1991, 03-13 Permit App: 91001037 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
PROJECT NUMBER=BER:= 9. 00137 APPLICATION DATE= 03/13/91 PAGE= 01
*)'it#ii( THIS ,{:,'• NOT F i PERMIT lf••ri n•3i•it»•
PENAI...T.I.I.:.!! WILJ_. BE ASSESSED FOR COMMENCING WOR4WITHOUT A PERMIT
SITE STREET= 3305 RAYMOND RD PARCELO= 32541 -0606
ADDRESS= i•F'11I t''+NE:: WA ILIA99206
PERMIT t• i..i;>F:::- SEWER CONNECTION ltiJSOUTH
**# SEE NOTE J! '
PLAT4= 000382 FIAT NAME= CHESTER HILLS ADD,.
BLOCK= 6 LOT= 6 ZONE= SFR DIST4=
AREA= 00000000 F/A= t.. WIDTH= i:'F::E•'T•. F:;;`. ::::
OE.. t:{: yf DW} 1 t ;,...: WATER DIST
OWNER::: {••ICO{...riE:S, KEITH PHONE=
STREET=4 :::: 3,h!5 S RAYMOND {•+:D
ADDRESS= SPOKANE WA 99206
CONTACT NAME:.:::: Rt.ii'tI_.{„tAN PHONE N{.if NUMBER= 509 922 Cia:)t: {.',
C'
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR:::: NA
: ii *rrnnNtNn :bhN ; tiiN ic*i *** k* SEWER
. : PERMIT' . A*P*h l..hP .h.PN )P* t l: !P *Plt
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 ,•s::: }
STREET= PO BOX 141562
ADDRESS=..SS= ''ifC J'- WA 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE F t. 10.00
SEWER CONNECTION 1 4i?:.00
PERMIT TYPE FEE AMOUNT AMOUNT I " : 1 OWING
IiiE::R PERMIT '5.1..00 .:00 5o:00
PROCESSED BY : JULIE SII T O
PRINTED BY : JULIE SHAT TC:t
SEWER Fc `''T{•irf AS—BUILT
INFORMATION IS AVAILABLE t:{I...I::. .+..I THE COUNTY
UTILITIES i)EFtiR OMEN t (456-3604)
CONTRACTOR OR A{.,F:'L..i:c::ANt IS TO FIELD LOCATE AND CONFIRM THEE{._E:vAT ION AND I:::O:i;>1:•'i':EO i I I{:- SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES , GAS PIPING , WATER I...:1.NE�: , ECT ,CALLI BEFORE iI: E `OU DIG 1 ('' a�..... 0:•'1 n •.
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TI.) INSURE
THAT THEY ARE:. CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
,c jt ii c)i•**u:1: CALL FOR INSPECTION PRIOR Ill COVER F.'. R•*****•h:•A**
AA*1'**3t•at•3iii{.iR NOTICE REQUIRED E f.�._IIF�'E-D •• •�iri•* •***ir.
..''4 I..i
•hi** ***•Pi•* 456•...3604 *P:A*•A•*'Pi3!i*•)!.'
1!••Jk•,i*9!'i!'9!•'N:i!:'X'?!'9 §r 1l•*i?•ii•ii-*•)?•it-N•li'ii 9C•tC it ii•9t h•*yl• THANK •t o I__i )t•4!•n)!•9k:!!•i!•9k•P.•*ih it yt it'N:R•!!•*•X•'}t)l'Il 3E P'')k)k'A:'')t'*:R•')L')t il'
SPECIAL CONDITION CHECKLIST
Project
Address: Project#_ Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
Engineer's _ RID/GRP
Easements
Road Plans/3mp.rovements, •
Bonds
Planning Bonds
Double Piv
Utilities m.Iainm:
ULID
•
Other
`*"*******"********** * '•, Tki:I:S+SPACE FOR COMMERCIAL PLANS TRACKING,CP•RTIFICATEOFOCCUPANCY ONLY* """"'°""°'*'°"""°'
Date received•for C/O rocessin. :. • Plans
p g pulled.fior fiinatprocessirig. :.. _-- -�--
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:
f- M37
JOB ADDRESS:
SUBDIVISION: LOT: BLOCK:
OWNER: PHONE:
ADDRESS:
CONTRACTOR:V1)-VA �-� �} PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: