1991, 07-23 Permit App: 91004192 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
PRO:-)ECT NUMBER= 91004-192A APPLICATION j'1•! :"j . ....... ? )I
DATE=t::.� t PAGE=.T F::._..
j..j.:l.]j.'j..l: THIS PERMIT
E r•,,r I.T
9.).):..i.}: .i.:'. NOT i A '1::.t'•.1"1.t. ( 4i..j,,*j..j+•*
PENALTIES WILL i... ....... ASSESSED FOR COMMENCING WORK .WITHOUT A PERMIT
SITE ::> ! ;•:I::.L:. , ._- 2 /14
> iAY; , }jHD ' Y :irin 29544-0521 r ^ i . }" _ i
ADDRESS= SPOKANE
WA 99206
PERMIT S,= SEWER : , ati. 0. I, N SOUTH'
.•,_,,•:l;r'O
*'* - SEE NOTE i.v ikit.1': .... _. __
PLAT4= 000382 PLAT t`-!F• :E. , , ,. HILLS i ADD.
BLOCK= O t i UR-3.5 '-}.i.;: ; :
WIDTH=
•„• ;:;- i1...1`'i'v :::: 4 :t)Wi;`I...5..... •ii.r,.. _ ?sj.fA TE1=: D:....
OWNER=Ic-•_ iY'_l3,P1 f' tl...Tt::. PHONE
STREET= 2714 RAYMOND I%A?
ADDRESS= SPOKANE WA 992i;}6
CONTACT NAME= STAN 1.:,t'••e;t L':.;i t (:E N PHONE NUMBER= 509 922 4994.
BUILDING SETBACKS :S : r'RE.)Ni ' NA 1..EF.T NA RIGHT= NA GEAR.... NA
*:lir}t'**-1=i*`)(”.}t'•)!r*:"**;i:;}¢•),j},i** =i 7si ,,i ,::li:.j,j hi:}i..)!r .'.r't?I I:1 t PERMIT T.. ............................................. 11r
CONTRACTOR= ECONSTRUCTION i
=} t " EC 509 922 :
STREET= PO BOX 14,1557
ADDRESS=
..if'Ltt'.f"t••)j. WA 99214
ITEM DESCRIPTION QUANTITY EEAMOUNT
PROCESSING
FEE :Y 10,00 1-j
SEWER CONNECTION 1 40,00
PERMIT TYPE FEE AMOUNT I (•'il'iri,,-1 +T PAID AMOUNT OWING
,'F:WEC PERMIT 50,00 ,00 50.00
50 .00 .00 50.00
•r
i.r x .. i 1
PROCESSED ;.: � .J ..I....I.;... ,.;t"t f•�? 1 . '..:
PRINTED BaY : JULIE SHATTO
SEWER ;TUB i ` . BUILT INFORMATION I , AVAILABLE " I THE COUNTY
U I .i.E...I i 1-.:; ?I.:.r`G:i{'. 1 i'11::N '•. '�4..:,.,....;h,A}?;!.4 1
CONTRACTOR OR APPLICANT .LS TO FIELD LOCATE; E •1N ii CONFIRM THE
ELEVATION AND POSITION -OF SEWER STUB i.iB F'R i..iR TO ANY OTHER
EXCAVATION
TO L...OL:A ! I::. BUi'•.a.E!? i..AIi'IL_ES , GAS' PIPING, WATER i...INESr I.';: .t ..
CALL r<CALL BEFORE YOU DIG ( 't4_?6—t-t;:�0;?.
I
r
SEWER STUBS f-i!•,i::. TO ri r::: CHECKED PRIOR ..1 CONNECTION TO INSURE
THAT THEY Y (- Ri::. CLEAR AND D UNOB,.`.• t RUC i I::.:_) TO THE SEWER MAIN
CALL f)'
INSPECTION
7NvfCT1 'IPRIOR TO COVER a :4anr t} au
********:k ti1R' V FrIIlttI
*********K
j,;•},:•n:n:"tl"7k jtP;•tq 456....3604 ..n•:::-:••h;-::*•fi:•)r•h•
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?,:.�.�,.�.?,s,ac r, f=. z,r,r•.�,t,:1�,r,n�!.a?•}4}f'�::a:z.n?:�:?I jt:4i., THANK YOU it.t z...r•.?.:•.r.�.r.r.?,t.:.....t.,...n..:..1.1 1•!
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: 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:
,; , j14'
ORTANT MESSAGE)
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FOR 1 '' 1 FOR /`-°'t _ j3
iA.M. DAr TIME
DATE '`� TIME P.M.
M S1441.v'N M i/ --) J
OF_ \ • �� � ee— OF7
PHONE PHONE -D--)-- --•( �5
AREA CODE NUMBER AREA CODE NUMBER EXTENSION
EXTENSION
O• q ! .?,*."4..,,::.,,,,„, 4,. TELEPHONED 3LEASE CAL!
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.
4• - . CAME TO SEE YOU WILL CALL AGAIN
,1#4,Mkg.t01004Altff
u WANTS TO SEE YOU BUSH
AI S %
•SR�YOUR CALL :: Ai 9'' ' RETURNED YOUR CALL SPECIAL ATTENTION
MESSAGE a 7/ L( kev, ( MESSA 4 '_ — _,
OPP ' , /I _ 6 _ �)
JPS �) /71..G7-c -.)--ca c..7
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SIGNED ....Aro! 1111 •� k." SIGNEDA
11/4 `LITHO IN U.S.A. AI ' UTHO IN U.SA. <
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TOPS 9 FORM 3002P TOPS 9 FORM 3002P