1991, 04-25 Permit: 91002085 Sewer SPOKANE COUNT , �_. ARTMENT 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 athorize Soxa eov nty to proceed with processing. In additionI 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 loc•I law regulating construction,or as a warranty of conformance with the provisions of any state or local
SIGNATURE OF APPLICATION 4:// s----/qj
OWNER OR AGENT ' lk, . DATE
PROJECT NUMBER= 91002085 ISSUED PERMIT DATE= 04/25/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE .',TREE — 1O6iO E 28TH AVE PARCEL:!::= 28544-6602
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION / CHESTER HILL.,:.!
*** SEE NOTE ***
PLAT:1= 000382 PLAT NAME= CHESTER HILLS ADD
BLOCK= i OT= 2 ZONE= UR 3.5 ^DI%T4= F )
AREA= F/A= WIDTH= DEPTH= R/W=
:1 OF BIA)G%= :II: DWELLIN�%= i WATER DIST =
OWNER= RING, L. �L J PHONE= >
STREET= 1061 " E 28 / H AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= HOLTEN BROTHERS • PHONE NUMBER= 509 926 9087
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= HOLTEN BROTHERS PHONE= 509 926 6978
STREET= 11704 E 8TH AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT /--
------------------------- -------- ---------- `
PROCESSING FEE Y 10 .00
::',EWER CONNECTION i 40.00
************ ***************** PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPT::: PAYMENT AMOUNT ||
04/25/91 2335 50.00
------------ `
' -
TOTAL DUE= .00 TOTAL PAID= 50.00 � . -
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50.00 .00 _ -
------------- ------------ -------------
' -
50.00 50.00 .O0
PROCEED BY : JOHN LAR%ON
PRINTED BY : JOHN LARSON .
SEWER...STUB AS-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
. UTILITIE% DEPARTMENT (456-36O4)
, CONTR OR APPLICANT is TO FIELD LOCATE AND CONFIRM THE
[EVAf�hN AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
ECAVATIOH
1 TO LOCATE BURIED CABLESGAS PIPING, WATER LINES, ECT. '- |
CALL BEFORE YOU DIG (45�-8OOO )
1.
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR 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 ( )
LockBox.---_---------------------------------------------------_-----
•
Engineer's-----_ --- _._ _ RID/CRP ____._.__ _.____._.__.__._ _____._-----______. ._.___.___. _ .__ __ ----__---- ------_---_---
--_ — Easements — - - -- — — _______
________. Road Plans/Improvements
- ----.__— _. Bonds — --
•
Planning__ __.._ Bonds. __-_---------------------------___—_� — __.___.-
•
Utilities________._.___ _ — -.-_ Double Plumbing
—__ _-- — U L I DOther
THIS
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 C/O issuance:
Owner/contractor called regarding the return of plans. _______________ —._____ Date:____
Received by:.___---_
Plans reharned: _ ---._.-------
No response from owner/contractor._plans destroyed: �___—