1991, 04-01 Permit: 91001376 Sewer SPOKANE COUNT,. ~-,ARTMENTOF BUILDINGS
Ni1303BROADWAY AVENUE
�
/ POKANE,WASHINGTON 99260
(509)456-3675
/vom,vmot/havooxummoom/opmm/vannnvunnn.motomutmomm,mxnonnontumoumnoououumntoouvmovnnvagentmoumpneoumn rmit/application is true
and correct, and authorize a okunoco nty to proceed with pwoossmo 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
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
OWN ER OR AGENT DATE
- -
PROJECT NUMBER= 91001376 ISSUED PERMIT DATE= 04/01 /9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
%ITE TR EET= iO7O9 E 32NDAVE PARCEL28543-5347
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - DI%HMAN-MICA INTERCEPTOR PKG 45
*** .SEE NOTE ***
PLAT4= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 53 ZONE= RUN! DI%T4=
AREA= 00000008 1::* A= F WIDTH= DEPTH= R/W=
4;: OF i DWELLING%= i WATER DI%T =
OWNER= HUD PHONE=
STREET= i0709 E 32ND AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= HUN VIETZKE PHONE NUMBER= 509 244 9607
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER pERMIT ******************************
CONTRACTOR= VIETZKE EXCAVATING PHONE= 509 244 9607
STREET= 20ii % CRAIG RD
ADDRESS= MEDICAL LAKE WA 99022
ITEM DE%CRIPTION QUANTITY FEE AMOUNT
------------------------ -------- ---------- .
PROCESSING FEE Y iO.08
SEWER CONNECTION 4 40 . 00
� . ******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPTa PAYMENT AMOUNT`
5O .00 O4/Oi /9i � 7i5
------------ '
TOTAL. DUE= .00 TOTAL PAID= 50.00
� !
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -----------
SEWER PERMIT 5O.00 50.00 .00
. ------------- ----------_-
•
50,00 50 .00 . 00
PROCE%%ED BY ' JULIE %HATTO
PRINT[D BY : JULIE 7H�TTC
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 CABLE%!—GA% PIPING , WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
SEWER %TUB% 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 NOTICEREQUIRED **********
********* 456-3604 **********
^ '
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: __-_ — __--._-.. Project#– ___� _Use: ---
Dept: Date: Condition: Init: Appr:
(in) (out)
DepL of Bldgs.
___ -_____.____.____ _ _ - Special Insp.Final Report _
__ _.__-__---_-_ _-- _ _-- _-- Hydrant ( ) _ --
----- -- ____ - - Lock Box - --- — - - -_-- - _. -
Engineer's__________ _____ RID/CRP __
__------- -- -- Easements - ----- - - - _____„__
___.______________-_.___ _ Road Plans/Improvements -- __-_____
-._-- ----_. ---__-- Bonds_ - -- - --
Planning __ - - Bonds----___------ _._.._----------__._----- ___-----_--------.__ __-----_-__-
Utilities___.___.__.__-_ _.__--- -__-- __ Double Plumbing______-___-. -.._-
- U L I D
Other -- - - -- - -- - -
-- -' ”""""""THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY--'''''--'°""""""
Date received for C/O processing: _ . Plans pulled for final processing: _
Temporary C/O issued:_.___________ _ -----. Certificate of Occupancy issued: _.__. ___
Office file review by: __ _ ----- -_. ----. Date:---- ----- .
Filed nap finaled by:__ ____- Date: _-
Ninety days after C/O issuance:
Ownerlcontractor called regarding the return of plans: -_ _ --.___-- -------__.__ Date.__-__ _-
Received b ______
tans returner: ---- -------___---._._ ...----------- -----
No response from owner/contractor-plans destroyed:____ _ ____ _ ----___._ _.