1991, 05-15 Permit: 91000852 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 m000u 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
PROJECT NUMBER= 91000852 I%%UED PERMIT DATE= 05/i5/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= iiiO4 E 27TH AVE PARCELO= 28543-3905
ADDRE%%= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION
*** SEE NOTE ***
PLAT4= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 39 LOT= ZONE= AG%UB DI%TO=
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= i 4 DWELLINGS= i WATER DIET =
OWNER= HA%KIN% PHONE=
STREET= 1i104 E 27TH AVE
ADDRE%%= SPOKANE WA 99206
CONTACT NAME= ROM %LOAN PHONE NUMBER= 509 922 8500
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= HA
***************************** SEWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= PO BOX 141562
ADDRE%%= SPOKANE WA 99214
ITEM DESCRIPTION QUAHTITFEE AMOUNT
------------------------- -------- ----------
PROCE%%ING FEE Y 10, 00
SEWER CONNECTION i 40 .00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
05/15/91 2909 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 !:.5 5O.00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE SHATTO
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% 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 (45
-8OOO)
SEWER STUBS; ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBETRUCTED TO THE JEWER MAIN
********* CALL FOR INSPEcTIONI 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
• . . .
Easements
Road Plans/Improvements
Bonds • . . .
• . •
. . • •
• .
. . . . .
Planning • . Bonds -
•
• . •
Utilities Double Plumbing
ULID
. .. • . .
•
•
Other
.. • ' .
-• • • - •
. .
. .
; . .
. .
. . .
. , . .
----THIS SPACE FOR COMMERCIAL PLANS TAACKING,CERTIFICATE OF OdpuTANC) (5NLY-***'"
Date received for C/O processing: • Plans pulled for final processing:
Temporary C/O issued: • Certificate of OccuparYc:31:issued:
. . .
Office file review by: _ . Date:
Filed insp finaled by. .Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: Date:
Plans returned. Received by.
No response from owner/contractor-plans destroyed: