1991, 07-10 Permit: 91002563 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 correctand authorize Sxu 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 OnAGENT DATE
PROJECT NUMBER= 9i002563 I%%UED PERMIT DATE= 07/10/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 10713 E 30TH AVE PARCEL4= 28543-4507
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - SOUTH KOKOMO
*** SEE NOTE ***
PLAT4= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 45 LOT= ZONE= UR 3.5 DI%T4= F
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W= 7O
4 OF BLDGS= i 0 DWELLINGS= i WATER DIET =
OWNER= BROUGHER, JANET PHONE=
STREET= 10713 E 30TH AVE
ADDRE%%= %POKANE WA 99206
CONTACT NAME= STAN ANDERTON PHONE NUMBER= 509 994 4230
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= A PLUS CONSTRUCTION PHONE= 509 922 4594
STREET= PO BOX i41557
ADDRESS= SPOKANE WA 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 18.00
SEWER CONNECTION 1 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT:: PAYMENT AMOUNT
07/10/91 4564 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.00 50.00 .00
------------- ------------
50,00 50,00 5O.00 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE %HATTO
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER %TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GA% PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (45 -8� OO) '
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO IN%URE
THAT THEY ARE CLEAR N %T D 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 Fildgs.
Special Insp.Final Report
Hydrant )
Look Box . . .r. . .
•
Engineer'sRID! R
Easements__
Road Plans/Improvements
Boids
-17
....,..
—• .4--
.:4
. .
. .
Planning i • j3endsi.
•• •
•7777-- .
. . -
. . . .
Utilities Double Pimbing . • . . .
HUD
• .
Other •
. -• . • .
. .
. . , . .
THIS SPACE FOR COMMERCIAL PLANS ftlkiCKINid,CERTIFidATE.O0'b6otIOANCV ONLY---
Date received for C/O procesSing' i • PlecSiptilled for final processing
Temporary C/O s ued C.ertjficatte.of Ocettpaitcy issued:
Office file review by • • •
1- led nsp fnaled by -. Date
Ninety days after C/0 issuance:
Ownefosonfracrof called °W no the return of plans Date:
Plans returned: Received by
N- response from owner/contractor- 0lans destroye.d