1991, 08-05 Permit: 91004763 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 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 constructi. .
SIGNATURE OF APPLICATION
/ 5 ^?
OWNER OR AGENT / �. :, DATE
PROJECT NUMBER= 91004763 ISSUED PERMIT DA(E:= 08/05/91 F'ACME= 01
*************************3i•** PERMIT INFORMATION ****************•********•*•'* a
SITE STREET= .10905 I. 28TH AVE:: PARCEL: 2854 3-3803
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION -•• SOUTH KOKOMO
*** SEE NOTE. ***
PLATO= 00i393 PLAT NAME=:: KOKOMO (OWNSI.T E
BLOCK= 38 I._tiT= ZONE= AC:SUB DIST:„::::
AREA= 0003 0404? F'/A= F WIDTH= i00 DEPTH= •i :.() F;°/W= ;:'
OF DI...DGS=•: DWELL INGS= 3 WATER DIST
OWNER= BRADLEY, PAUL PHONE= 509 928 $953
STREET=T::= l09 5 E ;'OTI"I AVE”
ADDRESS= SPOKANE WA 99206
CONTACT NAME= PAUL.. BRADLEY PHONE NUMBER= 509 928 6953
BUILDING SETBACKS : FRONT= NA L.EFT::: NA RIGHT== NA REAR= NA
P:****•it**P:************:********* SEWER PERMIT **********•it3':**3':'il•R:•b:**3•:***b:**•P:*
CONTRACTOR= MOUNTAIN WEST MECHANICAL PHONE= 509 928 2471
STREET= 9116 F:: SPRAGUE AVE
ADDRESS= SPOKANE ., 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y' I ':i ,C)'i
SEWER CONNECTION 3 40 .00
k 3 *** 4 e PN*3 k i 3 **9l3AP {** t M� tP4* fT "E � SUMMARY)r 3 t 7
**i 3 3 3 **3 3 **** 1 3 * t** {h 3 *3hf A
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
08!'05/9i 5346 50.00
TOTAL D ..00 TOTAL PAID:::: 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 5 50.00 i
t?,�"i 4;1 ,(:0
90.00 50.00
PROCESSED SED BY : ...Ui._:FF- SHATrC)
PRINTED BY : JUi_.1:E:: SHATTO
SEWER SiI.JB AS—BUILT INFORMATION IS AVAILABLE AT THE: COUNTY
UTILITIES DEPARTMENT (456-3604)
)
CONTRACTOR OR APPLICANT IS TO FIEL..I) LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES , GAS PIPING, WATER. I.isNES; ECT ,
CALL.. BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE::
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
•i=:******** CALL FOR INSPECTION PRIOR TO COVER **3':'****3';*•*
**•*3'3r***•* '4 FHOU..If.. NOTICE" REQUIRED *3h31.** ** •*
*•a.•***•***n: 456-3604 **********
•;,.*3;*****************•****3i•*3i•3'i3s•3i** THANK You ****•*********xn•** 3r******u••r*n•-rr**
SPECIAL CONDITION CHECKLIST
Project
Address: Project# --- -_._-� Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs. ----__ _- --- --_ ----- --- --- __- ----- -- _______.
— Special Insp.Final Report
Hydrant( )
Lock Box
•
Engineer's-----___. RID/CRP — —_--
— Easements • •'•, _ •; . . .
Road Plans/Improvements
Bonds .. • . •
•
Plannipg.._._ __--- Bonds.
Utilities_--- _.._. Double Plumbing
ULID
Othen_.__—.__._______--
.:_******'**“.,**..,***''***'THIS SPACE FOR COMMERCIAL PLANS TRACKING,:CERTIFICATE OF OCCUPANCY'ONLY******"°'****'**`"`*** •{****
Date received for C/O processing .� Plans:pulled.far ftnai processing.
Temporary C/O issued' • Certificate of Occupancy issued;:_.__
Office file review by :Date...
Filed Insp finaled by: �. Date:
Ninety days after CIO issuance:
Owner/contractor called regarding the return of plans: _—____ , Date: _
Plans returned: _—__-__ __ . Received by:_�_
No response from owner/contractor-plans destroyed: --__---