1991, 11-26 Permit: 91008236 InsertSPOKANE 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OFnQ t APPLICATION / �7
OWNER OR AGENT 1 VIA . 1�. LLx G. �.� DATE
:7-'POJECT NUMBER- 9100G236
♦ ; •. t t P t 1t : v; 't' i'j t-=: ! .. ,2./9iPAGE= 01
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SITE :=• t : , ...::. 1 = 1003 N B r:.:k .' I I:' RD P F•1 E': (:E;•- .H... 1:7:154i -09.H:3
Al oi':'i:::.:.. - SPOKANE WA 9921 h'
PERMIT 1 USE- INSERT
1...04.1':::::
(JC ..
_ AREA=000000
00j ;78,8
12
PLAT •jl"11`IE:::: i•y1 •T'CH1.N., C1N ` ADD.
LOT= 10 ZONE— t(: R E 1)1: ': i :::: E:
r.:•/ -4'a= i•" Iii1.t'T•i•1= 20C DEPTH= 50 •'rW
DWELLINGS= 1 WATER DIET =
OWNER= = 'SIJI._i...T.V''FA4i'i , CALVIN
STREET= 1003 N
IE RD
ADDRESS= 4::.: SPOKANE WA'' 99212
509
920 4626
CONTACT NAME= CALVIN SULLIVAN PHONE Nl.JriBi":R=:: 509 928 4626
BUILDING SETBACKS: FRONT= N A LEFT= NA ESI i IGYH 1 NA REAP= A P= Jv f i
g•::• ''P: jr ji• •P: •R• r• 7* ii• .jt . i* .P: i* ii• * •M: i4 .j{..* .M• i* i* •l* i{.*.ri ii , : :, . ,••. E R :. . . ..................... .... ..r.:.:. • ::. • i :::...: ,.
I ::. i., " IV .. t.: H 1._ i" l::. !':1"! ! P: 'P: 7C 7C •n• 'n• ;!: 9C 'R 9r :u::�•;.:^..R• •A: 'R• 9•. P n •n P P 1, r r. 1
CONTRACTOR= OWNI: R PHONE-
ITEM
'rfO 1:::::ITE:h DESCRIPTION QUANTITY E'EF AMOUNT
T
PROCESSING FEE ,f: 25,00
k OODETCIVE/ Iii BERT i 25,00 : 0
Y':•:)• :.Pi X }i j{..h:• hi jai *.jf,. •yl. *.jl• •7 . Nf .... * •jt• *.k.:14..j(..j,..j(..... pAyHENT summARy d* 9r: •ii• ., if ni .j¢ .x.. i..j{.....jt.*...*.}{ .jt..j!..jt..x. * * •h; i,: * .* .h; .n:
PAYMENT t^TCtiECEF PT sPAYMENT AN ii,
li/26/91 9063 50,00
TOTAL DUE- ,00 j TOTFAIL... PAID= 50„00
PERMIT T'YP'E FEE AMOUNT AMOUNT PAID AMOUNT (14:rNr;
MECHANICAL.. PRM 1 50.00 0. 00 .. 8
50,00• 50,00
PROCESSED BY: JI.1L_1.E. >HA TC1
PRINTED BY: JULIE SHATTO
.);:****************k*********** THANK y!Y:}t iP 1 j. ffnnnP :P k PJ!H4*P1n*yi 3
Project
Address:
Dept:
SPECIAL CONDITION CHECKLIST
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other
Date:
Condition:
Project # Use
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
[nit:
(in)
Appr:
(out)
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: