1991, 08-01 Permit: 91003189 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
f
PROJECT NUMBER= 91003189 ISSUED PERMIT DATE= 08/01 /9i PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 10713 E 29TH AVE: PARCELO= 28543-4412
ADDRESS= SPOKANE WA 99206
y
PERMIT USE= SEWER CONNECTION -- SOUTH KOKOMO
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 44 LOT= ZONE= SFR DISTO= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
OF BLDGS= 1 w DWELLINGS= i WATER DIST =
OWNER= MOYER, DAVID PHONE=
STREET= 10713 E 29TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= JIM NIELSON PHONE NUMBER= 509 924 6077
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= J.R. II CONSTRUCTION PHONE= 509 924 6077
STREET= 10504 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE � 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT* PAYMENT AMOUNT
08/01 /9i 5232 50.00
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT -~- 50.00 50.00 .00
50.00 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)
ETq6PRAPg RqYqqNTO SAIBlfR A Ng1
hRTHE
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
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project#
Dept: Date: . Condition: lnit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report_
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Lock Box.
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Road Plans/Improvements
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"***'"7****'********7**7'7**7 THIS SPACE FOR COMMERCIAL PLANStRAbikINW.6EITI:#1bATEalbCdiii5AkithY ONILY. —****"***"*************-
--:•;:ftt'.....•.t.",
Date received for C/O iiitic66§in§f; ,i-j±-1f n
i c , :.; !c1;:
Temporary C/O issuect*._• Cediticatp,.9f pscppancy issued: ;;•:
, •
Office file review by: ' Date: v"• . , '
insp:tina4te0.t?y: : :-• :4-444 pate: : -4 4 4 •4
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: