1990, 12-13 Permit App: 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
ArpLic7T0,p,,
RD PAPCELT.— 20542
BL'IrOK,
DEPTH-
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•• • • • ••
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CONTRACTOR= TLC PHONE- 50?
ITEM ti A NI" y• FEI:* A M f7i
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At,trf IN 1"- A T A NI 0 Li 014 TNr.;•
CONTRACTOR UH ARHLICANT IE To FIELD LOCATE -ANv
ELEVATION AND POSITION OF ANy-
EXCAVATION
TO LOCATE -BURIED CABLLi..: ,
-CALL... BEFORE YOU DIG (456-8000)
2;EWER ARE TO BE CHECKED PRIOR TO CoNNEcTION TO T.NURF
THAT THEY ARE CLEAR AND UNfTPETRUCTLD Tn THE. ..3EWER MAIN
********* CALL FOR IN,':PEcTION PRIOR TO COVER **********
********* • 24 HOUR NOTICE
• - *********: .. : 4563604 ..*47:-********:
"* * --THANK you *******************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: mit: Appr:
(in) (out)
/
Dept.of Bldgs
Special Insp.Final Report
Hydrant( )
Lock Box
--.
/
Engineer's _-' RID/CRP --
'
Easements
| --,
Road Plans/Improvements
Bonds
--'
Planning _- Bonds
' --
-_'
Utilities Double Plumbing
ULID
` --
Omer
`~^~'^~``~'~~^^^^``~`~~~^~THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE DFOCCUPANCY 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 inapnnu|od by: . Date:
Ninety days afteC/O issuance:
Owner/contractor called regarding the return of plans: _ mate:
Plans returned: Received by:
No response from owner/contractor-plans destroyed:
i/e__ Lm q
-Pay-l(_le
JOB ADDRESS: 6 / ( 6 t J /d Lu4
SUBDIVISION: V / 3 LOT: BLOCK: 6 ,4^
OWNER: -1-0 e J� `ell Er V 1.J (--) le PHONE:
fS 1
ADDRESS: / /_`� -
CONTRACTOR: l-- '" d -4 I () PI 4 PHONE: -(a I - V� ( P 0
ADDRESS: 1 .? ( 1 ca-? ,4 9.9aj \n
LICENSE #: -r-LL 4/u9
INSPECTION DATE:
TYPE OF OCCUPANCY: