1990, 09-26 Permit App: 90004934 Sewer1
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
is:i:t:C;t. i r:'r• NUMBER= 90004934
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APPLICATION
SITE STREET= 2119 E PIERCE RD
ADDRESS= SPOKANE WA 99206
PERMIT USE= ,::i::.Wl"F ;; CONNECTION .... 9001
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,-A•(' „:= 001393 PLAT NAME= !<. C,Ktii-i(:T ..#.Oij?•i ':i ..#.r..
. LOT= ZONE= AGSUB :i 1:F'i.,.' ":N:::::
Al'cL..:.: . :.:: : :...t:k k 0 F/A= FA=F WIDTH= DEPTH=
NOF .lDY r_t uDWELLINGS=
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OWNER= tai 'r` T•:{ t:i F1 iJ F:: `f' , MARK PHONE=
STREET= 2119 S PIERCE RD
ADDRESS= , ij::;:11<r ti;E: WA 99206
CONTACT NAME= . f.:::::: i...E(aNARD _.. ;..i
BUILDING i::. (BAC,K,\ : FRONT= NA LEFT= ::_ IBJA
DATE= 09/26/90 PAGE— 01
APPLICATION
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PARCEL4= 20542-310G
F•' / W =_
PHONE NUMBER= Fi:::_ 509 926
RIGHT= I'•J;f REAR= NA
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CONTRACTOR= i•1. S CONSTRUCTION
STREET= L•"•:T- •1 'i -:t 8.i 7 E '„'' LLi:::YWf-i''! AVE
ADDRESE= SFOKANE WA 99206
PHONE= 509 926 8964
ITEM DESCRIPTION QUANTITY FEE AMOUNT
r
PROCESSING i::' i::. i::. 7r 10,00
SEWER CONNECTION i 40,00
PERMIT T''Y PE VEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 00 50,00
50.00 .00 50,00
..
PROCESSED BY: : ,,it,ii.. TE ,SF•#A•T'TC1
PRINTED BY: jULIE SHATTO
:>i:::W#:::R STUB AS—BUILT
UTILITIES .T:i F` F' f:.} R T'r1 F i'•J •T
(456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD i.. OCATE AND CONFIRM IRi-1 Ti..lF:
(
ELEVATION :i:(:it AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE Bt.iRIF::Ti CABLES, GAS PIPING, WATER LINES, F:r't•:
CALL BEFORE Y I _ U ? I G (456-8000)
SEWER STUBS ARE •T•(:i BE CHECKED PRIOR TO CONNECTION TO INSURE
t iRF::
(.HAT. THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
)i• )+i )i• P: •b: * * :n: * CALL FOR F: 1:iv 'F`1 (.7.T1 tiJ PRIOR T • C i COVER ii• h:• ),: ai * )i R• •i+; fi: •h:
)i• .ii )6 h: )i ii• )t : ; 24 HOUR NOTICE REQUIRED )i- ii• • Vii• )i• )i )i• ): )i- )i
)i• •N• •r: •p; -u• )i• •iR * )i 456-3604 .. ,
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Project
Address:
SPECIAL CONDITION CHECKLIST
Dept: Date:
Dept. of Bldgs.
Planning
Utilities
Other
Condition:
Project # Use.
Special Insp. Final Report
Hydrant ( )
Lock Box
'„
RID/CRP
Easements
Road Plans/Improvements «-'
Bonds
Double plunifii»n`'•�
ULID
�.`
!nit:
(in)
Appr:
(out)
�
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'ate•
Temporary C/O issued. Certificate ofOccupancy issued:
_-__
Office file review by: Date
Filed insp finaled by: Date:
Ninety days afteC/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/coritraCtOr p|^nouoamye&
Received by:
JOB ADDRESS:
SUBDIVISION:
1 ()Y LOTS
OWNER (,LJ f _Y r ! lG0-- HONE:
ADDRESS:
BLOCK: 1
CONTRACTOR: D PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY:
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