1991, 08-06 Permit: 91002138 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
E'`r<Ci:.!E::C::i- NUMBER= 91002138 ISSUED PERMIT DATE= 08/06/91 PAGE= 01
ii i1 k iL9Rt h 9R993k fi1iuF&*N*7 ) ^ " . . INFORMATION 3: * ***
it 9it 9 &M9Hi49i9k 19R1
SITE STREET= 2317 .3 UNIVERSITY RD PARCEL4= 28542-3521
ADDRESS= SPOKANE WA 99206
PERMIT i•�U E= EF
CONNECTION .... NORTH KOK MO
E:. *3 *
E:`L-Af'd:= 001393 PLAT NAME= KOKOMO TOWi~�;,f'1:iE::
WIDTH=AREA= 00000000 F/A= F
•u• OF BLDG'S= I :N: DWELLINGS= I WATER DIS t ....
C:II.4r.ER=: PARKER R E'`HO NE:-:
STREET=REE:.'T ==: 231 / UNIVERSITY RD
ADDRESS= SPOKANE WA '' ?(y6
CONTACT NAME= RON .LOAN PHONE NUMBER= 922
BU:I:I...iiING SETBACKS : FRONT= NA LEFT= NA R°IGHT:::: NA REAR:::: NA
h* !***n * e p ) ur*n htnr n pi* i t nt xhSEWER F': ! " . rilx nhe* k kb ***xbb*} ii ia ** ! {unr
CONTRACTOR=ACTOR:::: ALWAYS ACTIVE PHONE= 509 922 8500
STREET= r'II BOX 141562
ADDRESS= SPOKANE WA 92. 4
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE x' -10,00
SEWER ;i:ii' iWU :r ON i 40,00
na*n*rur r {h * iE ta ; n*nhhnx ; ;X t i i nPAYMENT S _m, - { ri***ue i b3r n * :n » :u*nie r nnnr **
PAYMENT DATE RECEIPT-0 !'AYMEN I AMOUNT
TOTAL I FAL_ T_)i.1i :::: .00 TOTAL PAID= 50:.00
PERMIT TYPE FEE AMOUNT AMOUNT ,,FAIR AMOUNT C:!,J:!:NJG
50,00
SEWER PERMIT '?�,:j.,4:11;1 , 00
50 ,00 50,00 ,00
PROCESSED BY : JULIE SHATTO
PRINTEDBY : JULIE SHATTO
SEWER STUB FAS....Tr;j.!1:i... ! INFORMATION IS AVAILABLE AT . !'•1!::. COUNTY
UTILITIES DEPARTMENT (456-3604)
3604)r
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
FI...I::.+rFTT1.IIIJ AND POSITION OF SEWER STUB PRIOR TO ANY !..; ( ?•'!±-.R
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES; ECT .
CALL... BEFORE YOU DIG (456-8000)
SEWER STUBS ARE:: TO BE:: CHECKED I' E'Et:7:COR' TO CONNECTION ON "i II INSURE
THAT THEY'Y` ARE" CLEAR AND UNOBSTRUCTED ESD t O THE SEWER MAIN
N
*r:*.•A•.a•)!••N.•** CALL F t.)1=' INSPECTION PRIOR TO COVER b:ai ai•.A 3c*ii•p:•n.••a:
24 HOUR NOTICE Imo'I-.!'I.i:LI'•'.I-.I i ii•f!•x•it*•ri•ie M•ri•'ri-
.),..r..;r•a•x•ri••i<k•* 456-3604 •,,:ie i!•*:u•r:•a:it**
?i ji-•)t•*ik ii i!.N:ii is fi ri••;f*r•'•r 9i•*n:sk*i!)i k iE it**)k ii THANK Y O i,i r• • •if•i!••'x.•*•H•ii•it»••r.•*** ••; 1•:•"r.'•:)i.ii•ii•ie i(ii•ii•:d• ;.:r•r•***
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
****----"—**********"""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 from owner/contractor-plans destroyed: