1991, 04-10 Permit App: 91001725 Sewer ~1111W -_
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 Conty to proceed with processing. In umo 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
• ' >
, PEN;:iLTIE::;: WI.
SITE STREET=%TREET= 23�
ADDRESS- %P(
PERMIT USE= SEWER C
*** SEE NOTE ***
PLAT4= 0O0393 PLAT NA E= KGKU� �
BLOCK- 2i L T= ZO�-
� �- -".` '
AREA= 00000000 F/A= WIDT =
4 OF B •- := i 4 DWELLINGS= i WATER *DI%'i
OW�ER=- IER D T PHONE=
STREET- 2307 E UNIVERSITY RD
ADDRESS= SPOKANE WA 99206
CONTACT , - = L �� - . PHONE NUMBER= 509 926 8964
BUILDINGETBACKC ' FRUNT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ************************* ****
CONTRACTOR- H & % CONSTRUCTION PHONE= 509 926 8964
STREET- ti817 E VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
ITEM DE%CRIPTIONQUANTITY FEE AMOUNT
------------------------- -------- ---------....
PROCESSING FEE 10,.00
SEWER CONNECTION ' 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
-------------= ------------- ------------ ------------- '
%EWER PERMIT 5O...OO .0O 58.00 ` !
--_---------- ------------ ----------=--
5O.00 .00 50.00 � .
� ~-
PRACE%%ED BYJULTE %HATTU
PRINTED BY : JULIE %HATTO
` %EWER %TUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-36O4 )
CONTRACTOR OR 'APPLICANT I% TO FIELD LOCATE AND CO�FI�� - -
ELEVATION AND--PO%ITION OF JEWER %TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, FCT ,
CALL BEFORE YOU DIf. ,.456-8000)
SEWER STUBS ARE TO BE OHECKED PRIOR TO CONNECTION TO INSURE
'�H�T THEY ARE CLEAR A.` . �E�� � TO T�� !. EWER MAIN �
* **** * CALL. �FOR I E N PRIOR TO COVER **** ***,k,..,... ' ' .
' / 24 'HOUR' NOTICE REQUIRED ******** * 1
45673604 **********
****** ************A************ `TAAHK YOU ******************************* *
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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/CRP
Easements ._
Road Plans/Improvements
Bonds __—
Planning Bonds
Utilities _ Double Plumbing
ULID
Other
******************************THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY******************************
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 from owner/contractor-plans destroyed:
JOB ADDRESS: ' L " "',
�` I l'
SUBDIVISION: s - 3 J< LOT: BLOCK: sg /
OWNER: a l PHONE:
ADDRESS:
CONTRACTOR:
1( j PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: