1991, 12-09 Permit App: 91008474 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
PR?.?:.Ji`:+": i NUMBER= 91008474 Ai"`Pl...]: f•Y"']:C1N DATE= 12/09/9i PAGE= 01
'i•* •1i• •* THIS IS NOT fl PERMIT **)tyeu r•
PENALTIES WILL 1rz: ASSESSED FOR COMMENCING iF;ORK WITHOUT A PERMIT
SITE SIF';f::E::i'= 607 S SUNDERLAND ft:.? PARCEL4= ...,?;,
ADDRESS=':::. ;'I'`OItANE WA 9920,6
PERMIT USE: SEWER. CONNECTION .... UNIVERSITY HIGH 488-02 (91E-128)
3'•'** SEE NOTE 3f**•
PLATis 01 :be PLAT NAME= I<:EI...L.00;l::; PARK SUB
BLOCK= I LOT= ': ZONE=II. .: A G U E:t ice?:i:S'T'4:::: i s
AREA= 00000000 F%'A::: I.. WIDTH= DEPTH=;••1= r=..; ;,:::::
N OF BLDGS= 'i 4 DWELLINGS= s WATER DIST =
OWNER= AU 'T]:NC;/EtE::RCF'IF:]:M PHONE=
}T R°E E-.T' :: ;ri:'}' ;\ SUNDERLAND RD
ADDRF:ss=: SPOKANE WA 99206
CONTACT Nfif .= ALWAYS A: TihE . FON " OfN PHONE NUMBER= _
09 922 8500
jUIiD [NG
SETBACKS : FRONT= N/A .r `T: N/A RIGHT= N/A REAR= N/r::,
4 u ppsRiAR pRk 3iC f NN :M k P} it NNiRSEWER -EF " ] "
pA t H* $P4 X 4 XP*P*Tb...
pb**R**} 4
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= P it T;t O:x 141562
r"r }):?F f..: '':::: SPOKANE WA 99214
ITEM DESC:RIF''T']:c:iN QUANTITY FEE AMOUNT.
PROCESSING FEE Y 'S0. ?jt'}
SEWER CONNECTION 1 40:.00
PERMIT TYPE FEE AMOUNT " y; ( ," PAID fCJ+ - OWING
E::IBJ[ER PERMIT 50:.00 ..00 50.00
0 :00 ., 00 50,00
i.;i";:';i:,...<"•t �, :-.Y ,-.ON.I._ ..
. t�. E:.z:.,�"C-"; ::�r : ut.rl"t.i. Il'St.tn'.i.?:!"l, ROBIN
PRINTED BY : DC1NITRC1VICU, ROBIN
SEWER
ETJB S. Ii)] iT INFORMATION IS AVAILABLE A_ THECOUNTY
UTILITIES DEPARTMENT (456.."360<}
CONTRACTOR OR APPLICANT IE TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER ;: l t.)T:t PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE:. BURIE:.I? CABLES, I_rAs PIPING , WATER 1...3.Ni':.E , ECT .
CALL... BEFORE YOU DIG (456-8000)
EEWER STUBS AF 1::. TO BE CHECKED IE::C::!tE::D I'`Ft:[?.1F': TO CO1aiai":i::T]:O.1N TO ".-.,.•,,,RE
THAT '1"i•'!i:-'•i r'ti-;is CLEAR fIivI? I..IN[:1rtETi=:i..Ji-:'I t I? TO TI-ii=. SEWER J 't-ifl'[i:i
.,,..,?..p..,t..P:)k'N:'R•* CALL I...I... F��i")F�: ] N E EC T] !N PRIOR TO COVER a ; ; **} *x; *
.. . . . . . . . ' ; - .U+ NOTICE REQUIRED
7+i•JC•/4.**.}?:.p:*:p; 456-3604 *jt':iii'Vi•N•Pi-}!i Y:i+i
N7 1 i1 t t 91 9i7 Ri1 Y 9 i ? 9 ) 1i i 3R? ii *n ? THANK
- i` ' yo ? 9 (X nni iA 11 99t ) fi 1k Y nRi kF Fy9t 9 fiPi
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: lnit: 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
. .
Other . .
• '7" ,
. . , . , . . . . . •
„ . . .
r " " "' • •
• •
•
************* ****"" ****" THISSR/NCE"FOR COMMERCIALPLANSTRACKING,CERTIFICATE OFOCCUPANCY ONLY.******"*"***"*"*************"*
Date received for C/O processing: • • • Piens pulled for final processing:• • •'
. . .
Temporary C/O issued: .dertificate cf 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 from owner/contractor-plans destroyed: