1991, 05-29 Permit: 91002654 Sewer i --- ' �
'
. _
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 submittedov me or my agent // said /vu /.cm/ 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.
SIGNATURE OF APPLICATION
OWNER 0nAGENT DATE
,
PROJECT NUMBER= 91002654 ISSUED. PERMIT DATE= 05/29/9i PAGE= Oi `
**************************** pERMIT INFORMATION ******** ***** **********
SITE STREET= i0722 E 28TH AVE PARCELAI:= 28543-44i0
ADDRESS= SPOKANE WA 99206
PERMIT U%E= SEWER CONNECTION - SOUTH KOKOMO / VOID .
*** SEE NOTE ***
`
PLATO= 00i393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 44 LST= ZONE= A�%UB DI%TO= F
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDFS= i 0 DWELLINGS= I WATER DIET =
OWNER= SARGENT , MARGIE PHONE=
%TREET= iO722 E• 28TH AVE
I ADDRESS= SPOKANE WA 99206
CONTACT NAME= J & S CONSTRUPHONE NUMBER= 509 458 9314
BUILDINx %ETBACK% : FRONT= NA- LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
cONTHACiuR= j & S CONSTRUCTION PHONE= 509 458 9384
I STREET= 6155 E HAYDEN AVE
ADDRESS= RATHDRUM ID 83858
� _
ITEM DESCRIPTION QUANTITY FEE AMOUNT , _
------------------------- --------PROCESSING FEE FEE Y iO.00 !
SEWER CONNECTION 'i `- 40 .00
******************************* pAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
O5/29/9i 3 ,28O 5O.00 ,
------------
TOTAL DUE= .00 TOTAL PAID= 50.00
� �
� PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
-_------------- --------__--_ ---_-------- -------------
1
1 SEWER PERMIT ' 50.00 50.00 .00
------------- ------------ -------------
50 .00 50.00 .00
PROCESSED BY : JOHN LAR%ON
PRINTED BY : JULIE %HATT0
SEWER STUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNT;
1 UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, FCT ,
CALL BEFORE YOU DIG' (45"-8OOO)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE - EAR AND UNOBSTRUCTEDTC THE SEWER MAIN •
********* CALL FOR INSPECTION PRIOR TO COVER **********
1 ********* ' ' HOUR NOTICE REQUIRED **********
^ ' 456 �6O4 **********
********* -"
******************************** 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 Plans/Improvements
-- Bonds
Planning — Bonds
Utilities Double Plumbing
ULID
Other.__
""' ""—****'""""`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:
Plans returned: _ —.—__— _— Received by:
No response from owner/contractor-plans destroyed: