1991, 02-13 Permit App: 91000502 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
E 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
,. i :,1,, t NUMBER= >'-1' :1l::i'.:i'; :i.:
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AD
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i y 7.-xOK.tx'i Etii::: WA 9204
PERMIT USE= x,: i::, i.M i:, F . CONNECTION
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PLATO=
BLOCK=
AREA=
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'OWNER=
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TACT
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0 F;;i.-i •j ;;, t„i?;) t i 1 / { , ::::
0 D{%,IE:.LL.{,iiiGE::,.
::. i AUr INCxER7 LOUIE
11015 E 23RD AVE
SPOKANE i NE E-xiA 99206
PARCFLO= 23542-3313
NORTH KOKOMO'
K(:)KOMc: C2.1uji•NS., I E.
-ZONE= r``i i:%:`:' i,j T't
F WIDTH.- 100
NAME= LEONARD -.., I,.{ , s
E::TBA1-:1': S : FRONT= E :::. Nt i LEFT= T = f:}A
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CONTRACTOR= I:_t7SR—ION
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ADDRi::- r,S::.: SPOKANE WA . 206
ITEM DESCRIPTION
:=i Oi_E:',':s :{: inti:: {...:
SEWER CONNECTION
i^ ROC
PR
PHONE= 509 920 3620
I"`,`,,•jE:+iE NUMBER= •;r.j:, :_ 26..?6
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.A 1'P }' Ft 7. .. 1.1
QI.,JANT 1 ;''
•
PHONE= 509 926 3964
FEE AMOUNT
10,00
40,00
PERMIT TYPE- ;-tAMOUNT AMOUNT PAID
; ;`:i"OE.`,i•• OwING
iEWE..t•. PERMIT i -. 50.0000 50
.00
50,00 ,00 50,00
,JULIE EHA't"`
JULIE SHA T O
':EWER STUB AS—BUILT INFORMATION
T ,Li..-,(, I E,ES DEPARTMENT (456-7604
CONTRACTOR OR APPLICANT IE TO FIELD
ELEVATION AND POSITION OF :EWER :::
EXCAVATION
IE AVAILm.:d
TO LOCATE
CALL,.- , . •_ x-_ O
SEWER ;_TUBE A
THAT THEY ARE
,; ;iti }r- ,ir, ,it. ,,,..„, a,. ,.
AT THE COUNTY
TO BE E:, C:HEC:i t':.D : R,E •_..
; CONNECTION TOy
LEAR AND i-3 O :tETRij(. t i:`k) TO THE :71!EWER MAIN
FOR INSPECTION PRIOR TO COVER -'t!• u: * l.' •n: •1<: r• •it: -iE;+:
.C, • HIl1•,IR• NOTICE- REQUIRED- j:::C? -• **4c:****** :,
456--^..” 04• ••' it , , .... -,
:'>,' .:.:it f}i 1Fi :}i '• :: Sir •'7!•'j" ift 7 f, 1. a;. u, y, 9.• ? 3i..;;.:,` T•- i!'• i • 9.- :,y, * * ,i:, *' A N i . y E i E . ********************************4:
SPECIAL CONDITION CHECKLIST
Project
Address: Project # Use.
Dept:
Dept. of Bldgs.
Engineer's
Date: Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Planning Bonds
Utilities Double Plumbing
ULID
Other
[nit: Appr:
(in) ( (out)
** THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY ******************************
Date received for C/O processing: Plans pulled for final processing:
Temporary CIO 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: