1991, 06-18 Permit: 91002844 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 construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER== 91002844 ISSUED PERMIT DATE= 06/18/91 PAGE= 01
**************************** PERMIT INFORMATION *r*t**********3i•***************
SITE STREET= 11120 E 28TH AVE PARCEL4== 28543--4206
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION •-• SOUTH KOKOMO
**r:** SEE NOTE ***
PL_ATt= 001393 PLAT NAME= KOKOMO TOWNSITE E.
BLOCK= 42 LOT= ZONE= AGSUB DIST':;�:
AREA= 00000000 F/A=DWELLINGS= F i WIDTH=t HTE.Ft DIST DEPTH=H= R i W.=
:„ OF BL..DGS::� i
OWNER= HODGE, INEZ PHONE
STREET= 11120 E 28TH AVE.
ADDRESS= SPOKANE WA 99206
CONTACT NAME= I)CONNA COURCHAINE
PHONE NUMBER::: 5O9 924 5485
BUILDING SETBACKS : FRONT:- NA LEFT= NA RIGHT-:: NA REAR=- NA
t••1{aN31:*** **A•*************** ** SEWER PERMIT :****** +**h*****"*"'a***A*** •:,;:**
CONTRACTOR= COURCHAINE CONSTRUCTION
PHONE== 509 924 5485
STREET= 16402 E VAI._L..E::YWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 10.00
SEWER CONNECTION 40.00
*i b*>:* ***k*:*•u*** *********** **** PAYMENT SUMMARY •*:*•**•**** •*********•** :*: :A*
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
06/18/91 3892 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 50.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS—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 ARE:: TO BE CHECKED PRIOR TO CONNECTION TO INSURE::
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
*:**>:*ra • ** CAL.I.,. FOR INSPECTION PRIOR: TO COVER *:**t • * x** •
* *>: •**i•*k •* *k 24 HOUR NOTICE REQUIRED * •*r*t•* •*;•*r*i•*i:
**C*'P:•h*t*:P•*: 456-3604 1k**P•3t*:•yl* •*
*r*k*r •**A•*E*i•*6*k****i• • •*i•*t•ii*F*it•*i*E*E*; ii ii:*h*E THANK Y O i.i *e k•*i•:a r.•#ii*i•*e ri#*i•*i•?i•*E n*ae•*E *i•*i•*f}i n*E*i•*i•* •*i•*>•
SPECIAL CONDITION CHECKLIST
Project
Address:
__- Project*_ Use:
Dept: Date; Condition:
(in) (out)
Dept.of Bidgs.
Special Insp.Final Report
Hydrant )
Lock Box
Engineer's_ *
_ Road Plans/Improvements
ULID
Date received tor C/O „ptans.,puffed,fgrfinai.ipropeming: ,T
•
Office file review by:•:, . Date:
Ninety days after 0/0 issuance:
Owner/contrdcto aued regarding the return of plans me:
D _
Plans returned: -- ---
. Received by:
__-
No respon e from owner/contractor .plans destroyed: