1991, 03-13 Permit: 91000714 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.13O3BROADWAY AVENUE
SPOKANE, WASHINGTON 9S2G0
(509) 456-3675
1 certifythaO haveexaminedth is permit/application, state that the information con/ ed in .t and submWedu t to compilesaid 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 agreetocomplywith samy/01 provisions of lawsand odinances governing thistypeofwork will becomplied with whether specified
hereinornot. 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, orasa warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 000004 ISSUED PERMIT DATE= 0303/9i PAGE= 0i
**************************** PERMIT INFORMATION ****************************
SITE STREET= i005 E 29TH AVE PARCEL*= 28543-4306
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — SOUTH KOKOMO
***
SEE NOTE ***
PLATO= 00393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 43 LOT= ZONE= AG%UB DI%TO= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W= 70
0 OF BLDG%= i 0 DWELLINGS= i WATER DIST =
OWNER= CARBON, J P PHONE=
STREET= 10915 E 29TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= JIM NIEL%ON
BUILDING SETBACKS: FRONT= NA LEFT= NA
*****************************
SEWER PERMIT
CONTRACTOR= J.R. II CONSTRUCTION
STREET= iO5O4 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
PHONE NUMBER= 509 924 6077
RIGHT= NA REAR= NA
******************************
PHONE= 509 924 6077
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- -------------
PROCESSING FEE Y iO.00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
O3/i3/9i
TOTAL DUE=
.00 TOTAL PAID=
PERMIT TYPE FEE AMOUNT AMOUNT PAID
--------------- ------------- ------------
%EWER PERMIT 5O.00 50.00
5O.00 5O.00
PROCESSED BY: JULIE %HATTG
PRINTED BY: JULIE %HATTO
SEWER STUB A%—BUILT INFORMATION IN 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 (45-8OOO) ' ^
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR IN%PECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: _
Dept:
Project
Condition:
Date:
—
—
_
_
—
—
Init:
(in)
Appr:
(out)
Dept. of Bldgs.
Special Insp. Final Report
Hydrant ( )
--
Lock Box
Engineer's
—
—
RID/CRP
=,..
Easements
r_=;�
'.
Road Plans/improvements—
Bonds
Planning
-
:,:Bonds.
Utilities
_
Double Plumbing
ULID
—�
Other
THIS SPACE FOR COMM ERCIALPLANSTRACKING,CERTIFICATEDFOCCUf-'AR1CYOtdLY
Date received for C/O processing: Plans pulled for final processing: ----
Temporary C/O issued; Certificate. of Occupancy issued: —�
Office file review by: Date -'_---__—_—.
Filed i.ns ,,finaled_b :.---------- _. Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: _ Date:
Plans returned: Received
No response from owner/contractor - plans destroyed: _