1991, 03-13 Permit App: 91001069 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 NUMBER= 9; 00106 • APPLICATION IC ATION DA t E= 03/13/91 PAGE= , i
j,j1.*),;JF* THIS ti. ,#,s NOT A PERMIT *iYit:***
PENALTIES W1:L..t.. BE ASSESSED FOR COMMENCING WC:lR#C wi. T•E•#itii'I r+ #•:E.::#•t:m i. i
SITE STREET= 3018 : UNIVERSITY RI.) PARC:: L."-- 29544-0705
ADDRESS= SPOKANE WA 99206
''i':.,..,.:•r USE= SEWERCONNECTION SOUTH KC:tKCiMf-t
. ** SEE NOTE fr3i•r'
E:L..fa #'tt::::: 000376 PLAT NAME= CHESTER HILLS i..IE IGHTS
5 ZONE= UR 3,5 t):E,\T 9•' t'
00000000 E F:+:::: F WIDTH= DE:.(_..#.E,#= E:;;'w=
... OF BLDG,?.:::: :i,• DWELLINGS= `i WATER DIST ::::
OWNER= LYNCH, G M PHONE=
STREET= 3018 S UNIVERSITY RD —
ADDRESS= SPOKANE WA 99206
CONTACT NAME= RI.tf'( ,.#...C:tFYi`J PHONE Ni..ii•'tT.tE::i ::_ 5i 9 9228500
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR:::: NA
u•*ae•>•:7G•ii••j!•yr•Ji••i1:h:ji.a1:•a:•i*:*.x..k.*:J,;.u..#..x..J,..,,..J,..t,,.J„.p. SEWER::.. ::.:t t'C:.P4 t" ... 1. ....................................i, *'r:**•r::U:r:
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= POt t:it:i;f 141562
ADDRESS=S::" SPOKA(vE WA 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE I 10,00
SEWER CONNECTION 1 40,00
PERMIT .. YP#::. FEE AMOUNT AMOUNT PAID AMOUNT OWING
}EtaiEE! PEf'M.#.i 50.,0'. :.00 50,00
50,00 s 00 50 ,00
#-RCiC:ESSE.c? BY : .tt.iL«IE ; 'Hf::, I I0
PRINTED BY : JULIE S#-#A t i t+
SEWER STUB AS—BUILT INFORMATION 1 ` AVAILABLE ;TTHE COUNTY
U iI#. T E: DEPARTMENT
456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION'A(ICil4 r''+i i; POSITION OF SEWER STUB PRIOR tisi ANY OTHER
EXCAVATION
TO _ i " EBURIED :- S. Et , _ Y: PIPING, WATER LINES,
, E ( t
I1# _ BEFORE YOU ) E1456- 800 ))
SEWER
r- J tJ nh# t IBE CHECKED PRIOR (II ; , +i4 f t 1 • TO INSURE
# ` THEY ARE CLEAR AND UNOBSTRUCTED ` <"'W " ,r # ;
Nir, Napjs CALL 1 _ EINSPECTION #«`R..L.R TO COVER **.yi.:P..Pi ik ii•?k*9?•
****3):.*tt•N•4r 24 HOUR NOTICE #2t:.In+t.i.#.Rt-..? *•J?-*i?•3r***:+?••)i•
. ............ 456-3604 .R.**.j,;*.;,...ji..ji..j,.K
J:4:P•li•iG;,:)••is 3:i=9:•J:•J:•.:H:is 9?•9t J?9+:)k 9?..P:9b 94'jt••Pi**iL"Jk•J}: THANK 7(J t„t :M•J?•t,.9?''Jt P::k p?•;t?..p:'!l'1,:•},;•!:'iNr'jt'*3t')t JF)i'iii.:Jr.ji..,?..Jt j,:.,..,,..J........:...:
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: Init: 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 DoublePlumbing
ULID
. .
Other
.•
• , . Y.-- :
. . ,
. . .
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71-itSSPACE FOR COMMERCIALPt:ANS TR itoKIN6','OEFITIFICATE OF OCCUPANCY ONEY'-*********"********************
. .
Date'receivedlor C/O '':Plat-ts putted lot firialpi•Ocesging: •
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: So ` Y tbA; 01---e__A4;
SUBDIVISION: A ` U` / 6 IDT: BLOCK:
OWNER: L. PHONE:
ADDRESS: dC�q� J 1
CONTRACTOR: CI- b-1 1 [ ,� t —� l PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: