1991, 05-14 Permit: 91001178 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 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= 91001178 ISSUED PERMIT DATE=: 05/14/9i PAGE= 01
3i-ii•3i•3c3i3iii13ti>h3E3i*3i•)k••r.•3k*it•3i•3i•3i•3{3f3t•3 ** PERMIT :ENFORMATION *3r**•***it3r*3t3ts3t*it3k*•3i 3i•***9i3i•**
SITE STREET= 11012 E 30TH AVE PARCELO= 854_ -•'51 08
ADDRESS= SPOKANE WA 992.06
PERMIT USE= SEWER CONNECTION — SOUTH KOKOMO
3 ** SEE NOTE ***
t'L..r'1T4- 001393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 1 LOT= :'_ONE= AGSUB IFi 1):E >T4::=
AREA= 00000000 t'/A= F W7:T,TH .: DEPTH= f./W= 70
'N'
OF BLDGE= 1 4 DWELLINGS= WATER DIST ::: MODEL.
OWNER= CE:.RUT CI PHONE=
STREET= 11D1 :' E :30TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= STAN ANDERTON PHONE NUMBER= 509 924 5595
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
k AlR*A* t t 3 *P33H Ik i3iA3A3hA3h3SEWER PEF � IT *33r*# kt3tlP****3t
3llP*Pit3PPP
CONTRACTOR= ENVIROGUARD INC PHONE= 509 994 4238
STREET= F'' 0 B O X. 141557
ADDRESS:::: SPOKANE WA 99214.
ITEM DESCRIPTION QUANTITY FEE.: AMOUNT
PROCESSING FEE T 10.00
SEWER CONNECTION 1 40,.00
3i•*3i 3>*a•*3ik•*•h:*3i•3i*3i**3k3i•3r3i•*3i•3i•3 *n:3i•** F:FtyhF::±N T SUMMARY 3k*it•ib*•b.•*3t'3l*•A••,i''P:•A•P:*'P:*•P:•,l3t**3i*3t:$
PAYMENT DATE RECE:rP'T Y PAYMENT AMOUNT
05/14/91 2857 50.00
TOTAL DUE== .00 TOTAL.. PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 ,00
50.00 50.00 .00
0
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS—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, FIT:.
CALL BEFORE YOU DIG (•456.-)0; 0)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE. CLEAR AND UNOBSTRUCTED TO THE:: ;EWII". MAIN
3i•3i••ri•3t3i3i•*** CALL FOR TNSFE::C:T:EON. PRIOR TO COVER •ri•3e•'v;;tie3i•*3i•3(3i
3t•3i•*3t'*3r3,:** 74 HOUR NOTICE REQUIRED 3i•3i•3i•3i•3z3i3;•3E3e3i•
• 456-3604 •n'x•*M 4r•*3i hi•A•b:
3e•,h•)k 3!'3i•3i•3t 3k 3t•1k)C 9!•)!'4!•Ji•3C X 9t•P.-*R•3!•it 3[)4 3i•R 9?'ii•It 7t•it THANK T f?t.! '3i'3t•3i 3i•3k 3t'4h i!••A.••P.•R••&iF A•!h k!1 9t•9t 1!•it•it 4t'9t•P.•M'•P.•R' k 4t•lI:P:
SPECIAL CONDITION CHECKLIST
Project
Address: _______._-- Project#_-- ___-- Use:_�_�_w__—__
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report_
— — Hydrant
_— __-- Lock Box
Engineer's__._.__--- --_ —_w-- — RID/CRF
Road Plans/Improvements
------ ----- Bads
Planning_.._ _— BondS —
Utilities_.__ — Double Plumbing •
ULID -
Other_—._____—__ • ..
.
••"`--***,•••--**,`•`•t" THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE°OFOCCUPANCY ONLY*******"**—*"************—
Date
******"**`**""°*'**•**<Date received for C/O processing {dans pulled fpr final processing
Temporary C/O issued" .
Oertrficate"of Occupancyssuerf:
Office file review by _ Date
Filed insp finaled by _._— —_ ___-- —.Cate: ---_—
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:_ ------__----___-- ---_- _