1991, 02-07 Permit: 91000390 Sewer - - .--
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
/xom,vmat/huvoovummoomwnmmmunnnouuon.ommmotmomm,maovncv"mmoumxonuoubm/uouuvmoonnvagenn000mp/leoumpermit/application is true
and correct, and authorize e kCounty to roceed with procuom» In additionI have reaand 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
| DATE= 02/07/9i PAcF= Oi pROJECT NUMBER= 9iO0039O I%%!/FD PERMIT
|
********** ***************** PERMIT INFORMATION ****************************
SITE E11-21.1..... i = i2221 F 371H CT PARCEL�= 33541 -9O04PTN
|
ADDRESS= SPOKANE WA 99206
'
| PERMIT USE= FEWER CONNECTION - MIDILOME 5TH ADDITION - -
_
|
*** SEE NOTE ***
•
PLAT4= 004369 PLAT NAME= MIDILOME 5TH
RADD
5 DI%T�= F
BLOCK= Z ~ F ` / W�"��- " 5~^ DEPTH= i5O R/W= 50
4 OF B; G;= 4 DWELLINGS= i
|
| OWNER= GERMY INCPHONE= 509 924 9486
STREET= i22i2 E %IOUX CIR
ADDRESS= SPOKANE WA 99206
PHONE NUMBER= 509 924 9406
CONTACT NAME= FRANK COBB
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** 'SEWER PERMIT ******************************
| CONTRACTOR= GREMY INC PHONE= 509 924 9406
STREET= 122i2 E %IOUX CIR
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
-------------- --_-----
-----------
� PROCESS IR-~ --- Y iO ^OOx
^—
i SEWER CONNECTION ' 40.00
} ******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT -
568 5O O0
O2/O7/9i ^--
TOTAL DUE= .00 TOTAL PAID= 50 .00
. PERMIT TYPE FEE AMOUNT_ AMOUNT PAID AMOUNT OWING
------------- ----- �
-- -
SEWER 5000 5O0O PERMIT _ �__ �__ __�_------�OO
5O OO 00
�
50.00 ^ . ^
.
� PROCE%%ED BY � WENDEL, �LORIA
PRINTED BY : WENDEL, GLORIA
| SEWER STUB A%-BUILT INFORMATION IF 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
| E�C��ATIG�
TO U]CATE `BURTED CABLE%� `:GA% PIPING, ' WATER ECT .
CALL BEFORE YOU DI:::, (456-8000)
D PRIOR TO CONNECTION TO INSURE
%EWERT%TUB%H= ' ARE ~L BE' UNOBSTRUCTED TO THE SEWER MAIN
/ nn /
*********� CALL FOR 'INSPECTION! PRIOR TO COVER ********
**
******** 24 HOUR NOTICE REQUIRED **********
�**31:31*.•*41:.K* 456-3604 **********
******************************** THANK YOU *********************************
{:
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
Engineer's r RID/CRP
Easements
Road Plans/Improvements
Bonds
Planning Bonds
Utilities _ Double Plumbing
ULID
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 insp finaled by: .Date:
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: