1991, 05-08 Permit App: 91002371 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
certify that I have examined this permit/application,state that the information contained in it and submitted by me or my agentto compilesaid permit/application is t
rue
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
DATO5/O8/9i
� -
•;:• •") Thl% I% NOTA PE:F.:MIT
PENALTIE%-WILL BE ASSESSED FOR COMMENEING W0RK 'WITHOUT A PERMIT
---------------------------�-.----------_--------=------_-------=-+-----------
SITE STREET= 2920 % UNIVERSITY R0 - - PARCEL�- 29544-O7O2
- ADDRE%�= %POKANE WA 992O6 �- — - -
- PERMJT1JSE= %E]WER CONNECTION - -%QUTWYOKOHQ * ` ^
NOTE
�LA ' �= O�O 76 PLAT NAME= CHE�TER HILL% HE' - -
BLOCK=
AREA= -00000000 F/A= F WIDTH= DEPTH= R/W=
OF BLDG%= DWELLINGS= 1 WATER DIST
OWNER= THULA J W PH�N+
� c=
%TREET= 292O ^ ONIVE�%ITY PD ��`
ADDRE%%= %POKANE WA 99206
C3NTACT PHONE NUMBER= 509 94 5595
BUILDIN� J� �/../.. � .``'��. � .',�. LEFT= NA RI�HT= NA REAR= ` � �
**** *********************** *
CCN�RACTUR= A PLC% CONJTRUCrION 509 92 '� 5�9559':::%T;�EET=- PO BOX � 4557
ADDRE %= %POKANE WA 99214'
-- - ' - AM0!NT
-- - - ----------
iO. 0O
i 4O.00
� - - - ' ' ---
PFRMIT AMOUNT PAID AMOUNT OWING
-_----_---- ----------- -----------
%EWE3 PEnMIT •• . 5O. '
- - - - ------------ -------------
5O. 00 .00 �� . �O
PROCE% EB BC' JULIE %HATTG
PRINTED BY : JULIE %HATTO
�EGER %TUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNT"-:'
�T'LITIE� DEPART3
ME�T (�5�� 604) ^
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM T';•-',F
EL VTION AND %TUB PRIOR TG ANY OTHER
EXCAVATION
! i
TO LOCATE
CALL BEFOREBURYOIUEDDCI�ABL(4E5%c| -C8OA%PIPING,WATER LINES, ECT :.%FWER ETUBE ARE TO BE CHECKED PRIOR TO CONNECTION TO INURE
TFAT THEY ARE C EAR N UNO %TRUCTED TO TH� %EWER MAIN
********* CALL FOR % -
NPRIOp TO COVER **********
24HOi;RNOTICE REQUIRED '' ***m******
456-3604
**x »x" x*x**x *x************* ,THA NK YOU ***xy******************
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: _---
1
JOB ADDRESS: C0 ell/LA € f J l -1/UL5&te'
(
SUBDIVISION: �_,l 64 "( - O'7D� LOT: Q - BLOCK: cp— /-7. ' 1�S
OWNER: ( t-�Ll t _____\ LCD PHONE:
ADDRESS:
CONTRACTOR: PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY:
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