1991, 07-09 Permit: 91002777 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SP@KANE, WASHINGTON 99260
(509) 456-3675
/ certify that / have exam moum/opvmn/appnoanon'state mutmo/n/o,mouonoont^mou/nuanuauummouu/moonnvagentmvum»no,ump nnn/avp/muunn/»true
and correct, and authorize Spokane County to proceed with processing. In addition, / have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree '" comply with =~~~' ~ and
plied with whether specified
herein or not. / understand that the of this mu ..mnionon "�'"=
u»vv��» «°""° """"''=~~`~
~^~~~Occupancyshall not uoconstrued tos.onnmon/nm�o,/mm/
/ wm n to violate mmmm
o,uxncm/v»,vnounvmmn
state law
"o..".°,"-""°"`'".^...~.~~~...`..,—..
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER 0nAGENT DATE
PROJECT NUMBER= 0002777 ISSUED PERMIT DATE= 07/09/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= i1Oi5 E 3i%T AVE PARCELO= 28543-5i2i
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — SOUTH KOKOMO
***
SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 51 LOT= ZONE= UR -3.5 DI%TO= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 0 DWELLINGS= i WATER DIST =
OWNER= COLE PHONE=-
STREET=
HONE=JTREET= iiOi5 E 3i%T AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= TLC PHONE NUMBER= 509 927 6760
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
*****************************
SEWER PERMIT ******************************
CONTRACTOR= TLC CONSTRUCTIONPHONE= 589 927 6760
STREET= 1306 E 12TH AVE
ADDRESS= SPOKANE WA 9906
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ------------
PROCESSING FEE Y iO.00
SEWER CONNECTION i 40.00
*******************************
PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT� PAYMENT AMOUNT
07/09/9i 453k.)
50.06.)
TOTAL DUE=
------------
.00 TOTAL PAID=
5O.00
PERMIT TYPE
---------------
FEE AMOUNT AMOUNT PAID AMOUNT
OWING
%EWER PERMIT
------------- ------------ -------------
5O.00 5O.00
.00
------------- ------------ -------------
50.00 58.80
.00
PROCESSED BY: JULIE
JHATTO
PRINTED BY: JULIE
%HATTO
SEWER STUB
A%—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,
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 INSPECTION PRIOR TO COVER
**********
*********
24 HOUR NOTICE REQUIRED
**********
*********
456-3604
**********
******************************** THANK YOU *********************************
Project
Address:
EM
Dept. of Bldgs.
Engineer's
Date:
SPECIAL CONDITION CHECKLIST
Project #
Condition:
— Special Insp. Final
— Hydrant ( )
— Lock Box
— RID/CRP_
J j
— Easemenis"
— Road Plans/Improvements
— 136nds f 1
-J
m 1�0
Plarinj
0 P ;r4 7:1 1*1
V I 1A
Init: Appr-
(i n) (out)'
7.
THIS SPACE FOR COi�MERCIAL PLANSJRACKING, CERTIFICATE OF OCCQPAN.CY ONLY
Date received for C/O pracesging: pulled for final processing.-___
V
Temporary C/O issued f',
Certificate of Occupancy issued: --------- -
Office file review by: v- Date:
filed inspJi.nVqd r.nr,Z-3F X- r Ii 7 -------- -t if, A-!"* P. :1
Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed:
Received by:
Date: