1991, 06-25 Permit App: 91003547 Sewer SPOKANE COUNTY DEPARTMENT QF.BUULDUNGS
W.1303 BROADWAY A�gNUE
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= 9i003547 APPLICATION DATE= 06/25/91 PAGE= 01
****** THIS I% NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
---------------------------______________________________ __________________
%ITE STREET= 11120 E 29TH AVE PARCELO= 28543-4711
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - SOUTH KOKOMO
*** SEE NOTE ***
PLAT4= 001393 PLAT NAME= KGKOMO TOWN%ITE
BLOCK= 47 LOT= ZONE= AC:%UB DI%T4=
AREA= 00080000 F/A= F WDEPTH= R/W=
OF BLDG%= 0 DWELLINGS= i WATER DIST =
OWNER= GOGDWIN PHONE=
STREET= 11i26 E 29TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= JIM NIEL%ON PHONE NUMBER= 5O9 924 6O77
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 Y 10 . 00
SEWER CONNECTION i 40 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ _____________
SEWER PERMIT 50 .O0 .00 50 . 00
------------- ------------ ---- -------
50.00 . 00 50 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
%EWER :::TUB A%-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
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
**************** ************ * THANK Y0] *** ********** *************** *
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SPECIAL CONDITION CHECKLIST
Project
Address: _._.__—. Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept. of Bldgs.
Special Insp.Final Report
--- Hydrant( ) -
-.—__ Lock Box
•
Engineer's_____ Y 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:
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: