1991, 03-08 Permit: 91000972 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.13V3BROADWAY AVENUE
SPOKANE, WASHINGTON 98260
(509) 456-3675
1 certifytha" hue "am inedth is permit/application, state that the information contained in it and submiked 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 x not.1 unArstand thatNeiss"nceofthis permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not beconstrued to
give authorityto violate orcancel the provisionsofany stateorlocal law regulating construction, oras a warranty of conformance with the provisions of any stateor local
laws regulating construction. >
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 91000972 ISSUED PERMIT DATE= 03/08/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET- i0906 E 29TH AVE PARCEL*- 28543-4605
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION FOR RESIDENCE
***
SEE NOTE ***
PLATO= OOi393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 46 LOT= ii ZONE= UR 3.5 DI%TO= F
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 0 DWELLINGS= i WATER DIST =
OWNER= KIENTOPP JACK PHONE= 509 928 5034
STREET= i09O6 E 29TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= HOLTEN BROTHERS PHONE NUMBER= 509 928 5034
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
*****************************
SEWER PERMIT ******************************
CONTRACTOR= HOLTEN BROTHERS PHONE= 509 926 6978
STREET= i17O4 E 8TH AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- -----------
PROCESSING FEE Y iO.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT� PAYMENT AMOUNT
03/08/9i iii9 50.0O
------------
TOTAL DUE= .00 TOTAL PAID= 5O.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50.00 .00
------------- ------------ -------------
50.00 50.00 .00
PROCESSED BY: JOHN LAR%ON
PRINTED BY: JOHN LAR%ON
SEWER STUB 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 YOU *********************************
Project
Address:
9003
SPECIAL CONDITION CHECKLIST
Project
Date.- Condition -nit: Appr:
I I I 1(i n) I (out)
Dept. of Bldgs.
Special Insp. Final Report
Hydrant ( )
it !T- `V -
Lock Box
ipv,
)j.'if 77—
!T. -A.�--4
sv -Y It It, `1
Engineer's
RID/CRP
Easements:�
Road Plans/Improvements J I k.)
Bodaj- LV-.; fl Fj'.,ti M 1.:; f) t`:."
J
Al
PlanningBonds
. ... ....
X- -W
'K
W
X -)I
... . .. .... .... . .. . .. .... .... .. ...
... ....
Utilities_
Double Plumbing
U L I D
-)r 6.
L "k� n .
.. .. ....... ......
Other--
--Ll-t
. . . . . . .
Il f. -I
I T A �71 D?.:111
. . . . . . . . . .....................
4 i
7.47,771 �J -77
.1
.71 1 t IJ J 1 6
i i.}3. 1" MA 0 i0J I ff* V
J H
i7
...... ... TH IS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFF.GATEM0=01ANOT QNLY.f,
f
Date received for C/O jfidobOin6i Plans pulled '..iVP.Bnil*'prat'!"nq'-:::i-,i'*f'
W.
Temporary C/O issued: Certificate of Occ,u•pafLn'cy issue
Office file review by: -Y A ':P" Date: 4 A;
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed:
Received by:
Date:
JOB ADDRESS:
SUBDIVISION: /� , iil , �P LOT: //szx ,2 BLOCK: /4
OWNER:
ADDRESS:
11 _PHONE • 72 3 -f a 3
T�
CONTRACTOR • - PHONE: _'-Z � JV D S
ADDRESS:_ 6Z7Q(- 'V=6 yf-1;12) 0-LLICENSE #: 7 9 /J '-1 �7 5 Z -A
INSPECTION DATE:
TYPE OF OCCUPANCY: