1991, 12-18 Permit: 91004248 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
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and correct, and aumv,/zon kCountym proceed with processing. In addition, I have read o understandm INSPECTION REQUIREMENTS/ oro
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= 91004248 ISSUED PERMIT DATE= i2/i8/9i PA�E=
**************************** PERMIT INFORMATION ****************************
.SITE STREET= 11411 E 29TH AVE PARCELO= 28543-4114
ADDRESS= SPOKANE WA 99206
PERMIT USE:::: SOUTH KOKOMO SEWER CONNECTION
*** SEE NOTE ***
PLAT4= 001393 PLAT NAME= KOKOMG TOWN%ITE
BLOCK= 41 LOT= 21 ZONE= UR 3 .5 DI%T4=
AREA= 00000000 F/A= F WIDTH= 91 DEPTH= 130 R/W=
4;: OF BLDG%= i 4 DWELLINGS= 2 WATER DIST =
OWNER= MAYFIELD DAVID PHONE=
STREET= 11411 E 29TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= JAMES NEIL%EN 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= i0504 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
12/18/91 9531 50. 00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE . FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
SEWER PERMIT 50 .00 58.00 .00
-------------
•
50.00 .00
PROCESSED BY : JOHN LAR%GN
PRINTED BY : DGMITROVICH, ROBIN
•
SEWER STUB A%—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% 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 CON ECTION TO INSURE
THAT THEY ARE CLEAR ANDijNOB%TRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 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 Plumbingy_-
- ULID
Other — —
•
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing: ______ --r�. Plans pulled for final processing:_
Temporary 0/0 issued:_7 Certificate of Occupancy issued: _ —_
Office file review by: --____ . Date:
Filed insp finaled by: . Date:
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: _.._ Date:____v__._._—____________.___- ___._.____.____ _
Plans returned: _-_ —__-- . Received by: _ _ ____________
No response from owner/contractor-plans destroyed:____._--_ — ____________