1991, 03-22 Permit: 91001293 Sewer •
SPOKANE COUNTY DEP---AFIENT 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 correctand authorize Sokane County to proceed with processing. In uun/ I have u and understandm 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= 91001293 I%%UED PERMIT DATE= 03/22/91 PAGE= Oi
**************************** PERMIT INFORMATION ************************ ***
%ITE STREET= 11220 E 28TH AVE PARCELO= 28543-4217
ADDRESS= SPOKANE WA 99286
PERMIT USE= SEWER CONNECTION - SOUTH KOKOMO
*** EEE NOTE ***
PLAT4= 00.1393 PLAT NAME= KOKOMO TOWNEITE
BLOCK= 42 LOT= i ZONE= %FR DI%T4;= F �
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= i 4 DWELLINGS= i WATER DIET =
OWNER= JOHN%EN, OTTO PHONE= 509 928 6402
%TREET= 11220 E 28TH AVE
ADDRE%%= SPOKANE WA 99206
CONTACT NAME= TOM WILLIAM% PHONE NUMBER= 509 926 9378
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ********************** *******
CONTRACTOR= TRW BACKHOE SERVICE PHONE= 509 926 9378
%TREET= 11223 E 18TH AVE
ADDRESS= SPOKANE WA 99206-0000
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10 , 00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
03/22/91 1466 50.00
------------ -
TOTAL DUE= .00 TOTAL PAID= 50^OO
PERMIT TYPE
__ FEE AMOUNT_ AMOUNT PAID AMOUNT OWING
• -----------
%EWERPERMIT 50.00 50.00 .00
------------- ------------ -----------
5O.00 50.00 . 00
PROCE%%ED BY : JULIE %HATTO
PRINTED BY : JULIE %H�TTO
%EWER STUB AJ-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PO%ITIOH OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER EINES, ECT ,
CALL BEFORE YOU DIG (45�-8000}
' -
SEWER %TUB% ARE TO BE CHECKED PRIOR TO CONNECTION TO TN%URE
THAT THEY ARE CLEAR AND UNOB%TRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
* ******* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU ******* **************** ******** !
SPECIAL CONDITION CHECKLIST
Project
Address: _ _ _ Project# r 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:________._______._—