1991, 07-03 Permit App: 91003943 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
PROJECT NU 'iT:iL..:R - 91003943 ;-AAPf::,....7.i--;'::;..i .;.i.ij'•{ DATE:- .',.. ... 91 . .. - ''i',
t+-*ii•lE** THIS IS NOT A. PERMIT 3•3i****.
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 2406 E UNIVERSITY RD PARCEL4= 29544-0301
AI_J!.%?''•:ESS.... ::;?"'..!K.AfiJE WA 99206
PERMIT SEWER CONNECTION — NORTH is?::li<:.O?'O
ii• i ji• ,.. :.1::. NOTE?:.. ii*)i•
PLATt- 0003e2 PLAT NAME= CHESTER HILLS ADD ,
:.t;..t,!(.}s,.... .7 L.OT.... 13 '(tN?::.= AGRI* D 14=
AREA= .00000000 I../.f,-? I" WIDTH= 't i J„:} DEPTH- 180 P/W= ..
OF J.=f...DG WATER ;.} t fi =i
OWNER= ?"?ASt,!N K PHONE=
STREET- '2406 E
NIVERETTY RD
ADDRESS= €. OKAi'''?E 1WA 99206
CONTACT
r' i4 LEONARD t.:p.i#,'i`J : t4i,Ito Ti•-k:::: £.i':'i Y.26 0964
BUILDING ..( }1:'<., FRONT= NA LEFT= NA RIGHT= NA REAR= NA
iriu; , rai nnhrn ix in: ] „ i : w { SEWER ; ? '? ± ? fin jjitii1; iii . l :i *Jiy
CONTRACTOR= t•-? •?; CONSTRUCTION PHONE- 509 26 8964
STREET= 11817 ?... 5;r..#E...L..#::.T W A f r••i b}::.
ADDRESS- SPOKANE WA 99206
ITEM DESCRIPTION » F N ._ Y FEE AMOUNT
FRu •
ING FEE 10,00
SEWER� �� ,.'Di:Nr-; T:i:O: I 40.00
PERMIT TYrcFEE AMOUNT ar ! !` PAID
A1 : F ? ! iNOWING
SEWER PERM... . 50.00 .00 50.00
-----
50„00 00 50,00
PROCESSED I S , j U t....t.}... :;'i-
•-'F/i: .
{.: t ? 9 F
t•E:W E i ? U B A.::•—BUILT INFORMATION AVAILABLE A ; '•,••i 1::. COUNTY
,- , v,,..
.. s.....ICIE:‘, ..?i...t'¢a:,; {},...iv T t.456—:f-,604't
CONTRACTOR OR APPLICANT L {.+_,iiiN•I +: TO FIELD LOCATE?::. AND CONFIRM THE
ELEVATION ANDPOSITION t.!+" SEWER STUB t.B P`L':I:%iR TO ANY Y+ O H :;
EXCAVATION
TO LOCATE BURIED t.:{.a;t i...?::.s t-Y F4't S PIPING, i cir.".: E LINES, ECT,
t.:{••?3...3... !_=?...t t,-!I•>., i t-,i ,! D i.•.Y (456-8000)
SEWER STUBS r•t rt r:. ? t.i �:t e:. CHECKED i:t:.s.tJht: TO CONNECTION
THAT ? ?-•IE ! ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
.1'.r. }r} hn : :: 1CALL : � . v. :t ( aPRIOR TO a s : :.
:
Jvr :nir) 3 . HOUR NOT ICE REQUIRED ai **ri3ir
Ai1i9 '} in :i.
456-3604 1}r•P A•)**Nr:ui-i}i iq•
.. i*:t.J:J:3t,.J ..J-.. *..:.J J;i}r lY»t*i2.4i'9i-9M1 ai.:* THANK y i.i..i i1?•Jt-it}...9.9•.J.'.'i•1t c}'r i$i1?r i^r*ili•iR•J`!i-th i},.i:: .,*J.9i•i}i•iei.*.,....:.hr:'t-
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:_______—