1991, 04-12 Permit: 91001784 Sewer ^
SPOKANE COUNTYDEPARTMENTOF BUILDINGS
W. 1303 BROADWAYAVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I haveexamined this permit/application,stethat the information contained in it and submitted by me or my agenttocompile said permit/application is true
and correct, and authorize Spokane County to pro•-,d with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with• e.All provisions of laws and ordinances governing this type of work will be complied with whether specified
hffein or not.I understand that th uance of this pe /application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel t . ovisions of an e or local law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction
SIGNATURE OF 14111ftta APPLICATION 'i/—/ 1-9
OWNER OR AGENT DATE
44111
PROJECT NUMBER= 9i081784 ISSUED PERMIT DATE= 04/12/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
%ITE STREET= 11312 E 27TH AVE PARCEL4= 28543-4016
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - SOUTH KOKOMO
*** SEE NOTE ***
PLAT4= 00i393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= LOT= ZONE= UR-3.5 DI%T4=
AREA= F/A= F WIDTH= iOO DEPTH= 138 R/W= 70
4 OF BLDGS= 0 DWELLINGS= i WATER DIST =
OWNER= JANSEN, OHN PHONE=
STREET= 11312 L 27TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LYNN RUTHERFORD PHONE NUMBER= 589 928 9545
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= TOTAL LANDSCAPE SERVICE PHONE= 509 928 9545
STREET= 12208 E 8TH AVE
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
04/12/91 2020 50.88
------------
TOTAL 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 : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
SEWER STUB AS-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 (45"-8OOO)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR N %T ED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
}
SPECIAL 1TIKL1 T
Project
Address: _-- _._--- --. _-----___--Project# Use:____.
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
_-- -_. Special Insp, Final Report_____ —_--
�__ -- Hydrant( }
Lock Box
Enoineer's RIDiCRP _
• r.
•
Easements
Plans/Improvements ---
_ Bunds ___—•
Plartrung.:_ __ _ • .Opnds .
* , •
Utilities Double Plumbing g
UID
Other
- - l -
.,... 'THIS SPACE FOR COMMERCIAL PLANSI'RACKtNG,CEiRTIFIGATE+F'!•06 t1PANCYONLY$"•••••""•'•<.< ...,....*.—
Date received for C/O "tace .s+n . •
P J' _ j •--' __ Plans pdfPed'for sinal proees�inq --
Temporary C/O issued ,-6.4 , GertsfiCate..of Occupancy Issued. __
Office file review by
--------- --._. Date
.Filed lnsp:+4ina+ed 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. ___---