1991, 03-31 Permit App: 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 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
r , 1 ) 1 NUMBER= 91001066 APPLICATION Dr ! . 03/13/91
PAGE= 01
=Ai')'. ' •)'')'-)i- THIS I:SP i``t fj..i. (-, PERMIT gip'**' -tt*
PENALTIES w.LL€... BE ASSESSED FOR COMMENCING i; WORK uWI'T•i-IOUT A PERMIT
SITE STREET= 1010 OBERLIN:.> RD PAR(: :::: 20544-1431
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION ..- 8802
**'•a: .•'E:.E NOTE *'.'.ji'
F'L..A••i-,I:Y:: 0r) ) 0.4 PLAT NAME== •OUNIVERSITY_ PLACE
BLOCK= # ' LOT=::: ..ti ZONE= Al UT:f riI •T'M:::: €:
AREA= ?:,0 0 0 0 k),;)(7 #::'/A::: F WIDTH= DEPTH= k?/i.,T:::
4 OF B€...T>t;,S= 4 DWELLINGS= ; WATER DIST
OWNER= POLLARD F'#..€t:)r?I:::::::
STREET= 1 i:).t i:i ,: OBERLIN RD
ADDRESS= SPOKANE WA
99206 92
CONTACT Par : RON ;Lta fPHONE sJMI # :: 509 9. 2 3500
BUILDING SETBACKS : FRONT= NA I...FF:'T:::: NA RIGHT= NA € EAR:::: NA
•A•:,,:•m n:-r:'A:'A-'7+:-i+:'ii•i4•i+;*iii•'i+1-ii•i4'ii'it-'n:-)+:•)r-'i+:')r:***aG•n: SEWER - :t " . A , j � ijNje nc nA :Anft ?* . ttth : :nA
CONTRACTOR= ALWAYS ACTIVE PHONE !!5()9 8500
STREET= PO T:t O X 141562
ADDRESS= SPOKANE WA, 99214
:I.TE:M DESCRIPTION QUANTITY E'::: AMOUNT
PROCESSING IN FEE (' 10„00
SEWER CONNECT:I.ON 1 �0,.0
PERMIT TYPE F•E::E: AMOUNT AMO iintT €:'F`,:I:I:) AMOUNT f)W:i:i,1t:;
SEWER PERiMI•I 50.00 .00 50:.00
5 5.
,00
PROCESSED BY : JUI..:rE SHATTO
F'FtI:NiE:D BY : JULIE t'HATTo
SEWER STUB t.ift rxS—;:ti.►I€....T INFORMATION Is AVA1:Lr•iI:t#...E AT _i.H#: COUNTY
t..........:I:TIES DEPARTMENT (456-3604)
CONTRACTOR OR APP#...:I:f'F,i.JT IS TO FIELD LOCATE: AND CONFIRM THE
ELEVATION (',iti€ri POSITION OF SEWER STUB UI PRIOR TO ANY OTHER
EXCAVATION
TO €...t:)t:::ra T F:: BURIED CABLES, i:;r'? ' PIPING , WATER LINES, ECT,
CAL..I... BEFORE YOU DIG (456..-8000)
SEWER STUBS r•"?FtE:: TO BE cFIF:C€<€:::r) PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR ('cNr) UNOBSTRUCTED TI I THE SEWER MAIN
I N
CALL FOR INSPECTION PRIOR TO COVER 'k••A:'N•*i+r'Ai**.k..p;
.t,.r..,."•..T?.."•.*.'* 24 HOUR FR Nt.) !It...€: €;F.t. ' I I ::.!1 .1')i'N'•)+i 3'.a-)t-,i-ii''i'
9,:.A..A.'A:**-1+_.}i'P: 456-3604 **.i(..j,..j,,K:k.i,,.jr..p.
.t,,**I,:3?.3?")+:)?'**.j,.*.A:J?')?':+?'*-A')+:-A:'I?'9+:',?'*:":'i+:*:N'**:K'i:' you,,
THANK r,•.),_,i k:J+::":•f?-9!-'1?9C 9C R••1!••1?'9t-'tt 9h:q-iC)'i H•'1!•it•A;'A:a*:+i•ik 9E 4l•*)i')i 3F.i"i
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
T
. . . .
. . .
Engineer's RIDICRP
Easements
Road Plans/Improvement -:••• •.; •
Bonds .
•
• .
. . . .
Planning Bonds
. .
, . , • ..
' •• •• •
. „ . .
. .
• • . . , = • .
Utilities • - • Double Plumbing :
ULID
Other • • • • •
. .
. . .
. . . . . , . . . .
• . . , , . . . . .
' • ' " '" "" ' "
. . . . . .
THISSPACE FOR COMMERCIAL PLANS TRACKING CERTIFICATE OF OCCUPANCY ONLY,.*/::************"****•**********
. .
Date received-for Cf0 procesting:. • .! . •• 'Plans pulled for finarprocesSing: •" • ••• , • •
Temporary C/O 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:
- / �-� X6.41
.
JOB ADDRESS: l / �� () (0, -__ __12.4,c
SUBDIVISION: D--U 544 - / 431 LOT: BLOCK:.
/ 3
OWNER: LPO � , PHONE:
ADDRESS:
CONTRACTOR: (4)119PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: