1991, 05-16 Permit: 91002448 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 correctand authorize Spokane County to proceed with processing. In addition, / have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to com/with same. All provisions oflaws ununrdmx,000 governing this of work wil! be complied with whether specified
herein o,not. / understand that the issuance nfthis permit/application anuunrou»oo«vontmopovno"onpmv ls 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 construcon.
SIGNATURE OFOWNER OR AGENT
APPLICATION---
4p
�
DATE ��
PROJECT NUMBER= 91002448 I%%UED PERMIT
DATE= 05/16/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE
2506 % BOLIVAR CT PARCEL4= 26543-0102PTN
VERADALE WA 99037
PERMIT U%E= SEWER CONNECTION - EVERGREEN POINT 5TH ADD
*** EEE NOTE ***
PLATO= 999999 PLAT NAME= RANGE
BLOCK= 16 LOT= 3 ZONE= UR -3.5 DI%T4=
AREA= F/A= F WIDTH= 50 DEPTH= 138 R/W= 50
4 OF BLDG%= 4 DWELLING%= i WATER DIET =
OWNER= W R % & A%%OCIATE% INC
%TREET= P O BOX .14084
ADDRE%%= SPOKANE WA 99214
PHONE= 509 922 0782
CONTACT NAME= BILL SMITH PHONE NUMBER= 569 922 0782
NA RIGHT= NA REAR= NA
BUILDING SETBACKS: FRONT= NA
LEFT=
***************************** %EWER PERMIT ******************************
CONTRACTOR= W R % & A%%OCIATE%
%TREET= P O BOX 14084
ADDRE%%= %POKAHE WA 99214
ITEM DE%CRIPTION
PROCE%%ING FEE
SEWER CONNECTION
QUANTITY
--------
PHONE= 509 922 0782
FEE AMOUNT
iO.O0
******************************* PAYMENT %UMMARY ***************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
05/16/91 2937
50,00
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT
PROCESSED 7v: WENDEL GLORIA
PRINTED BY: JULIE ^HATTG
50.00 50.00 .00
----- ------------
50,00 50,00 5O.00 .00
%EWER %TUB A% -BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% DEPARTMENT 0456-3604>
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER %TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLE% �A� �IPIN�, WATER LINE%, ECT,
1
C�L[�R�-Y��-Df�-T��"-8O�O)- - -' WATER LINEE, �-
%EWER %TUB% ARE TO BE CHECKED PRIOR TO CONNECTION TO IN%URE
THAT THEY ARE CLEAR AND UNOB%TRUCTED TG THE %EWER MAIN
********* CALL FOR IN%PECTION PRIOR TG COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
TO LOC�
CALL BE
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project # Use.
Dept:
Dept. of Bldgs.
Engineer's
Planning
•••• (;'.7
Utilities
Other
Date:
Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
. ,
Easements • • •
Road Plans/Improvements
Bonds .
7..
Bonds
..1
3i -
Double Plumbing
ULID
".
rf,' •••••
!nit:
(in)
..„ . „
. .••• "••
Appr:
(out)
•
'1"HIS SPACE POR aOOMERdIAL PLANS319AO<INp;.CEI:iftrMATE,OFIOOCUPANOONLr.t-7************************"*
,:;: C/O
:;•7
Date received for C/O pcpc,9in9i.'"!!....-:'.. 1: 77,7 ‘7,7, •77 7 ?lanspujied for iinopi-ocesiiri4- . • ! , ,. ,
Temporary C/O issudd' :i' ''': :.`':'(':•'''.:''"':' '::..::''''ij.." '.;-:.i1',10driOiOateO4 Occupancy issued::.' ':: :. '' ':''' •:":'''''''i .:' '
• .,-t : 1 ''.. , :„.i - . ', . ..: : : .• : ..:.(..... -,,.it .::+:• •,,:. i: ':';' .`f "-3t. ':,.'
Office file review by: .
Date:
Filed insp finaledby: . Date:
:7: •:-7-•-.7.7•• .:* -07 : •
Ninety days after CIO issuance:
Owner/contractor called regarding the return of plans: Date'
Plans returned: Received by•
No response from owner/contractor - plans destroyed.