1991, 07-22 Permit App: 91004346 Sewer SPOKANE COUNT'" 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= 91004346 APPLICATION fir•' !.= 0 !#.:l:: t:i
r•ir,•fir.•*:a: ♦ THIS IS NOT A PERMIT ')j)FF'i�Y N'
PENALTIES WILL BEAte. :#'-SSE r, E.:#.O!": COMMENCING Wc:iFIt WITHOUT i3 PERMIT
-----------------
SITE 1 T - 1224 vE `t ! ! " (IF _ °. } # . 22543-9095
ADDRESS= S - )h ¢ d- f 99216 yj1TPERMIT USE=
SEWER
CONNECTION
*A•* SEE NOTE "t'"'
BLOCK=CI• 999999 :+# 't NAME= RANGE I
LOT= ZONE= AGRI
AREA= 00000000
; J !0: : _ A..... WIDTH= 125 DEPTH=
1 F i
, :
rOF : . i ; . xDWELLINGS— WATER DIST : MODERN
OWNER= _ [ {Dt ` DONALD PHONE= 5 0 ) ryr s 0059
STREET= 1224 E VERCLER AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= LARRY COOK PHONE NUMBER= 509 466 2iFis
BUILDING SI # f; E' FRONT= i'-J.: LEFT= NA RIGHT= NA i,:-AR:::: !r_i
: gt : : jP3fif3ttiP ;, jiiP. tJN* SEWER PERMIT RNP *if 1 ; q ; t }*'ft'* R*l4 1* 4**j .j *
CONTRACTOR= LARRY . . . EXCAVATING PHONE= 509 466 2188
E T iil::.i... ! .... 7420 fx} ;IE..#Hi-?NN:.:t:.l. RD
ADDRESS= N .NE: MILE. F'AE...1...,: ,:i1"# 'y`':✓:9 "!
ITEM DESCRIPTION QUANTITY FEE «i.?t...
PROCEEEING FEE ..00
SEWER CONNECTION 1
PERMIT TYPE #..EE AMOUNT! AMOU 4 PAID AMOUNT OWJNG
_ ..KI
SEWER PERMIT `:i t;,,t;)!.7 ,}? %!::)'.:':.J°.`:,
50„00 ,00 750 :t::[t,
t''P{t.ft.:t::./',`: !::.D. BY : ..:l#E_.I.P.'_ SHATTO
PRINTED 1,5:Y• , „JULIE SHATTO
E.:.WE::.i'', STUB UB P'{ UI1... i INFORMATION I#_lN is ' AVAILABLE
UTILITIES DEPARTMENT ( 456-3604) .. COUNTY
CONTRACTOR OR APPLICANT.2..:fn?.`y••: .!.::: TO P'•t;::.E...1% LOCATE AN) CONFIRM THE
r•
ELEVATION AND #.:t.f:::• ! •.t.fN OF SEWER STUB tEB P R Ii,iR TO ANY OTHER
HE::.R
EXCAVATION
tLOCATE :tILEi CABLES, r ;: PIPING , !•aiAT._.. . LINES, FCE ..
CALL BEFORE YOU DIG (456-8000) .
;,..#I;:R STUBS ARE TO BE CHECKED 1, D k #.fr "in TO_CONNECTION TO INSURE
#E•'.'.#
THAT E 1 HP:.'f AP:E::. CLEAR AR
, CALL ' MAN. UNOBSTRUCTED
EB ;RUt , i i" SEWER HATi
nhkiP %ift . i, , „ ItNPc P TO ; , , ". k: xPx,':PtJ
J&
****K**** :?. HOUR,l f {% 1 i 1•!-:L±::;::: REQUIRED ***** ***4.•
.3' ..:7,j:P..p.:7,.:7,..�' P, .... 456-3604 .,... *i Pi i.:P iR''i" 'n:i?:.Et.:71.
:,C.:i.:i.:-.:,i.••.:::'.:::, :•.::.:::i.:•.:i.:':i..i *******4f:* *** *******************
.•.!•.J•.,t,r•.3t 7t,t N,t R!•.,t J-.,,.J:!t 1•.,?'it•)t•7!i ai$i 3f� !i Yi; 9'• THANK•.,:: .,.....E:
t t••I t•:{!�:3 E'•: f E.f -# 1:' :.
r'
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 OFOCCUPANCY 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:
U.Re�
ti� � rr�a • ' �2oa s ' '