1992, 03-13 Permit App 92001510 SewerSPOKANE 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 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
E {?r3 rE:�:::: �:?3/ 1 _h/9 ? PAGE.:: 01
PROJECT l�L�i~i�+I":{� �- 92001510 APPLICATION
* 3i• 3i• 3i ii• * THIS IS NOT A PERMIT -r..ji.:a: -x: 3i• •ii•
PENALTIES WII...i... BE ASSESSED FOR COMMENCING WORK WITHCti.•i.T A PERMIT
SITE STREET:::: 11801 F MANSFIELD
AD RE::SS=: SPOKANE WA 99206
PERMIT USE:= SEWER CONNECTION •--
.ii ** SEE NOTE •ii) •i;:
1'' E... A i T
BLOCK-
AREA =
0 OF RL_DGS::::
OWNER--
STREET::::
ADI)RES'S=
0020-i 9
00000000
.9.
,i .„.
AVE ,E E''ARCI:,E.. 4= 0 9544-l:lr'50 i
PLAT NAME-:
1._ O T =
F/A
1)WEI._I._INGS::::
(92E-1 96 )
t•'i.NE:.(..:RoFT 1ST AD)I>
r.' O N E ::= RI:
F W I D T i..1.-:
10 WATER D.E S
MURRAY
11801 1: i•iANSFIELD AVE
SPOKANE WA 9 206
CONTACT NAME.::::: G€)BER & SON
BUILDING SETBACKS: 1-RONT= N/A I._E:'I"T::= !filar
NYt C *E 1N33Ni A3ct ilt HPYb3;i3JHSEWER pERMIT
CON r RACT OR:::: (.rOBE: R,:: FUEL & OIL
STRE.:E::T= 11215 I::: TRENT AVE::
(DDRE:.,S'S= SPOKANE Nt WA "9206
ITEM DESCRIPTION
PROCESSING FEE
SEWER CONNECTION
PERMIT TYPE
SEWER I::IERN1IT
PROCESSED
PRINTED
FEE AMOUNT
50.00
50.00
ai (.? M 1. T R O u I iC ri , ROBIN
1)flti.I.TROVIC,I"I! ROBIN
}N
PHONE=
(COPY IN PRI
DIST:Ef'- H
PHONE NUMBER= 509 924 5372
RIGHT= N/A REAF:::: N/A
•u : 3j 3 .....}i• ii •.. ii .. i+:. 3r: •}i• ..... -ik .it.....ii..ii..ii• •i':• * i+: A• •N;
PHONE- 509 924 5372
QUANTITY FEE AMOUNT
1 t: i :. 0 0
40.00
AMOUNT PAID
.00
.00
(iiOt.iNT OWING
5 0 Efl)
50.00
SEWER STUB AS —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 BURIEDCABLES, GAS PIPING, WATER E:R LINES,:..: A
CAE_.L.. BEFORE YOU r I CT (456— :s000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED RUC' ED TO THE SEWER MAIN
* * * •>t• •it •it 3{• * 3i• CALL t'' i.} R INSPECTION PRIOR TO COVER •ii• •ii• 3{• 3i• •it• •ii 3i• -N: 3t- -ik
ii• 3t• •}i tt h }t ft * * 24 HOUR NOTICE REQUIRED *h x is * * ri li 7i
.1- .x. •ji• 34 3l 3i. 3;. 3i..yi. 4 5 C6 .... 3 6 0 4 : :..iE •ii..}i..ji..}4 •i6 ii .
* *rrrriaaat t 6 F F 3*3axarnt }333r :t iTHANK -t ; Y .tx*k@ ihi33~ i i333i3t t ixnr nx3 hi333>i