1990, 10-03 Permit 90005090 SewerSPOKI,i.c 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/applicationand any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate] cat\cel the provisiopsoi,any state or local la 'regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.., i
SIGNATURE OF APPLICATION f 1
OWNER OR AGENT " L.�L Y �I V DATE (�3 C , (, u
I''I't:!_,:.1I:::i::, , :,,r. lM:E L•: R:::: 90005090
?Y^..?'... 4.t. 9.:.• ),i 3!i ).Y.: ••?.k. )i 1i )ri•lh. E 3ii}}3iPt7PERMIT
SITE
AD
PERMIT
OE
1 2614
i'' i•: A i Y 1. l l:. AVE
SPOKANE WA 9921'
INFORMATION
ISSUED
0/07/90
PERMIT
01
X 3. 3>'• 4. )i it- 3e it- * ... 31 3.` 3i N' )!; )}: 3i' ^. ?
I_!,:• L:..... t•,':.Wr: R CONNECTION .... i_..S,x,...2 (FROM MOBILE
K**
ADDRC:.,: =
pi,T, ....,.
00.1940 PLAT NAME::::
:
,.•. 1? ,.n• !... r... 1. .!. I \ 1.Y ,.} ....
BACKSH
NA
tiiONE-. COMM
WIDtH= ......
**•.H•..*•.•..*3i•N:..-i!:'n'...;d*..**h:•:a:•){....rt• SEWER PERMIT
ACTOR= MOUNTAIN
REST
.. y I•=:i:: i::. t •�.iO3 N .1?`.i.SM I ST ... ._ .. ...INC
r':y: I i:RE:... s= ,.. ='0KAt4F WA 992
ITEM DESCRIPTION
SEWER CONNECTION i
HOME )
i i T . • .!R .._
t:`krltv`t::... r'•.{.;+.i? 92 :. G06
PHONE IN NUMBER=
, r.3** *3t:**5:3.3.. 3k3h3:'3%
QUANTITY FEE AMOUNT
40,00
H.4;ii,• -)1; 3. 34. 3. * 3f..14...... •... 'P: •R .* 3t: P• * 31 3t: ti * * 3. X ){• ).3i- PAYMENT SUMMARY ...... .. 3.. '...........h .... ...}!'..A: 3.....*..) )...:1:
PAYMENT DATE TOT' DUE=
PERMIT TYPE
:-.E.WER PERMIT
RECEIPT*
6007
FEE AMOUNT
50.00
r"'1)
I:.t ,' ► : BY: :.Itt, rE ;;H tTTlc!
j • Y. t f BY: jULIE ,M I-. A t i t,!
AMOUNT PAID
00
.....................
50.00
i-'r` `€' f^i- '-i- A;v; I I: ,
50,00
50,.0t;l
AMOUNT OWING
} EA!{ ,1€S'Ui_ INFORMATION ±} AVAILABLE
UTILITIES DEPARTMENT 4 }r',....:h ,0 4
CONTRACTOR OP .'°PLICANT
IS
; i FIELD LOCATE
S,ii" AND
CONFIRM THE
ELEVATION It. N AND I•.'i POSITION 1r ;4 r;W i-: TO
OTHER ANY
EXCAVATION
TO LOCA-
. ALL_ i:sE I
THE COUNTY
CABLES GAS 'PING: WATER LINES, EcT,
i:•i "i I.1 i : ARE TO BE CHECKED
3E 3i -ir: 3i * 36 )>: 34 3<• i f i i..I. •= O R INSPECTION
3!'3i•3k3.)t3.3{••if3r ,•y;: .....,.... „:.......
3b3.3 *3 *3t•.> )'i***).*k3.'*3.*N:3f•*)i•3 )i•3iJ *ii I k 'i THANK
PRIOR TO CONNECTION f OI
INSURE
0 tP;SEWER MAIN
i.1:
TO ; .:, u , •. rc hi •n: •; :x; * ,..r..p: ;,!...);.
3.*:>,..3.§...?i3i••N'
you u •?ti �.• Ji' * 3t• .u..?�''iF i'v '?•: f�"?v * '?i..k.* * * * :l`u *i fi iti '?i. r..?i ii ii' :!!.:y;
JOB ADDRESS: � /4 t [
SUBDIVISION: LOT:
BLOCK:
OWNER: j I- Q A-4-)i-� c,
PHONE: �,�zi -- `-5 ,;Z, 4,
ADDRESS: \ J-11/\
CONTRACTOR: M '� � , g i.,-Sa`� PHONE: Ci ,57q4/
ADDRESS: t hn , k.j 11i1S1uty P A+i.,-- (,Q)A, U
q� 2/
LICENSE #: 4'? (l " k_ r Q / ) ()}L
INSPECTION DATE:
TYPE OF OCCUPANCY: