1991, 04-01 Permit: 91000284 Sewer SPOKANE COUNTY DEPARThm. .i4GS
W. 1303BROADWAY AVElv_
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 com / with same.All provisions o/laws and ord/nvnvoo '/ thismwmmwmuovnmnoouwn»whemom specified
herein or /ummmm understand of this unmon subsequent/ approvalstypeberonvvues of Ocshall 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
OWN ER OR AGENT DATE -\
-.`.'
--' '
` |
PROJECT NUMBER= 940O0284 ISSUED PERMIT DATE= 04/01 /9i PAGE= Oi
**************************** PERMIT INFORMATIQH ************************* **
SITE STREET= -1i0i5 E 27TH AVE PARCEL�= 2854�-3523
ADDRESS= SPOKANE WA 99206
PERMIT USE- SEWER CONNECTION
*** EEE NOTE *** .
PLAT0= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= LOT= ZONE= AG%UB F
A REA= 80080000 F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 0DWELLINGS- i WATER_DI%T =
OWNER= RUDOLPH, TOM PHONE=
%TREET= 11015 E 27TH AVE
ADDRE%%= %POKANE WA 992O6
CONTACT NAME= STAN ANnERTON - ENVIROGUARD PHONE NUMBER= 509 924 55�5
BUILDIN� %ETBACK% FRON�= NA LEFT= NA RIGHT= NA REAR= NA
***************************** gEWERPERMIT ******************************
CONTRACTOR= ENyIROGUARD INC PHONE= 509 924 5595
STREET= PO BOX 14i557
ADDRE%%= SPOKANE WA 99214
ITEM DE%CRIPTION QUANTITY FEF AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10.00
SEWER' CONNECTION i 40 .00
******************************* PAYMENT %UMHARY ****************************
- /
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
04/01 /9i i696 50.0O
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 . 00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
SEWER STUB A%-BUILT INFORMATION IS AVAILAML— AT THE CO| —.
UTILITIES DEPARTMENT (456 _' . � �
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PG%ITI3N OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLE%, GAS PIPING, WATER LINES, ECT ,
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS RE TO BE CHECKED PRIOR TOCONNECTION TO IN%URE
THAT THEYARE CLEAR N ST � THE SEWER MAIN
********* CALL OINSPECTION O TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **** *****
******************************** THANK YOU ****** *****) *******************
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept,of Bldgs.
__ ._ _.__._ _ Special Insp.Final Report_____.__ __ _ —
_____________ _________ ____.------ . _-- Hydrant ( )
-- --- — —---- Lock Box------- __ __— _ .____—__
Engineers________ ---__----_-__.. RID/CRP _-- —
_._._._________.____ --- Easements _________
---___ — Road Plans/Improvements__.___-------___ ___._------- ____._
____ ___ Bonds__ ---___
---_.____— ---__-_--
Planning_—_— Bonds._
Utilities-------- Double Plumbing— —______ -------------___..___ -------____--
-------------- — U L I D
Other---___.___ _----- - _� — — — —_-- —
THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY"' """'" `""""""""`
Date received for C/O processing: -_..___.__.___—___—_____...__.__________ _. Plans pulled for final processing;
Temporary C/O Certificate of Occupancy issued:
Office tile review by Date:.
Filed insp finaled by: --------_ Date:.____.____.._
Ninety days after C/O issuance;
Owner/contractor called regarding the return of plans: _._____ ____—_ —._ . Dale.
Received by: _
No response from owner/contractor-plans destroyed: