1991, 07-09 Permit: 91003662 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
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 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
herein or not.I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupa cy sh II not be construed to
give authority to violate or cancel the pr.v' ions of a. ate or local law reg lating con uction,or as a warranty of conformance with th rovisi s of any state or local
laws regulating construction. -
SIGNATURE OF / APPLICATION ziOWNER OR Ac ■ r�+�'.�� DATE
• DATE= ? {/0`}'/;i1 PAGE ::: 01
PROJECT NUMBER= 91003662 :FSSI..JF��'� PERMIT
)i•if::..k..yf.***#i•****•a:*'a**ka•k*ri•***** PERMIT INFORMATION r:•*k* ** *•x•b:•**•x: *•>R***u•***)•3i**
SITE STREET=. 11921 E 38TH AVE PARCEL ;M 33541 -9004
�1
ADDRESS== SPOKANE WA 99206
PERMIT6TH ADDITION
r e:.I•t f"I:i:T SEE
USE= SEWER CONNECTION F I�i�f:::f`•T':I:(:i�.1 — i�:1:�`�:[f...�:l i�f C
*** SEE NOTE ***
F'I...AT4=: 005026 PLAT NAME= MIDILOMF:: 6TH ADD
BLOCK= 5 LOT= 6 ZONE== UR--3. 5 1) FST•„==
AREA=
F:'/•A-• F:' WIDTH= 99 DEPTH= I :a5 R/W= ""iia
M OF BLDGS= 4 DWELLINGS-:: j WATER DIST :-: MODEL..
OWNER= GRAFOS CONSTRUCTION PHONE= 509 922 291
2
STREET= 12609 E SPRAGUE AVE 02
ADDRESS= SPOKANE: WA 99216
PHONE NUMBER= , ''9 922 2.91 2
CONTACT NAME= DEAN C;F{EtF"CiS -:ii:i� :._.>
BUILDING SETBACK.S : FRONT= NA LEFT= NA RIGHT= NA REAR= N A
*a>Rx.:**x•*)t**x:A**•*•**x**•*•x••x*.**•* SEWER PERMIT .*** x*: •a***•b:71..>ta**)<•P:**•n:• •„**
CONTRACTOR= UNKNOWN PHONE=
STREET==: UNKNOWN
ADDRESS= UNKNOWN WA UNKNOWN
ITE:M DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE r 10 .00
SEWER CONNECTION i 40.00
Rri**•b:•**)i :a:A**#* :#*****>_•***•*•**3* PAYMENT SUMMARY ******* * * 1A
PAYMENT DATE.. RECEIPTO PAYMENT AMOUNT
i
0451650.00
-
4� / 9 •9•t / r7
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE:: FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.,0e/ ,00
50.00 50.00
PROCESSED BY : JULIE SHATTO
PRINTED BY : WE:.NDEL.., GLORIA
SEWER STUB AS-••BUIL..T 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, E::C: I ,
CALL.. BEFORE YOU DIG (456--8000)
SEWER STUBS A R E TO BE CHECKED PRIOR TO CONNECTION T O INSURE
THAT THEY ARE CLEAR ClAND IIr'IOBSTRI..JCTEr, TO THE SEWER MAIN)
h•*)t* •*R • • CALL FOR INSPECTION F'F.TOF4 TO COVER ,x) ' a:i :* x
****•i'* * 24 HOUR NOTICE REQUIRED •) ***** )E
i ) 1 k) 4 ik k N1 ! 99l t*R* k t 9C 1 i ) ***! ** THANK YOU ) ) F h k) 9 *) k k Rx*ri*iik t k 7 *9k) ** RiA
k
I
g CONDITION CHECKLIST
Project
Address. Project#
Dept: Date: Condition: Ind A
ppr:
(an) (out)
Dept of Bidgs
---a-
-- Special Insp.Anal Report
Hydrant ( )
Lock Box
'-
Engineer's • RIDAC'RP ;
_ Easements_._ •
�- _-- Road Plans/Improvements_
Bolide — —
Planninpr_ __ � _._ w_ Bcnds _ . . ..
•
Double Plumbing
—_ _-- U L I D
Other
•
THS SPACE FOR COMMER AL PLAS1RACKO CETCATEEOCJPAYONLYAiV :Y ONLY> '>•`tr<,"•,;°,•*_ DD
Date received for C/0 ptaeessmng • • _- P+an$P'v+.t d'for€msi
Certifecato of . .
.
••0/0 issued:
Office:file review by: •.
Date:
flied cusp finated;by fat
Ninety days after C/O issuance:
Ownervuootractor called regardina the return of plans: Date-
Plans returned. Received by
No response from owner/contractor-plans destroyed: