1991, 05-24 Permit: 91002841 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)4563675
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 additionI have reaand understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to c ply 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 issu 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 isio 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 AGEN DATE
PROJECT NUMBER= 91002841 ISSUED PERMIT DATE= 05/24/91 PAtA.= Oi
**************************** PERMIT INFORMATION ****************************
SITE %TREET= 11815 E 38TH AVE PARCEL4= 3354i -9004
ADDRESS= %POKANE WA 99206
PERMIT USE= SEWER CONNECTION - MIDILOME 6TH ADDITION
*** EEE NOTE ***
PLATO= OOOOOO PLAT NAME= UNKNOWN
BLOCK= 5 LOT= 2 ZONE= UR-3.5 DI%T4=
AREA= F/A= F WIDTH= 95 DEPTH= 141 R/ 5O
OF BLDG DWEli ING%= i WATER DIET = MODEL
OWNER= GREMY INCPHONE= 509 924 9404
STREET= 12212 E %ISUX CIR
ADD = %POKANE WA 992O6
CONTACT NAME= FRANK COBB PHONE NUMBER= 5O9 924 9406
BUILDINu %ETBACK% � FRQNT= NA LEFT= NA RI�HT= NA REAR= NA
***************************** SEWER PERMIT ************************ ******
CONTRACTOR= GREM; INC PHONE= 509 924 9406
%TREET= i2212 E SIOUX CIR
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCESSING FEE Y 10,00
SEWER CONNECTION i 40.00
******************************* FAYMENT %UMMARY ***** **********************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
O5/24/9i 3213 50.00
TOTAL DUE=DUE= .00 TOTAL PAID=
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
EEWER PERMIT PERMIT 50.00 50.00 .00
------------- ------------
50.00 50,00 5O.00 .00
PROCE%%ED BY : WENDEL, GLORIA
PRINTED BY : JULE -SHATTO
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% DEPARTMENT ( 456-3604)
CONTRACTOR OR APPLICANT I% 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 IN%URE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR IN%PE TION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 ********** ,
***************************** * THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
Engineer's 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: