1990, 09-26 Permit App: 90004905 Sewer10 -
SPOKANE 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. 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
'") )±: NUMBER=
,yslCjt.Jty,{ :,.:i.j5 DATE= 09/26/90 PAGE= 01
APPLICATION
Jt Jr.• Jt ht- Jt- !t Jt ii• :ir• Jt Jt 31 Jt• P• * * Jt 3) Jt * * 3) Jt• Jt * Jt• Jt •it Jt• * APPLICATION Jr. ::A• Jt• * 9t F- ." * )t• * 4t• 3' )t )t• )t• 1t• •3 3' Jt• It• 3' h Jt Jt Jt :Jt ,yt..jt 3' )' Jt J, *
SITE r:..i i•';1::. i::. ± :_. 515 1^' i::.R 1"; .1. I'•± 1::. RD
i
ADDRESS= SPOKANE WA r.
PERMIT USE-, EE: WER CONNECTION .... 8801
•jt- Jt• Jt• :: i 1: NOTE Ji' h• i`:
PARCEL4= 2i7541-2902
PLAT4= 001382 PLAT NAME= KIMBERLY SUB
AREA= 000 60000 i_j00 (:'/A= E WIDTH= DEPTH=
OF BLDGS= DWELLINGS=
i: -
OWNER= MC Gti /NEY: P J PHONE=
STREET= 515 1"'E Rk.1.rJE:. RD
ADDRESS,- :>'POi ANF i.,Ir°} 99206
:r.il`@TACT NAME= LEONARD .... E1 PHONE NUMBER=:: t:: 09 926 ,, = : j•4
BUILDING :::• I::. i� ;t f.:± {., K � : FRONT= uNALEFT= NA RIGHT= NA ( l F A i ; = NA
a
K**************************** e.': ::. I6. ±::. i''-. PERMIT -ii' 'P: Jai .jl. * )t..H1 .pt 1:..n: -i4 J}: * -n: )r -n: •n:.n..n, .n:.7,..n..p..it• )t N: )t •n: * *
CONTRACTOR= 1-1 x. "' c:ciN iTl i_Ic:�i :i:Oi'1
:`.'TE{:E::E�.T. ' 11817 i:: ,,'f i...1...E::''fWF}Y AVE
ADDRESS= ,:. . 1 •. 1.1(11 WA 99206
PHONE= 509 f3964
ITEM DESCRIPTION QUANTITY FEE AMOUNT
1•! i•'; C) {:; i::: ' : ' 1: i•? :; FEE E 'x` 10.00
EEWER CONNECTION t.O±4t i 40..00
PERMIT {rPE': FEE E:: Ar' ICiUNT AMOUNT r:'; .T: i:i AMOUNT OWING
EEisEEE? PERMIT 50.00 .00 50.00
50.00 .00 .30
PROCESSED BY: JULIE EHATTO
PRINTED BY: JULIE EHATTO
SEWE
._:-
'•E:.WE i UB AS—BUILT 3.i`dl.:Oi;•'i'•1!tiTIOii•-1 :1 ' AVAILABLE AT
THE COUNTY
TY
UTILITIES rJ :. t• ` j•:I i : r M I::.;`:rr (456-3604)
CONTRACTOR (.: R (:TE{: AI::+E'I...TC:ANT :1: t' TO FIELD LOCATE AND CONFIRM THE
ELEVATION Ai1T? 1="{: ":i: T•:1:1 ir•F OF c•'1:::u R STUB PRIOR TO ANYOTHER
EXCAVATION
,
O LOCATE , t ..�, •.... i, CABLES, GAS ; PIPING, WATER 1...:1: J.1 ECT.
CALL BEFORE DIG4'_:;t•`7.•_E ji:}i•j 'j
SEWER
ETUDE fAi Et: 't::: TO BE CHECKED PRIOR 'T' C1 CONNECTION TO :1: r1E i. i 1:,: E::
THAT (I..IiE:Y ARE CLEAR AND 4Ir4(It1{;'•(•1::°i.i(:::•(•ED T{:i THE SEWER MAIN
.. t it 'A n 1 1 ! JS ! r'ILL 1:.. {:'t i't. .1: ± .E E E.. is t 1..., : -, TO COVER * Jt• •i:• •it• r; J; Jt• -;': •ii- -P:
Jt •jt -it -it• Jt Jt Jt Jt Jt• } d HOUR NOTICE EI!"11D N: J£•!l•* Ji..J,•;n•)r-Ji. *
-h:Jt•jt•jt'..P:Jt•h:J'i 456-3604 Ji3,:HF:jt.it.... J..:
Jt• •it• Ji- Jai Jt• Jt- Jt Ji• . Jt Jt- Jt• Jt- Jt }f- Jt . ir... . Jt- Jt Jt Jt- . r- Jt .. Jt )t Ji• Ji- THANK i *****************************K
SPECIAL CONDITION CHECKLIST
Project
Address:
Dept:
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other
Date:
Condition:
Project # Use:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
Init:
(in)
Appr:
(out)
THIS SPACE FOR COMMERCIAL PLANS TRACKING CERTIFICATE OF OCCUPANCY ONLY ******************************
Date received for CIO processing: Plans pulled for final processing:
Temporary C/O issued'
Office file review by Date:
Filed insp finaled by: Date:
Certificate of Occupancy issued:
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:
JOB ADDRESS:
, //L32_,
SUBDIVISION: Q` C t / NT: BLOCK:
OWNER: i'^? 6_ 60 L,J---p` c,
e PHONE:
ADDRESS:
l
CONTRACTOR: (� ; PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: