1991, 03-26 Permit App: 91001338 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 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. 1 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
.PROJECT i'JUM E::R= 9100133O -APPLICATION DATE= 03/26/91 /26/9.1• PAGE= 0j
;!:*jL*** THIS IS Nc:I1 A PERMIT P•*:3t•**
PENALTIES WILL... BE::: i•=± ``E:.•`''FI) FOR COMMENCING WORK WITHOUT A PERM.
(.". D )1.4 EES- P O ±i A N E WA fl9 t) ,'-.
,•� ;;:, rc : ! .E. ( USE= •'k F WEt CONNECTION NORTH 'r : i % I i;"t i
,::,• NOTE is i':,:•i>-
BLOCK-
OWNER=
STREET=
001393
00000000
'1 E�
PLAT rJAi1E.M:
i-:toP:.E...i....E NG •...:
JACO f:s ,.; i::. i`H , tai
SPOKANE WA 99206
1`•� ! E.1 t.: i NAME= L l... t.11•d F•Y E•t .,
PARCEL4= 29542-3709
E1 OK, Oii%. TOWNS 1• TE
ZONEAGEUB
E... WIDTH=
WATER .'. it:i-<:'>
LEFT= NA
PHONE NUMBER= BE::E't`.:_: NA.. !:.},:.)iy. 926 8964
j:;HT= NA... ", ,;::::
* •.:: •- : l : '. •! •.: j.: j.: ::!:: j.' i.: j.: !: a(.:, •.: •: Cp::j.:�.:!,:.j : A!.: j:.�..jL..;,..j!. •i!: ?v ,... t ,'t.. i:: .. ... ,.., , :...:. - ....... - .
t.:,.:!. R n :,.:. F.:L . L }. 7. !. l ....L N... !.:.... L :. ,.r i::, txt ; :. ! ••. ! !... 1"•: i"i .E. t '�: 'P:.k .... 't. '!!• X .k .� .,L..3,: •P: 'P: 'R •!!: 'P:..:!!: 9....... 'F: 3..L' ..:!. 9!: ','.
CONTRACTOR= H. & CONSTRUCTION
STREET= i1is'i i:: V t-! E._ E. g' Y iLt A T' (• 1 'e i :.
ADDRESS= ;;;,= ,Pt.tKANE-. W(`; 99206
:E:•TE:::±M DESCRIPTION
PROCESSING E:.i:.
,..EWE::.: ._OiJ}J ::i.:; 1 .E.!_iiJ
PERMIT TYPE
SEWER PERMIT
PROCESSED
PRINTED
PHONE= 509 926 2964
QUANTITY F E: i-'. AMOUNT
-,g ,0
FEE AMOUNT AMOUNT PAID AMOUNT OOWINC;
50.00 .00 50.00
50,00 .00 50.00
JULIE
. EW EESTUB iE.tE..i- J is c,IE (VaEE7 AT THE COUNTY
UTILITIEE DEPARTMENT Y 'nri •`,.4.
ELEVATION
E:::%:CAVA-i•I
TO LOCA:. -• E:CALL BEFL:
EEWER + T E.i :e
THAT THEY ARE
iii!•J *i('P*•a!;i6
OR APPLICANT
TO FIELD
AND C 1F01 THE
AND '.: ! t.:....i.!:E:t.?1'•J OF ,`.•: E=: E,:1-.1-; STUB 1.. Ems. ; i't R TO AN'g` OTHER
Mil, CABLES, t::( ::> PIPING, WATER LINES, ECT,
IG (456-0000)
TO BE CHECKED PRIOR TO CONNECTION 1•i.:i 7: •? €. Ri::.
R AND UNOBSTRUCTrD 1±.t THE SEWER
MAIN
OR INSPECTION PR t..E. !., !, TO i i.:f.!hP:.1•t ******K***
•E'ii::'•E_IE: •?'Jf1T:[('E RED 1:.;:E:E E::: i is**•*•* -'n. -*i -i!:
456-3604 i!i •Pi ')i•')S"lti')!t 'Pi
i:i. :iunnnin. r:ni::nrL .:::j.).i• THANK Y*****K***:.*********************
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 i Bonds
Utilities
Other
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: