1991, 05-02 Permit: 91001412 Sewer SPOKANE COUNTYDEPARTME0WTOF 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 umo I have u and understand the INSPECTION RREQUIREMENTS/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 OqAGENT DATE
PROJECT NUMBER= 910014i2 ISSUED PERMIT DATE= 05/02/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
%ITE % REET= i0707 E 29TH AVE PARCEL4= 28543-4417
ADDRESS= SPOKANE WA 99206
PERMIT U%E= SEWER CONNECTION - SOUTH KOKOMO
*** EEE NOTE ***
PLAT4= 00 1393 PLAT N = KOKOMO TOWNSITE
BLOCK= 44 LOT= ZONE= %FR DI%T4=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDGJ= i 4 DWELLING%= i WATER DIET =
WN ER= COX BILL PHONE=
ETREET= 10707 E 29TH AVE
ADDRE%%= SPOKANE WA 99206
CONTACT NAME= JIM NIEL%ON PHONE NUMBER= 50' 924 6077
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= J. R . II CON%TRUCTION PHONE= 509 924 6077
STREET= i0504 EVALLEYWAY AVE
ADDRE%%= %POKANE WA 99206
}
ITEM DESCRIPTION QUANTITY FEE AMOUNT '
------------------------- -------- ----------
PROCE%%ING FEE Y 10 .00
%EWER CONNECTION 1 40.00
******************************* P�YMENT %UMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT �MOUNT
O5/O2/9i 25O9 5O .O�
------------
TOTAL DUE=
1 ,OO TOTAL PAID= 50 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
-r------------- ------------ ------------ -------------
%EWER PERMIT 50 .00 50 00 .00
------------- ------------ -------------
5O .. 00 50.0O .00
PROCESSED BY : JULIE JHATTO
PRINTED BY : JULIE %HATTO
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% DEPARTMENT (45�-36O4)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF %EWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GA' PIPWATER LINES, C
ABEFOR- YOU DIC ( �
4� -8O�0\PIPING, LI ' -FT^
LL
%EWER STUBS ARE TO BE CHECKED PRIOR TA rnNNFrTTnN TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE %EWER MAIN ,
********* CALL FOR INSPECTION PRIOR TO COVER *********),L
********* 24 HOUR NOTICE REQUIRED ********** ^
********* 456-3604 ********** ` '
******************************** 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 __--
-_ U L I D
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: _____.____.___-____._-- ____.