1991, 08-12 Permit App: 91004839 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= 91004339 APPLICATION DATF= (:) /i2/91 PAGE= 01
THIS TS NOT A PERMIT
PENALTIES WILL BE ASSESSED t iR COMMENCING WORK WITHOUT{..
,
SITE :.i I ;.;,i..1.. 1 :::: 11317 31ST AVE i•:.i- .. CO r
ADDRESS= SPOKANE WA 99206
OWNER= ADCOCK , r'
_„a
STREET= 11317 E
T AVE
ADDRESS= SPOKANE ijir:-i. 99206
CONTACT NAME= , NIELSON
:�a.t:�.:r :-i::. i 1;•i±..!j.:t.... - ?' . .i l i' ,'•°i•�t LEFT= .'.i'? RIGHT=PHONE 1`ti(� ....�'�i i"': ;::!.
iPi : : : „d : : '+r f : or P'F 7 7 h _h# . PERMIT *Rjj :1js : . j::, i :) i :.rj..:.,...::aj..:.!j..: j1 : .i
.
CONTRACTOR= J,R , IT CONSTRUCTION PHONE= 509 924 6077
STREET=
ADDRESS=.EI"`•:i::.,�,:. •• _ i.:1„;i;Ai'%?::. WA 99206
ITEM DESCRIPTION QUANTITY .'i::._: .it;:j.. ..i3 .
CONNECTIONPROCESSING FEE 10 , 00
SEWER
PERMIT I i... F !.,i::. !..!! ;,!.r ! AMOUNT ,'S..{ID AMOUNT OWING
SEWER PERMIT 50 ,00 ,00 50,00
50,00 ,00 50 , 00
PROCESSED BY :
PRINTED BY : JULIE SHATTO
SEWER .STUB AS—BUILT INFORMATION TS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT ( 456-3604 )
CONTRACTOR i i"' i jl. 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 , WAIL LINLS ,
CALL BEFORE YOU , 456-8000)
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
*K****k** CALL FOR INSPECTION PRIOR TO COVER K:f;:kf::;f: *:k:k
456-3604
,..,,..»..»..».....»..aa..»..•...,...»..».....,...»..,a..». e.:i.::::f.:i.:!i.:+:.:li.:}i. THANK i j'i