1991, 03-08 Permit: 91000976 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 correcand authorize SkCounty to proceed with processing. In addition, I have read and understandmo /wapscrmwnsoumsmswrS/wor/cs
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
Ar/ge4"/)e::: APPLICATION 3 g
OWNER OR AGENT DATE
PROJECT NUMBER= 91000976 ISSUED PERMIT DATE= 83/08/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 10715 E 28TH AVE PARCELO= 28543-3709
ADDRESS= SPOKANE WA 99206
PERMIT USE : SEWER CONNECTION FOR RESIDENCE/ SOUTH KOKOMO
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 37 LOT= i5 ZONE= UR 3.5 DI%TO=
AREA= F/A= WIDTH= DEPTH= R/W=
0 OF BLDG%= 0 DWELLINGS= i WATER DIST =
OWNER= KIVLE, JOHN D. PHONE= 509 924 7271
STREET= i0715 E 28TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= HOLTEN BROTHERS PHONE NUMBER= 509 926 9087
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= HOLTEN BROTHERS PHONE= 509 926 6978
STREET= 11704 E 8TH AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT� PAYMENT AMOUNT
03/C3/91 1i22 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 50.00 5O.00 .00
PROCESSED BY : JOHN LARSON
PRINTED BY : JOHN LARSON
SEWER STUB A%-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 (456-8000)
SEWER STUBS RE TO BE H TO CONNECTION TO INSURE
THAT THEY ARE CLEAR N %T D 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( )
Lock Box
Engineer's --___--- RID/CRP —_-
• ,,—: Easements
Road Pians/improvements
— Bonds...
Planning Bonds.
Utilities_......____. _ _ Double Plumbing
•
Other. --
•
,..w.a ,.......>..**. *** .THISSPfCEFORCOMMERCIAALPLANSTRACKING,CERTIFICATEQFOCCUPAN.C(ONLY•:**** x**.k,....,t.*.««.,,,<
Date received for C/O processing;'-_ _ Pans pulled for final:`processing
Temporary 0/0 issued; Certificate Sf Occupancy issued;
Office file review by _ —_ • .bate:
Filed Insp fina&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:_._-- __------_---------------------------_-____--__------------------___--