1991, 08-01 Permit: 91003547 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= 91003547 ISSUED PERMIT DATE=: 08/01 /91 PAGES 01
********3 ******************* PERMIT INFORMATION ***************************
SITE STREET= 11120 E 29TH AVE PARCELS= 28543-4711
ADDRESS- SPOKANE WA 99206
PERMIT SUE
E=E SEWER**CONNECTION -- SOUTH KOKOMO
PLATS= 001393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 47 LOT= ZONE= AGSUB DIST::::: E'
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
4 OF BLDGS= i 4 DWELLINGS= i WATER DIST =
OWNER= GOODWIN PHONE=
STREET= 11120 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 F"E:E'__ -------- __.____i{?A Qu
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT" PAYMENT AMOUNT
08/01 /91 5238 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)
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
********* CAL..L.. FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: ____--_- Project# Use:
Dept Date: Condition: snit: Appr:
(in) (out)
Dept.of Bldgs.
__--- — Special Insp.Final Report
�__ Hydrant( )
Lock Box
.. . ..
Engineer's_._______._ ___. RID/CRP r
i'
Easemenf$_`
Road Plans/improvements
!
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Utilities.___ i ! Double Plumbin __ 1
ULID
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THIS SPACEFOR COMMERCIAL PLA NS ,14.A0YCIN4?GEfiTC.RICATEQF'DCQUPA?SPYONLW'*" *'*******°**"**"*"°r"""
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Date received for C/O¢ro:cessing is. •
a e; u• t ;..I -
Temporary C/O issued
Office file review by: ,__ n ! : :'tt• Date
Filed tX9SY ftnaled �1' : .,..,.. {} ."!r -! (..:.7}. r - - ,i? ::.:2•{(!, .. } .! i^:
�'late-
Ninety days after CIO issuance:
Owner/contractor called regarding the return of plans: __ —__-- Date:
Plans returned: _-- - -----.._ Received by: -----__--------____--------_._____--
No response from owner/contractor-plans destroyed: ---------___._—_--_.___--