1991, 02-21 Permit: 90006764 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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SITE
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ADDRESS= SPOKANE WA 99206
PER-MIT USE= SEWER CONNECTION
-a .co IN c
AREA= 00000000 F/A= F WIDTH= . DEPTH=
n7 "777-- 1 DWELLINGS= I WATER DIST =
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STREET= ..l ..;...xi .SUNDERLAND ....
ADDRESS= '+ )t `•'+i*}i::. WA 99206
PHO
= 509 927 6760
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:.d.1.}!.3..!.H....•.1{. A.f•.r•.:{. !{.N.•Fk *91:tE{:gr:.p{.'!{::{{: sEwER PERMIT :R•3..:.j..:{l:••R•i'L•;:i.;{•�?{;tt{..y,..•h;.:K.jy:..}:..A:3k'1t:.P.•:{-F..* :is:yt.:, ..{:
PHONE= 50c.,' 927 6760
STREET— t ':
AVEADDREES- SPOKANE WA 99216
ITEM
DESCRIPTION
SEWER CONNECTION •E 40, 00
„ 00 50 . 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERmIT 50 , 00 50 ,00 , 00
50,00 50 , 00 „ 00
P-ROOESSED BY : JULIE SHATTO
t
CONTRACTOR OR APPLICANT TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED
, THAT THP4 ,ARE CLEAR AND UNOSTRLICTED Tfl THE SEWER MAIN
CALL FOR INSPECTION PRIOR TO COvER 4*******:k*
.. .. HOUR
.. .. .. .. .r.:y.:,{::!;.:;!•.:>i.:,..:;;:a !t._;.:*:{. .:.;.:{;.:{'.:{..:p.:.;.: .:;t:y:.:,t.:{;.:{,.rn.:r::;.:y.:{;.at.:{;.:{;.:,.:,y.:{,::!;..;
SPECIAL CONDITION CHECKLIST
Project
Address: Project# __—__._._Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report_
Hydrant( ) —
Lock Box
Engineer's _ RID/CRPEasements
Road Plans/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 response from owner/contractor-plans destroyed: ----_---------_-__-_----_---------------__-_-_--___--