1991, 08-08 Permit App: 91004805 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 d and submitted by me or my agent to compile said perm it/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 l 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 OF
APPLICATION
OWNER OR AGENT DATE
• PROJECT NUMBER= 91004805 APPLICATION DATE= 08/08/91 - PAGE= 01
x.*..x,.x.*.-k THIS IS NOT A PERMIT 3 r
PENALTIES WILL BE ASSESSED FOR COMMENCING IJORK WITHOUT A PERMIT
SITE STREET= 2615 S PINES RD
' ADDRESS== SPOKANE.:: WA 99206
PARCEi=.x= 27543-2810.
PERMIT USE= SEWER CONNECTION - DISHMAN- MICA -INTERCEPTOR PKG.$
rt3i* SE -:E NOTE: *..- * -
PLATO= 001230 PLAT.NAME= HILLCREST ACREE 7TH ADD)
'--BLOCK= i - - - LOT= - 10 ZONE= UR -3.5 -DIE -T4=
' AREA= F/A= E- WIDTH= 815—DEPTH= 146 R/W=:
4, OF F3LDGS=:: 0 DWELDWELLINGS=INGS= .. - i.. WATER.DIE T
OWNER= HENDRICK,SE:N NE::IL..
E: --
STRET=:: 2615 S PINES RD -
ADDRE::SS=:: SPOKANE WA 99206:
PHONE :=
CONTACT NAME= LEONARD PHO INE:: NUMBER= 509 93:3 2:376
rniii..D;I:NG SETBACKS: FRON'T':::: NA LEFT= NA R:[(.:UT=:: NAI REAR=. Nasi
.
i.k..u..-.- re.---x-*-x--;------xac.*.x-*..x--ii*.M..ri3i3i3i3i* SEWER REF :M TT' _ 3i 3f x..lth..-.*.>i-*x-3i3**,x**t** atif.*i..(E.
CONTRACTOIc H h S CONSTRUCTION-' -PHONE ::= 5109 926 8964
STREET= 1101"7 f::: VALLEYWAY 'r14'E: "•
ADDRESS== SPOKANE -WA 9920,;
ITEM DESCRIPTION UANTITY. ..'FEE AMOUNT
PROCESSING FEE 1` 10.00
SEWER CONNECTION i 4(7.00
, PERMIT TYPE: ' -FEE:: AMOUNT. AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 ,00-. 50.00
50.00 - - .00 50,00
.PROCESSED BY: WENDEL, GLORIA .
PRINTED BY': WENDEL, GLORIA
SEWER STUB 'AS --BUILT INFORMATION
UTILITIES DEPARTMENT (456--3604)
CONTRACTOR CJR APPLICANT- IS TO FIELD -.LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER- ,STUB PRIOR TMJ ANY OTHER
EXCAVATION
IE AVAILABLE AT THE COUNTY
TO LOCATE -BURIED CABLES, -GAS PIPING:, WATER'LINES ECT.
CALL BEFORE YOU DIG ( 456--8000) -
SEWER STUBS ARE TO BE:: CHECKED PRIOR TO CONNECTION TO INSURE::
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
xit.af..x.u.*.xuar CAI_.I_. FOR: INSPECTION PRIOR TO COVER 3E3(3t3e3Fk3t3i3P34
x.xiEiiiixafifif 24 HHLIR NOTICE REQUIRED .. - * 3*3i•3F3F3e3Exxx
-,
3k 343t hie 3i3kx*' .456-3604- -:; ,.. **nun**
3i 3f3i3k#ti
*** xx*3i3i Si x*3e3E*x3F3F3r*3.3E-3e*3f 3e ii
•
..x:,e THANK YOU *i3
K******************* i3e#*3i
Project
Address:
Dept:
Dept. of Bldgs.
Engineer's
Planning
Utilities
Date:
Other.
SPECIAL CONDITION CHECKLIST
Condition:
Project # Use:
Special Insp. Final Report
Hydrant ( )
Lock Box
Init
(in)
Appr:
(out)
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds,
Double Plumbing
ULID
— —
—*"—****************"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:
Plans returned:
No response from owner/contractor - plans destroyed'
Received by:
Date'