1990, 11-19 Permit App: 90006266 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 d ». BiR= 90006266" DATE= f 0 PAGE=. 0
.
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),),),n.)>.•r.)!1-.:'.1?1.1,)!.)t.,c)!),)!)-.:!.?l.**t,tr j!..)c.j.:it rr APPLICATION -)!._,. }..}_.*:tr:!r•?r sr•1;•it"1`::!'xr zr*s: r i;.!.' #'•jt•i;'**•P:'3`:7{'ii-^.•i•:)!;*;Ie•
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ADDRESS= S#::=1•.iKA1NE. WA 99216
PERMIT USE= SEWER CONNECTION — 0801
i-..f. .tt.= 000975 .PLAT t..t 1_r:.. :.is f:'. ' :.. SUBURBAN HOM7ADD ,
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OWNER= °TA, SHIRLEY PHONE=
,:; f r••'.E::.E::._ ::n 721 ,': k 1::.I I..:i._E:.E"; r°-'.1_j
Ay 1l:ti::,: :.,:.:S= c.E:t?EiANt:: WA 99216
CONTACT
NAME=
+ 1 . DONNA
N" ti„ ttt» 3 N jPHONE i
. :Eic50Y
BUILDING SETBACKS : FRONT== ef1E1: RIGHT 1A REAR= "'s).A
l. :n: ayta *uu* x ::,.)1x* ***sa { ; ;RA � : n . PERMIT
' R ` f :*R K a ..? i . P: n4**Aik** : :*F: ; * : t*
CONTRACTOR= t,:l,itii: CHA't.E.!'.jE::� CONSTRUCTION PHONE= 509 3::.'.'%
5485
STREET= 16402 4.. ::b:i: : E T.fAt r•j Y
fll.ji)r=.t::.,': :•::: VE::.RAI/u...i::. WA 99037
ITEM D1C. L ! fJ v ,:U! ` i ! . FEE AMOUNT
:.:}...,:t::..'; t.:i.i}@ N t...: . .c,,11't: , =4!..j
PERMIT TYPE is E I.•. AMOUNT AMOUNT PAID .... i LA • '�7 t��T
SEWER PERMIT ... .. . .. .. ,00 ... O_.'
50, 00 ,00 5C ,00
PROCESSED ;;i'Y ti f... ;T•Ef'^�.!..i f.3
PRINTED. ... � is!::: n
JULIE r'L: ~'TO
EEWER _STUB AE—BUILT INFORMATION IE AVAILABLE AT T;:-E COUNTY
i .......... t'.I.E::.,.. DEPARTMENT ... ...
—3604)CONTRACTOR OR APPLICANT IE TO FIELD LOCATE AND COIFIRM THE
ELEVATION ANDJ POSITION i„f: SEWER ETUB PRTOR .TO ANY P
THER
EXCAVATION
TO i LOt.:A f t:: BURIED CABLES , is f-
CALL BEFORE YOU DIG (45;.S—0000)
SEWER ,4 f '»i x3 w f"i P 1... CHECKED is:.i..:4�.is:.i,1 t,i `i`-i i'3 i"_. ..p{') 1 i'v,�•.;.:......
AND
...
THAT THEY ARE CLEAR
ir:Pi P.tk 31:-11r i:('•`:f L. F.•1 I ti
...•. t*t A i!.*.ac ,r..!HOUR NOTICE P E t!t..?.t.t 1'i i i' 1t T'!i•fr)`.i}r
a,:*:::') as:.:,::j. 45'6-3604 p
Ji•):9}'9!i 9!i ..1 fh'jt'f'i•)>.• !:'hi; T,'•jt '1Y•f•1!i)t i!£i'ti 9!r)r:)+• ;.:r its:.......................................... IA YJ f.{t) )$i 9?'.K..j:.t(..}:.:1;.;n')`'iE 4`•;�i•u'lt.)i It 7: ... .. ..
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Cf.
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 _ 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:__________
._._. off
JOB ADDRESS: ‘--?3_, i 1_,(242.a_a__,
G
SUBDIVISION: .D"--- 61-13-- - it/ 447 LOT: BLOCK: ! 18rdiL
OWNER: g. ` D C4-42....., PHONE: 51 1
ADDRESS:
CONTRACTOR: L6-1,l___-4 /1.�� PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: