1990, 10-17 Permit App: 90005451 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
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PLAT:1,-= 001835 PLAT NAME=
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ADDRESS= SPOKANE WA 99206
OONTACT_NAME TOM STONE .
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STREET= N MAMER RD
ITEM T--'RIPTION FEE. AMOUNT
PROCESSING FEE -
PERMir .PME FEE AMOUNT AMOUNT PAID AMOT
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,00
SITE ALSC INCLUDES NCRTH
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PROCESSED ..
PRINTED BY : JULIE SHATTO
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SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: mit: App':
(in) (out)
Dept.of Bldgs.
_ -- Special mop.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 isuuou._ 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.
JOB ADDRESS: q -
SUBDIVISION: r ? i / & 7 LOT: BLOCK: D
OWNER: t---LL -1/ 6 Q-C_.0PHONE:
ADDRESS:
_Q
CONTRACTOR;---T-25:34/7 PHONE:
--
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY:
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