1991, 05-02 Permit: 91001066 Sewer 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 permit/applicationis true
and correctand authorize Spokane Conty to proceed with processing. In umo I have u 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 ---_-
PROJECT NUM BER'^
***************
ITE %TREET=
........ . ........ ... ... . .. •.w ;••••
PERMIT U%E= %EWER CONNECTI
*** %E NOTE ***
PLAT = ONAME= UNIVER%ITY PLACE
BLOCK= LOT= 3 ZONE= AG%UB D .
AREA= O0�.• ` WIDTH= DE�
� OF BLDG%= i i WATER DI%T
0 IAN ER= P 0 LLAF.- PHO� ��=
TREET= iOiO % OBE
ADDRE%%= SPOKANE WA :
CONTACT NN HGNE NUMBER= 5O�
BUILDING %ETBACK% ' FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** 1.4 E: PERMIT **********************
ONTRACTOR= ALWAY% ACTIVE !':'HONE= �O9 922 85OO
TREET= PO BOX i41562 •
ADDRE%%= %POKANE WA 992.i4
' ITEM DEE CRIPTION QUANTITY FEE AMOUNT
----------------------- -------- ----------
PROCE%%ING FEE Y 10.00
%EWER CONNEC�ION i 4O...OO
******************************* PAYMENT' %UMMARY ****************************
PAYMENT DATE RECEIPTPAYMENT AMOUNT
O5/O2/9i 2531 50. 00
------------
TOTAL DUE= . 00 TOTAL PAID= 50O0
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
EWER PER50.00 50.00 . 00
------------- ------------ -------------
50 .00 50. 00 .00
EE:ROC ED BY : JULIE %HATTG
:"' NTED BY : JULIE
WER NI-ORMATION I% AVAILABLE AT THE COUNTY
CONT�
ELEVA�
EXCAVA [IUH
TO LOCATE BURIED CABLE% G
EF
CALL BORE YOU DI� (451-8�. . '
EWER %TUB ARE TO BE CH KE CO/-
THAT THEY ARE CLEND �� BTRUCTED O T. - . ''
********* CALOR I N. P E:CTION PRIOR T� COVcR *********�
********* 24 *OUR NOTICE REQUIRED **********
********* 456-36O4 � �*********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report -___ _.
Hydrant( ) — — -------
_ Lock Box
Engineer's____ RID/CRP
Easements
Road Plans/Improvements
Bonds
Planning _ — Bonds —_-
Utilities _ Double Plumbing
ULID
Other
******************************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: