AVE
ADDREE%= ZPOKANE WA 99206
C�KTACT NAME= COU�CHAINE EXCAVATION PHONE NUmER= 509 927
�GlLDIN� �ETBACK% FRONT= N/A LEFT= N/A RI�HT= N/A REAR= N/A
PERMIT ******************************
CONTRACTOR= CUURCHAINE CONTRUCTION PHONE= 509 924 �435
�T�EET= i64O2 E VALLEYWAY
VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEF AMCUNT
------------------------- -------- ----------
PROCE�%IN� FEE Y i � ^ ��
JEWE� CONNECTION i . ��
******************************* PAYMENT
PAYMENT DATE RECEIPT4 PAYMEN� ��OU�T
9569 50 . 00
------------
�OTAL DUE= . 00 TOTAL PAID=
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWIN.7,
--------------- ------------- ------------ -------------
PFRMIT 50 . 00 50.00 . 00
------------- ------------
50 , 00 50 , 00
5O . O0
PRSCE�%ED B/ DOMITROVICH, ROBIN
PRTTED DOMTTROYICH , RCP[N
%EWER %TUB A%-BUILT INFORMATION I% AVAILABLE AT �HE C�/���/
UTILITIE% DEPARTMENT (4�6-36O4 )
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM TH;F
ELEVATION AND POSITION OF SEWER %TUB PRIOR 73 AN'.;' OTHER
CAVATION
TO LOCATE 3ORIED CAC.:AE .
CALL FE YO ( 45"-�0OO)
%EWER TO BE CHECKED
THAT THEY ARE CLEAR AND UNOP. TRUCTED TO THE :::EWER M�I�
********* CALL FOR IN%TECTION PRIOR TO COVER **********
******************************** THANK YOS *********************************