1991, 07-16 Permit App: 91004226 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
APPLICATION
±'';!J:.J�...L.: ± NUMBER= "! ,•:}�;?�s':•:.:6 f;jA-.E.E= 07/16/91 r'F3i;,E= 01
i}J'*'h'** THIS IS NOT A !"ER!!.. , ii'r!n
PENALTIES WILL .BE: ASSESSED
lai" I"- F Cl R COMMENCING WORK WITi..ii.iE,j-j' A PERMIT
SITE ADDRESS=
:121 .F' RAYMOND :i:R 'AI't;7:±• tE:::: ,hrJ54-I ...!Cj."'>>!
PERMIT 1..,•t::.-•• ::>E::.!xl::.±'0•. CONNECTION . SOUTH h:,OK,-ii'ii,i
9**-h: SEE NOTE i*}a.";
000376 PLAT NAME= CHESTER HILLS HEIGHTS
BLOCK= 7 LOT= 6 ZONE= UR .ro
AREA= 00000000 F/A= F WIDTH= -100 DEPTH= , ) ./iA.l= 50
y OF • pp 3 t . xDWELLINGS=
WATER
t J.?IET ....
OWNER= MAYFIELD, DAVID PHONE=
STREET= 3219 E RAYMOND CIR
ADDRESS= S F�'!:K A±`'#I::: WA 99206
CONTACT NAME= .i a:t i"2 r:.,.'.• .i!::.?...::+E::.rt I''I"I f:i N r N I..l M R E::.F;= 09 924 A077
BUILD
^i0_,-
#;U•.LJ.? tttt-r SETBACKSFRONT= NA LEFT= i'wd;, RIGHT= NA REAR= NA d
:., t 1 ..R ,i^!. .. ... .....
***************K************* ,':�::.iM�::.±"•: ±''�:.�'.!�'±.l. ! 'Pi 3�::}i�Ri h:•-ik-Jk�!!:ik•Pi*.F,i.j,i.ji.jk.ji.ji.ji ini:Jy.K.jt..j,..j,.KW:J,.*.2,:t,:
CONTRACTOR= U.R. II CONSTRUCTION'•,± .. 509 924 6077
STREET=FkE..:E::T== 'i ,;:;L,i:;.tI::: .n7AI...E...E:::r WAY AVEADDRESS= SPOKA. ...
WA 99206
ITEM 1± :RI : ± J' QUANTITY F r , AMOUNT
PROCESSING FEE 10.00
S
Mt1
EWE F c::ONi`JECT:E:OEd ! 40,00
2::.t°:!'E.±. E ± T PE: FEE AMOUNT AMOUNT PAID AMOUNT OWING
,.:• :w't:::"•. PERMIT 50.00 .00 50.00
50.00 .00 50,00
PROCESSED SE::.J.J r)i; : ';HN L_ARSC:N
PRINTED (iY : JOHN !._,Ar ON
S±::.WEl.,. STUB AS—BUILT INFORMATION IS AVAILABLE LE {, t .TI.'r COUNTY
U {..... ± .t.±.. , 1: ( 2" vi••2•v i 456-3604 j
t.:CiNTRftc::TOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
FI...I:::A T .I.I..)r•; AND POSITION OF SEWER STAT PRIOR TO ANY OTHER
EXCAVATION
1 LOCATE F BU2•]:EE? CABLES,, (;AS t»'lPTN , WATER LINES,J EE: ,
CALL BEFORE
YOU DIG (456-80 00)
SEWER STUBS U.:{S f'!±''.E TO BE CHECKED D ="R.±.t-2•,. i I' CONNECTION TO INSURE
Rt::.
2 THEY ARE CLEAR ,:»'•v:--:-.
THAT, , •.!... ! .1t'.I-. .• ±::.(•'4±'�. (••1IVJ1 UNOBSTRUCTED t�:t.Jt.: ± ±::.±.} ± 1.J THE ';E:"uiE::.?•': MAIN
FOR INSPECTION PRIOR TO( !.;i..l'b't'.:.i'; 'u•)t••ii••'vi•u•'vi**h:-u:
ji•;te ft• t:':t•:n:*** 24 HOUR , ± E REQUIRED
l : 2 „ ;E ? n•**:a•af.a!:s,:*-jr*
S•'ti-'K a R:is:-J$*P: 456-3604 'iii-i i'Pi Pi'Ai** ,r*-Ni
: t : 71 _) *. . : x : . ..: . Patt . k*} :*)** THANK Y „ _ twJt ,
$ ? l491 * Ei : l * 7j **? Y 91'l�i? ) diR-j ! in:n
SPECIAL CONDITION CHECKLIST
Project
Address: _.__. ___.-- _ Project#_--
Dept: ', Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
_ __ Special Insp.Final Report _
------ _-- __ Hydrant( )
Lock Box -- ---- - --
Engineer's-_---. _ - RID/CRP -__-- __-----_-___--
- - — - Easements - ---- - -
_-_ Road Pians/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:_-__