1991, 04-11 Permit: 91001754 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 } n
SIGNATURE OF
OWNER OR GENT `�l L k_4'J //J 1 APPLICATION
DATE
PROJECT NUMBER= 91001754 ISSUED PERMIT DATE= 04/11 /91 ('AGE:: 01
3**•****3e******3 ********•***** PERMIT INFORMATION ************* i•*****• * • • • •**
SITE STREET=: 11315 E:: 28TH AVE PAR CE =: 28.5.3_••4024
ADDRESS== SPOKANE WA 99206
PERMIT USE= SEWE:R CONNECTION ..- SOUTH KOKOMO
***• SEE NOTE ***
PLAT:=: 001393 PLAT NAME= KOKOMO TOWNSITE:
BLOCK= LOT=- ZONE= UR-3.5 DISTt= F
AREA=: F/A=• F WIDTH== 1 02 DEPTH== 1 30 R/W:::
p OF BLDGS~ 0 DWELLINGS= i WATER DIST ::::
OWNER= OLSON , WAYNE PHONE= 509 926 6430
STREET= 11315. E 28TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= KEVIN HOLTEN PHONE NUMBER= 509 926 9087
BUILDING SETBACKS : FRONT= NA i...E.FT= NA RIGHT=- NA REAR- NA
• **********xai***•x********** SEWER PERMIT ****** •**•x**xx •ae* •***•tt**•;r>;•a:*•tt•*
CONTRACTOR= HOLTEN BROTHERS PHONE== 509 926 6978
STREET= 11 704 E 8TH AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE. Y 10.00
SEWER CONNECTION 1 40.00
• **********ac****************** PAYMENT SUMMARY **** *** ******* ***********
PAYMENT DATE RECEIPT0 PAYMENT AMOUNT
04/11 /91 1966 50.00
------------
TOTAL_ DUE= :00 TOTAL PAID= 50:00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
_ M _____ ____..___ 50.0
SEWERPERI 0 50.07 .00
50.00 50.00 .00
PROCESSED BY : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
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)
SE:WE:R STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
•***** * : CALL FOR INSPECTION PRIOR TO COVER *** *•ii•}t•ii•k
********* 24 HOUR NOTICE REQUIRED #****• * •aR•x•
*** ***** 456-3604 *• ** •**** •
h•**••x*******3 *;•****•x*3************ THANK YOU *********** * 3
SPECIAL CONDITION CHECKLIST
Project
Address: -.__--Project#_______— ----_-.________ Use:
Dept: Date: Condition: lnit: A
per:
(in) (out)
Dept.of Bldgs.
Special Insp.Fina, Report_--yrant(Lock Box_ -- --
Engineer's_ RID/CRP
Easements_____ setie
Road Plans/Improvements_ - ---
-- 7 - ,
,
- - (
tie e-te,
eit
ter
t tiiities__ _ ;`, d_- -- Double Plumbing
ULD_--._ -------_—_. —.----------.__.______
t- -;h, ;:;;;; i - 7 '::j t a(•• k,... -. f: 4 Y.. .11
,'•t S -____ - .. .�_,__�____. �_ ..__.�_ T ._.._
,
Other 7•
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•" —**S " """>THISSPACEFORCOMMERCIALPLANSTeAC.{4r40.I°CslnfiTtfrc41TE'OFUC.00FIANo`ONLY:,".,>
Date received for C./0 p'rooessing ..: s Pan 'p€tfked br f inet procees;ng _ _:
'TemporaryCIO issued d
Genf, a€e of Zia �ncy,assued
Office file review by ._ h f.._ 1. . Date.
,Pate
Ninety days after CIO issuance:
Owner/contractor called regarding the return of plans:_ , Date ----
Plars returned: __-_ Received by.No response from owner/contractor-Diana destroyed — —