1991, 04-25 Permit: 91001821 SewerSPOKANE COUNTY DEPARTMENT 'OF BUILDINGS
W. 1303 BROADWAYAVENUE
SPOKANE, WAST INGTON 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, 1 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
OWNER OR AGENT
APPLICATION l r a S , G``/
DATE
NNECTION MIDILOME 5TH ADD
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Project
Address•
Dept:
Dept. of Bldgs.
SPECIAL CONDITION CHECKLIST
Project # Use:
Date:
Engineer's
Planning
Utilities
Other
Condition:
Special Insp, Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
!nit: Appr:
(in) (out)
`****************************** THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OFOCCUPANCY ONLY ******************************
Date received for CIO 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
Plans returned
No response from owner/contractor - plans destroyed:
Received by:
Date: