1990, 09-27 Permit App: 90004901 Sewer 411111111
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
rRt # : NUMBER= " : .0ir i ' DATE= 09/27/90 " r# . 01
REVISED S:i:TE INFO
i?'',?'',!:',!:',v*)!:',i i,..il.',':',!:*')!:)!:)l..,i)?..,?.!?.*)v.r?••)}.*}?.J}.*.R.* APPLICATION *)Z:ii.Vii..,:')?':lS::!t':!!:1?'',i',!:)?'1?.*.}i.**1j.:,?':}?')?')?')!':!!'**}-'.':!!::N::!!.*Ei.
SITE :�. # #'°:t"ry # , ! 4 :; 'd�E:.#•t i..�i i���:' E{;T) ✓:•'t .... ......,•- 22542-2176
ADDRESS= SPOKANE . WA ...99216
3921i.
PERMITt.tSE::: ., EWER CONNECTION .... 8801r::H ri• ,SEE= NO # E: *i!N:
P 1...':,.....>,.__ 000975 P± i:i • NAME= .. :E::..B R E:::1 E:: . SUBURBAN i. ;;..,i ADD,
BLOCK= ; LOT= ..t,i?vj-::::: iAii t!1:. DIET =lMi.
{ij.. ,},:,} :}i}i}!;:}i}ii . /A= i. WIDTH= DEPTH= R;'iAi:::: 50
4 OF BLDGS= i ai DWELLINGS= 1
OWNER= LUjAN, EM & ED PHONE=
ADDRESS= _.?r!T"iKANE: W; 99216
t.:OIti r•'4 t..: # NAME= LEONARD H ... PHONE NUMBER=._ .. ....... .. ..
4
BUILDING SETBACKS : i:OE`'� # :::: }•:f.:; LEFT= : RIGHT= i� i �i".r•�i'•-• {..t
P1Yc R : :pPA ? ? k R1k PPPPPP1 :9P :PjSEWER P# : C ! # *9t;*•Pi:ii'*'P::k•P:-P:*1!:P:k•16**9?•94 P:9,r.":•P:1!:;:•P:*:'k•P:*
CONTRACTOR= H ' CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 is:. 'N'A i...I...r rf IAAi r.:i r A V±...
ADDRESS= E : i KrU iWA 99206
ITEM DESCRIPTION Q !F , : , ;"7 ri )w
PROCESSING`i,SINC; FE ::
,::?:: ......1-; CONNECTION 1x r
PERMIT T T PE:. FEE AMOUNT AMOUNT PAID AMOUNT OWING
i• ••i,;, PERMIT 50,00 . !00
50.00 .00 50.00
F'R i:l(:::I::.;•,::E D B Y : JULIE -A ± I
PRINTED JULIE EHATTO
: iA; rSTUB rS. TtIii INFORMATION .?.::: AVAILABLE AT THE#::. ..,i_ii..iPJ ± Y
UTILITIES DE.PARTMEN (456-3604)
CONTRACTOR OR APPLICANT
IS
T
FIELD LOCATE AND l_.:C;,)I::'TRi'i ;iii:.
ELEVATION AND POSITION OF :'EWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE E Bi,7i•!.a.?::.D CABLES, GA:. PIPING, WATER Er=•: ±.. t.i.,i.. -, ECT ,
CALL BEFORE YC:U `)I G (456-8000)
tWrti ; tB : ARE TO
BE CHECKED PRIOR TO CONNECTION TO E
NS
tRE
THAT # ? rr � .# =hi AND UNOBETRUCTED TO THE SEWERgEWER MAIN
....... ... ..... CALL r..
��r n�P:�!;�u''u'i?•r?•n: 1 ;••;i•cJ;`j:=E C...3.T:i�J PRIOR TO COVER yt.:ri.k'#••};::1?•**x:
1i.:r..}.-j..},..,.*-p . 24 HOUR :#r'Y_I". t".i::. REQUIRED 'Pi 1t is.:,?•Ju.•1i•
:,j.:}... .r•;,j.:,:•}. 456-3604 •}!:•P:ie'P.•}u:i!i i!i fii•i!: ;.
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:tl:)!:',!:)!')!:)?'J!-i!'��9!:•,!•it 1i..il:4!:?Y?!"T?'9t 9t 9?-??-??•fi:);?!•:fit.r+..}E.1!.:�t.:yH:• �i"i fAt CJ i'. �{+..i#..i it,••,!':!j'•1-)?'::�')?'f:',?')?..i..l f f....:� �?...:..ii...::::::?'..::'::•.'1'::::::k: :":
SPECIAL CONDITION CHECKLIST
Project
Address: _ _ Prmject#_- _____ _Wsw: _
Dept: Date: Condition: mit: Appr:
i | / (in) (out)
- -- -' / -- -- --- ----- --' ) - | ---
Dept,c«Bldgs.
--- ----! -i -- 8peoial |nop.Final Report
- -- --- --- -------- ! --' --
Hydrant(
| ' � Lock8ox
------ - - | -- - - -- ' -----
| --! - ---� ---- ------- --- / -----
| `
-- --- --| --i - --- -- � | ---- --
Engineer's___ �/ _- ! __ RID/CRP
Easements
_-_- -^ '.
Road Plans/Improvements
Bonds
-- --!^--' `- �_ ----�
� .
-- - | --' --- -- -- - ------- -------
--- --| --| --� ---- ` ' -- ` � -
Planning____- ' | Bonds
----- ! --/ --------- --
| '
-- -- ! � --' --
— � )'° ^ .
---� -- | --- - ! --� ' '
•
Utilities_ | __�' Double Plumbing .
UL|D
.
Other
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~`^~^^~~~``^`~~^~~`~^~~'THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTF|CATEOFOCCUPANCyONLY-``^~``~~^~~~^`^~``~~^^~^
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:
1,2 ---6/6)0P
JOB ADDRESS:
SUBDIVISION: ` �" L ()
LOT: BLOCK: 67
OWNER: LLL Q Y7 PHONE: i% r,s
ADDRESS: 1/ n
CONTRACTOR:
PHONE: 9a ,r "?. /�CY
YL
ADDRESS: / / l / Oa/ t< )0_1
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: