1991, 03-22 Permit App: 91001267 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
P i:Z 0...IE:.t:T ?'v,..?{"iBER••.. 91001267 - - APPLICATION-- DATE= 03/22/91 Ft•ti:vf= 01
THIS IS NOT A COMMENCING's`i:::?•°;;`i., 7 it n:3{••ik3l::N:
PENALTIES WILL BE ASSESSED FORFORWORK WITHOUT 7 PERMIT
SITE . t R 3027 s RAYMOND D i s ..
544-0810
ADDRESS=
... .E: ' SPOKANE WA <• -'992
PERMIT 1- #..?'' E::- SEWER CONNECTION — SOUTH ,i...?K-OM •
BL
' ;.. ... 000376PLAT {'J f.i!mss r•=• CHESTER HILL?..S HEIGHTS
ci1':::.;y_.. ::10000000 ;.. ;;`,•i=.. i'• WIDTH=i.••I:::: yE;TH:
t O} B?...1:G:+`= i :,; DWELLINGS= t WATER?; D {.... .
OWNER== A:'Git.?GH PHONE=
=
STREET= 3027 S RAYMOND ,1R
ADDRESS= SPOKANE
WA 99206
`.tt N T'af••: _ _'i Ari1=•• .i! M 'J•i•E: iJHONE :'R..._
:
BUILDING SETBACKS : FRONT= ;?f••I 1...l::.{-� ! N A {':.{.G t..? ? t?A R E:f..;{•t.:::: ��•J;.:1:.
t:+i i+t•ki••1G t+i lt•tn:-tk)+i Pi:it..tt--N:lr.ji..ji.3+i.y..R•3+i tE•!C'i+i 7ti i+i Ai it.:?' t;' :.w F:r 4PERMIT k Ki : A :.}i AC K} ¢ji i PPry ^
Ah :
CONTRACTOR= :.?.:{•E , .{. .{. CONSTRUCTION PHONE=? . 509 , ..+,_?..
STREET= 10504 ?::. 1t - I...i..{::.T iii t Tr A 4'`::
ADDRESS= SPOKANE WA
:.:-.:•
06
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE T 10 ,00 ..
SEWER CONNECT..t 1 40,00
?. { { YE'E: . { FPf + ? ttat � ? AMOUNT ?,OWING
:S.'E.tA E:R I::'E:R{'eI. i 50,00 .00 50;00
50.00 .00 50.00
PROCESSED BY : JULIE SHATTO
PRINTED BY : jULIE SHATTO
SEWER STUB AS—BUILT INFORMATION ,r AVAILABLE AT
..#..I E COUNTY
U { .i?.. I ? .?.i::.:.i DEPARTMENT (456-3604)
CONTRACTOR t..{'. APPLICANT IS. TO FIELD LOCATE AND CONFIRM ..F•?F
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES : GAS WATER LINES, {_.'..:_4.
CALL. BEFOREYOU ?; I G (456-8000) .
SEWER R ; ! I..?J,t, ARE TO BE CHECKED PRIOR
TO CONNECTION
EINSURE
THATTHEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
isfipiikiiCALL f ° INSPECTION � ,, _ t _ _ COVER nkni % rx*x}
*rii) ) iiHOUR : iii `tREQUIRED Pjrii ; 1 ?
R ) i4it) 41
456—
"n,,E.,:r;j.{ft :I 4' : :4•;II%+:')(*')>.'
****** ***************K********* THANK VOH :h n
i"? 7i ) i It 4r? ¢ jl .::. *jj : : .ytf.: *
I
SPECIAL CONDITION CHECKLIST
Project
Address: _ Project# Use:
Dept: Date: Condition: mit: 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 OFOCCUPANCY 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: . Dam:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: Date:
Plans returned: __ _ Received by: