1991, 03-08 Permit: 91000975 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.7363 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 local law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction. �/J
SIGNATURE � i"1 ""C.�'i%C.�.•--� APPLICATION "Z --'$ y/
OWNER OR AGENT DATE
PROJECT NUMBER= 91000975 ISSUED PERMIT DATE= 03/08/91 PAGE= 01
***** :•*****3**************** PERMIT INFORMATION , ***************arR*********
SITE STREET=: 10707 E: 28TH AVE PAR.CEI_.•e= 28543-3708
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION FOR RESIDENCE/ SOUTH KOKOMO
*** SEE. NOTE. ***
PLAT• = 001 393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 37 LOT::: 13 ZONE= UR 3.5 DIST:H== F
AREA= F/A= WIDTH= DEPTH=:: F,/W=•:
OF BLDC;S::= 4 DWELLINGS= i WATER DIST =
OWNER= WHITING, GEORGE PHONE= 509 926 0797
STREET= 10707 E 'BOTH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= HOLTEN BROTHERS PHONE NUMBER= 509 926 9007
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
******************•*********** SEWER PERMIT ****************•***•ki•******:**•**
CONTRACTOR=:: HOLTEN BROTHERS PHONE== 509 926 6978
STREET= 11704 E 8TH AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
--------
PROCESSING F E E: Y 10.00
SEWER CONNECTION i 40.00
*****R*********************it•*3k* PAYMENT SUMMARY *****•******.k.* **********•;r***
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
03/08/91 1120 .50. 00
TOTAL DUE= .00 TOTAL PAID:- 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 .00
50.00 50,00 00
PROCESSED BY : JOHN LARSON
PRINTED BY : JOHN LARSON
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPL..I CANT IS' TO FIELD LOCATE:: AND CONFIRM THE
ELEVATION ATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT..
CALL. BEFORE YOU DICE (456-8000)
SEWER STUBS ARE: TO BE CHECKED PRIOR TO CONNECTION TO INSURE:
THAT THEY ARE. CLEAR AND UNOBSTRUCTED TO THF SEWER MAIN
*****•*** ( AI...i_. FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
**m:*:**•*** 456--3604 •:*********
******•************************** THANK. YOU **•*******************************
SPECIAL CONDITION CHECKLIST
Project
Address: __.-____-_ Project# _Use:_ _
Dept: Date; Condition: !nit: Appr:
(in) (out)
Dept. of Bldgs. -___--- ---- ------------- ____— _— _ _ _—
--.-----__--- -__ Special Insp.Fina! Report _�—
Hydrant
Lock Box
Engineer's .RJDLCRP•
Easements-
Road Plans/Improvements
Bonds iL.ii ";'::•.`i .f
Planning, Bong .—
..is e�� ,• : :
Utilities.___--- — Double Plumbing_
— — ULID
Other
.. ...
7.5
.... ....>.,><,.>"*.>{...._*«THIS SPACE FOR COMMERCIAL PLANS''-RA:OKING„'CERTIFICATE OF OC'C.I)PANCY ONLY'•••r—**`***—************—***
{
Date received for C/O prdcessing " flans putted;far f€naf,.processing
Temporary C/O issued C,etthficate of 1:15cupancy issued! •
Office file review by :„
Date
Filed insp finaled.by Date:
Ninety days after CIO issuance: -- --------------- --___
Owner/oontractor called regarding the return of plans:___.__ Date:---_-------------._____------_-------_----___
Plans returned: .—_. .Received by: -----------------------_-__-
No response from owner/contractor-plans destroyed:. —_------__.--- _._ ___.___---------_--_---____-_