1991, 07-09 Permit: 91002784 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
VK 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON g9260
(5U9)456'3675
ceNythki have examined &is permit/application, state that the information con/ ed in it and submittedby me or my agent n said permit/application istrue
nd correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
pwisions 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF AppUCAT|0m
OWNER onAGENT DATE
PROJECT NUMBER= 0002784 ISSUED PERMIT DATE= 07/09/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= iiO20 E 3i%T AVE PARCELO= 28543-5417
ADDRESS= SPOKANE WA 99206
PERMIT USE- SEWER CONNECTION — SOUTH KOKOMO
***
SEE NOTE ***
PLATO= OOi393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 54 LOT= ZONE= AG%UB DI%TO= F
AREA= 00000000 F/A= F WIDTH= iOO DEPTH= i30 R/W=
0 OF BLDG%= 0 DWELLINGS= i WATER DIST =
OWNER= %IMON, GEORGE PHONE= 509 922 0565
STREET= ii020 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
***************************** %EWER PERMIT ******************************
CONTRACTOR- TLC CONSTRUCTION PHONE= 509 927 6760
STREET= 13816 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 453i 50.0O
---------- -----
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE
---------------
%EWER PERMIT
FEE AMOUNT
-------------
50.00
-------------
50.00
AMOUNT PAID
------------
50.00
------------
50.01'..)
AMOUNT OWING
-------------
.00
-------------
.00
PROCESSED BY: JULIE 5HATTO
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 (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AN %TRU T D TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
********************************
THANK YOU *********************************
Project
Address:
Dept: . Date:
Dept. of Bldgs.
7-
5T
Engineer's
Planning
Utilities
—
Other—
V
TH IS SPACE F
V'
Date received for C/O Vr6c46Wn§!.31A-i—-.*
Temporary C/o issuqo".
Office file review by: 'A -A'
-F -
iled.� W.,f inaled:. .. .. ..
Project #
Init: Appr:
(in) I (out)
Special Insp. Final Report
Hydrant ( ) —
Lock Box
4
V
RID/CRP.
-7-7777:- :
EasementL, W.::1 7-
Road Plans/Improvements
Bonds W
0
C. 7�
. .. ....... ..
Bonds.--
-'1 4 4. +! .4 q -W Al
... .... .... .... .... ... . . .... ...
Double Plumbing
ULID
-----------
. . . . . . . . ....
6
:4
7 '1
OR COMMERCIAL PLANS,,,T-8'ACKING*,;URTI FICATE OF OCCUPAMY ONL.,-.,-; .... . ......
:,Pian6.Ouiled,,.#Ofint�tiprQcestin(Y.!.,!,i, 1' 4 1-iT
J9
Date: .4
77
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: