1991, 02-13 Permit: 91000464 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 sub equent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel isions of any state or local law regulati nstruction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction
SIGNATURE OFG� � CATIOfV�
OWNER OR AGENT 4WA 'J DATE
• {tF:.r. `. Ni..• . ?
_ i"t E :. ; :. : s02/j3/.91
RAGE= 01
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.. t. ! !! t! n it } a ai..t..t...t..}}..},..ij.:i..i PERMIT INFORMATION is 3t.:)..}t..,t. :.t1:.:!,.;ii•;!f• !;•jr ji..!:..}i.9i':R•fl P.:)i..!t.:!t..j;.a..X..jt..t;..jt.
EITE STREET=
. ...,_•i,lR �••'i SPOKANE {L ilk'' 99206
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PERMIT UEE= EEWER CONNECTION
•it)i•)i' .:E E NOTE if•)i•)t;
PLAT I:}L:. ....._ k;j lr•)�•!.h'r•:: : A 7 i..,t,:,.?::.= C{..??::.:: 7 Y...R HILLE ADD.
9 LOT=
AREA= . o_ 0C )tt1-/A. fWIDTH= _ DEPTH= 181 60
'
.5. OF c{ T t G::::::: •i ii `!u.!r-: ' .' i• i -
STREET= 1512 g BLUFI- DR 01
ADDREEE= zt.:tyL''ANE WA 99206
CONTACT NAME= JAMEE SAME
• • ;i ± .;{ '•' !.i;." � FRONT= 40 { I::': 3'... _ 'i•1" ir'r!Rii!
j jyjK: : &P 1: : 9 : i j r) p ! : j" t'r !: • • a r , PERMIT :, ^ (' ) ; i) j) ) jj) : : ) j ,i.. ,M. 7 : 1 :
CONTRACTOR= ?i., t PHONE=
ITEM vEc _ , " , „ ,. QUANTITY
ia . _Y FEE
AMOUNT
u•?::.IW?:::f CONNECTION 'f tlll, ,1.? •,
! : : !* :: :Pi1: Pl {**7aP: : ) ) i1k'1±:9 k 99PAYMENT LA ! fP :SI %) a.AjjjP :jy ! 1l i jj :iK ji
PAYMENT DATE RECEIPT-0 PAY-?i?;;N ? AMOUNT
02P
.... ................................................
TOTAL DUE= AO TOTAL PAID= 50, 00
t .., s... _ i::y„ti';:,N -AMOLNT PAID AMOUNT OWING
SEWER PERMIT , 50,00 50.00
50,00 50,00 .00
PROCESSED`S?: !j Yl Y JOHN LARSON
PRINTED BY : JOHN LARSON
EEWER STUB AE—BUILT INFORMATION TE AVAILABLE AT THE nr.liANTY
UTTLTTTEg DEPARTMENT (, 4756
CONTRACTOR C:IR APPLICANT TE TO FIELD L.-c:tc::ft•I•F: AND c.',ONFIRM THE
ELEVATION AT::€:ON t-:,{,D ?•'O,.T t .?.I. N tOF ,::•1-.11?::R ;JTUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED } :B1E" . GAS PIPING, WATER 11r1 ' : _i
C;AL]... BEFORE YOU DIG (-456-8000)
:.x?::.t4i :R ,:. ? :,i :t.: AF'F.:. TO BE CHECKED PRIOR PRIOR i { CONNECTION j.
INSURE
THAT THEY ARECLEAR ;_ `TYICT :D TOTHE SEWER MAIN
*****:**:A4 CA? _ FOR a ' § E : ? pt ` r COVER 9j : 1flP ) Nil
)i•)i-)i')i-)¢•Pi)i':i•.'I. .....1 HOUR`.ai l•1 I'CE REQUIR r „ )i si.)i"1!i i!i'*N*R'jt'`-
i!.)j.:::i.:,j.:::t::i.:. 456—:.?.:604 ****K*****
.)'.;!:94•tk 91•:!:•91•?!:t}L.*7•.9`:'1P 9!':!1•'Y•.'9t 31'31')t•9;;)k 3p.R•d','i!:•,!:a'•P•.'7?'•11•)t THANK 'fr t„f},,: 9t•.'k)h 9!:'t`:;!:}:':9:is a 9:91•')1.7:•tl•9t••!F Jk 1t::9.9E').).*:i*it t.**!/i'
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: ________