1990, 09-26 Permit App: 90004935 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. 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
• LRI_ ,.Il.r NUMBER= J-;:1 "5 DATE= � : 9/;6/90 PAGE= 01
APPLICATION
)* ••}{• )* ie )* )* •j* -j* -i* ii ){..j* •j* )* )* )* if )* )*){- )* )* )* -j* •j* )+::+{• )i- *APPLICATION 3f3* c t xr t*M v7tii* ****nnr ** s*y}}*
EITE ,'-f I:; I:::ET:::: 2505 E PIERCE RD
ADDRESS= SPOKANE WA 99206
PERMIT USE= ;jjR CONNECTION 0 •
)* )* EEE NOTE )* :R• )*
28543-3116
PLATt= 001=9 PLAT NAME= K'f)I4.Ctt`'i(•i ..1.O4:'i,,1._i.r:'
BLOCK= 31 LOT= :`: •:.t.tr,fl::. ffit:,,:.t,jri DIET4=
AREA= 00000000 I::'/F;,:- r:• WIDTH= DEPTH=
•}+' OF B t.. D G ,:: I 'N' MA 1-. t... I....r r''t l.x ,:.:::: •I
OWNER= I::I:{'.(:I 1\,' l:l..l...l:::R , I... L.. PHONE=
STREET= 2505 S PIERCE Qr.
ADDRESS= SPOKANE WA 992�;:i
t«: t.! ; :J .). A t.., ..1 NAME= L..i::.(.!?'1r'3rtiii ..« H ... ,::• PHONE NUMBER= 509 ,., • ; 8964
..
BUILDING SETBACKS: FRONT= NA LEFT NARIGHT= NA REAR= NA
****************K************ SEWER P":,•4i`'II ********************KK*:***:***
CONTRACTOR= r'I & CONSTRUCTION
STREET= 11817 E M' A l...1... F 1Li A Y AVE
ADDRESS= SPOKANE WA 94'206
:I:Tr::M DESCRIPTION
T';:ON
PROCESEING FEE
PHONE= 509 926 8964
QUANTITY FEE AMOUNT
T 0,00
SEWER CONNECTION i
PERMIT TYPE I- I:: L AMOUNT T l:.j,•1t.i(_ N ( PAID AMOUNT N OWING
•EuJr:.F. PERMIT 50.00 .00 50.00
50,00 .00 50.00
PROCESSED BY: JULIE
PRINTED [:f .Y : JULIE
SHATTO
SEWER i (.) I:f AS—BUILT INF='(::+Rl•' AT INFORMATION:.:• AVAILABLE r"{ t f ,..f t:: COUNTY
UTILITIES I)r:.r:'AR T til::.fy t (:+._i.:i--,;ir_'•ii:ih:j )
(:;(::tNrr{A(:'TOR (::Il: APPLICANT IS TO FIELD E1._D
1O ( A'E AND CONFIRM t
THE
ELEVATION ^i, -tEttI_rt� SEWER ETUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE !•:: i. 1 R I t::. D t.: l••? is I... I:.. ; G f i i PIPING, WATER 1_ :r N E ; -. • ECT.
CALL I:fr:1:-(: iR1: Y (:) (.) I) :i: (:Y (456-8000)
SEWER STUBS APE TO BE C::I"1EC::KEI) PRIOR TO CONNECTION TO :I•.i~ URr:.
THAT THEY ARE CLEAR AND t. ►uCi :;,'' 'Idif:;:......} TO THE SEWER MAIN
**x****** CALL r:• (:) R INSPECTION NOTICE PRIOR_T• C. i COVER P A )I Ott• )t : gin: j{• •* •n:
)**ie)*•r:•*n••r.••u- 24HO(.iNOTICEREQUIRED •r. iiN•)i•*)E*•ir •N:•
*****K*** 456-3604 .j,..j{..j{ * :p..j+; i; * •is: *
M)*)*)*P.)..)...j:.)..:Pr)*)*),:)r'.j{.)!.){.j*•.)*)*)*•i*.3i:•j*)+r)*)*)*)* THANK X tt* t
F i)ri* * Pu * d * ) )*ta* )*nj 1 * n}.nr )jj{
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SPECIAL CONDITION CHECKLIST
Project
Address:
Dept:
Dept. of Bldgs.
Planning
Utilities
Other
Date:
• -
Condition:
Project #
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
RoaUPlonn/|mpmvomemo`�
Bonds
Bonds
Double PliA-�
UL]D
Appr:
(out)
~~`^~~~``~``~`~~^~****+°^ THIS SPACE FOR COMMERCIAL PLANS TRACKING, CeRTr|CATEOFOCCUPANCY ONLY ~`~**'~~~~^~`^~°`~~^```^^
Date received for Gb processing: Plans pulled for final processing
Temporary CiO issued Certificate ol Occupancy issued
Office file review by: Dote'
Ninety days after C/O ssuance:
Owner/contractor called regarding the return of ptans:
Plans returned: Received by:
No response from owner/contractor p|unuuost,nyeu•
JOB ADDRESS:
SUBDIVISION: J `I B - /l LOT:
OWNER: ne-t5---P-2 0 1 / 4o A/ L L PHONE:
ADDRESS:
P Le4e /6.)
BLOCK:
CONTRACTOR: 1?
ADDRESS:
PHONE:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: