1991, 02-12 Permit: 91000254 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that 1 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 permNapplication 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 '
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i4W1:BEF = 91000254
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ERMIT
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ADDRESS= ;i.i Ok;ANE WA 99;1 )
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BLOSSEY 1•:)
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N-rACT NAME= DONNA C OU!C HAI Ni::
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PHONE NUMT1EF = 509 924 5425
DING Sr:ETBACKS: FRONT= NA -I, -NA RIGHT= NA REAI
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PERMIT .TYPE -
FEE- AMOUNT
PR NTED
JULIE SHATTC: - -
Pr°iY`ri!iiJ r' AMOUNT
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TOTAL PAT :).= .. >';;. C)';)
A`iCk:!NT F AID AMOUNT O 1TNG-
.0 .. '00
TUr{y� AS -BUILT 7Nr'i:1i{L'jA'UTiI(N 1;:,i,' AVAILABLE 'AX
TES DEPARTMELJT 4s6--26., `1
CONTRACTOR OR (-i h'I'',1... 1. 1,'i::, Rf .1 .�. `r TO r..i r. L:.l.i LOCA I k_ Pj IV 1i %:I tivJ!^ 1, rm THE
rvo..T':!ON 1:?1`i.!) POSITION ;u.: ,h!ii.la!E:i: STUB I'T•;i 11 Tfi r.}fd`r OTHER
lig r._L1j.A'T'EGAS' PIPING; WATER L..]:TII'-E'S:,"E::ia',
)ali- • r L CABLE '
CALL. BEFORE , YO!) DIG t 6-0000)
SE:.W,_ y STUBS ARE i'i:l: !;il:i:' ;1=11:i::I<Ei;h PRIOR 'TCI t.;t'i J Jii::f::T1 i1) -; Ei' 1:'NSi!PE:'
TWAT THEY ARE CLEAR 1; -Ji: iJNQT:i;:.'TRORTEET) '(i) THE SEWER iMATN! ,t ;,-
(ir:.)ry..ui')i.N..H..tt' (:4'+!_L. FOR 1W>I''f. C;T.I: CIN PR:Ci:)Pi TO i:::; 11: r:: Gi' 'Yi it 9i'ai'ie"ii'bi i()i'd('
*ds it ti.;i.:ni di'dri iE
.?: HOUR NOTICE UC;U1t:r-
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P)*'1i1,'..:)etini'Pi iT ie ille'll"!Yi^:'T:'ir.:p}:,e'Pi.)e.?ii i,He 1e iF.p: *di is *iE i' THANK l 1.i!.! ***K ik9H`.ik:rt iS'4t"lePE'1r 9i'ii It ie tiE
_COUNTY.
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