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1991, 03-05 Permit App: 91000854 SewerSPOKANE 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 nt inspection gherein or not. ive authoriitylto violate ordthat the issuance of this cancel the provisions of apnyrst to olocal haw reguon and lating congstruction,, or as a warranty of conforovals or lrmates of nce with the provisions lof any state or local laws regulating construction. APPLICATION SIGNATURE OF — DATE OWNER OR AGENT ` Project Address: Dept: Dept. of Bldgs. Engineer's _ Planning Utilities Other_ Date SPECIAL CONDITION CHECKLIST , Condition: Special Insp. Final Hydrant ( ) Lock Box RID/CRP Easements Road Plans/Improvements Bonds Bonds Double Plumbing ULID Project #. Init (in) Appr: (out) 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: Plans returned: No response from owner/contractor - plans destroyed: Date: Received by: