1991, 06-25 Permit: 91003625 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 I al law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction. ,
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SIGNATURE OFr�it�� � APPLICATION
OWNER OR AGENT L-e DATE
PROJECT NUMBER= 91003625 ISSUED PERMIT DRIP.= 06/25/91 PAGE- 01
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SITE STREET= i0822 E 27TH AVE PARCEL4= 28543-3720
ADDRESS= SPOKANE WA 99206
PERMIT USE.- SEWER CONNECTION — SOUTH KOKOMO
PLAT:. 001393 PLAT NAtr= " % ceTOWNETTE
BLOCK= LOT= ZONE= UR—3 , 5 DIST4=i
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4 OF .....GE= 0 DWELLINGS:::: ? WATER DIST
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STREET= 10822 I:. 27TH ;..; ,?v.
ADDRESS= SPOKANE¢t;+ii::. Wr•°; 99206
CONTACT NAME= ?4. HOLTEN PHONE C:. f+jt.,ii"iB?.:.R:::: 509 _..i? A97... R
BUILDING ... E". ? 1;A:.:±t::': : ±"Rt.)±'d ? :::: NA LEFT== i'•.A RIGHT= NA REAR::r. NA
3Ck.............. .. .... .. .. .. ............ ...... .... ...... SE WE ; PERMIT k t ! PF Pt 4 JPAF A 1 l 1 4 1 .
CONTRACTOR= HOLTEN , K V PHONE.: 509 926 6978
STREET= 11704 E 8TH AVE
ADDRESS= SPOKANE WA 9920A
ITEM DESCRIPTION QUANTITY FEE AMOUNT
----------
PROCESSING FEE 10,00
SEWER CONNECTION
40,00
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PAYMENT 1,A t t:: ?-'.:EI...?:..±.F E 4 PAYMENT ?"tMO%,iN.t.
06/25/9i 4101 50,00
................................................
TOTAL :...:...
PERMIT TYPE F'r:.?::. :.t"i±±iii'.j_I. AMOUNT PAID±.ij r';i``t± i;ri a• :•.iiti.i.NE,,
SEWER PERMIT 50 ,00 50 . 00 , 00
50,00 50,00
PROCESSED t;5 r . WENDEE...; GLORIA
PRINTED BY : i1+1i"N E , t•t...ORIA
SEWER s AS—BUILT INFORMATION ± S AVAILABLE : t I FFt.,. N_ :
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS O FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
....:::_C:t'.iV AsrT±':J
BURIED
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TO ': LINES, FCT ,
CALL BEFORE YOU DIG (456-8000)
:::±::.(„t?:R : ? 7F ' RE . BE CHECKED ?R ? LcCONNECTION T INSURE
THAT s t..,±::.'; i•i?".?::. CLEAR f+'I!'J t t,!i`J t,i l,'. ..t•:;!t i.- ? E::.} .f. .'•?..q i.. .?::.U.I?._.. �•.±J..•i.?.f;?
;t:1t•*.•p:.ji.�,.,„..:J,,..j.. CALL FORINSPECTION i:::R I i...±,'•.:TO
t...COVER *.?,.,},...ti•**'1+:.7..R..J,:
) J 7h y„..1,*.f,,r.* 24 HOUR NOTICE REQUIRED
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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
------- __ Easements
—
Road Plans/Improvements
Bonds
•
Planning___ • Bonds — —
•
Utilities Double Plumbing
-
- — ULID
Other — _
•
•"""'"""""""""""""`THIS SPACE FOR COMMERCIAL PLANS TRACKING,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: ___.___ __ _ 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: