1991, 04-26 Permit: 91002125 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. ovisions of an -tate o - .1 law regul ' g construction,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF / ,' APPLICATI /
OWNER OR AGENT / DATE ooCC//
PHoJECT t`-.;, i"tr<.f...i.':::: 91 ,Jv3:125 ISSUED FERWIT fii-; i `: o4/26/9i PAGE=
:)*****************§**** ***** :1.:•.:l.:1..:{..:..:::,;.:��.*id'ii Iii i4':i:*iii.. .:,iii Ni}ii 3i::"i 'i"i
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ADDRESS= cj•:{..i,<{: ',)i-, WA 9'r1 2 i 6
PERMIT „ CONNECTION— 8801
PLATO= 999999 PLAT RANGE
,
BLOCK= LOT=
,1 BLDG
E=
AREA= 00000000 1.�.. WIDTH= ._ _. ..1},I::::
•,,• ...- # .,,• DWELLINGS= '1 WATER DIST E'('+
1',
DFIN
OWNER= : - 1t . DONALD PHONE= :09 924 ? ; :
STREET= 1224 VERCLER AVE
ADDRESS=•' ,:1 'OK NE WA 99216
CONTACT
NAME= DONALD s,1.: „ t .: ;.:E..Et.! `7' BE• `i:::: .. ...'.::5 .}�)';•:i
BUILDING SETBACKS : FRONT= f'-}:•�I LEFT= E''J F:: RIGHT= ,`-1 t:�: REAR-, I v i.:,.
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:?:. ..?�.'r:•a::;,`?..a•u''ii:t?•:r ::>#::.tAi t:.E"•: _'s E". 1 E
CONTRACTOR= OWNER PHONE=
ITEM t::M DESt.:#'+.-I.E'' .l,,,N QUANTITY
'Ems':. AMOUNT
PROCESSING FEE 10,00 .
SEWER CONNECTION
'•:'t: '.:r.::.:::•.:,..s:*: •..:•.:'.:..:,'.:, ;..I1.:c:'. .:1.....-i..:,1i.:(.:-,::::1.::'{....•...i,.:?;..j,.*'*.p.:?F.
:!+:14•.+:::•?•.!?a.P.:,.? ,-.1?•:,P.ti. J-. �.}:..jl..j...j,:'li::n:'A:')t:s:••.": ...jt..j,..jt, i.:F`i':f('°S :.e�2 ,:;i..)F'i�t(`•t l:�.-`; ....1...1-.N.•){,. A...?,:. .:.}?!.r1 4. 1
PAYMENT
c ,M+'-i,i a ,''•. i - PAYMENT AMOUNT
04/26/91 2385 50 ,00
s
PERMIT- TYPE E_`,•.,.: AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50,00 50,00 00
PROCESSED BY : V
, JEFF
PRINTED ED U • JULIE ,.:'e"irt.i•.E:.i
SEWER STUB AS—BUILT INFORMATION
UTILITIES i,t E..y.:ii..:: �E:v 3 (456-3604)
' AVAILABLE i THE:..
COUNTY
is l 'i
CONTRACTOR ,R APPLICANT 1 S TO FIELD A: h ! N_ CONFIRM + _
ELEVATION AND POSITION :..t?•• SEWER STUB PRIOR i_iR t.0 ANT li..iEr;
EXCAVATION
TO LOCATE E:.. t•.1„t :'.E.E::. CABLES, GAS PIPING, WATER i_.!i .....E.NES; _
CALL BEFORE T t.. _: :. d.t:r (456-8000)
SEWER ;iC; ARE TO
B CHECKED , '.. OpI `i ')EiirN .iINSURE
THAT -3r ;� . CLEAR ANDUNOBSTRUCTED i t ^ SEWER 'MAIN
.};.*1k*1}t 7 1t.*.* CALL E•::: ' E"t.t R INSPECTION PRIOR .. COVER 'H bt'';'h '1:::;P:t:';
p,P3'.•:ii1}ii'i•)k1!'4' '4 HOUR +i?1E „t• REQUIRED
,.,.?t'.P )'.:?i' S R• 456."}-',."!Ci`.%.<y )L'i"..'i•R•'1 !•i,. i..j:;•p: •
.. .... ........ ........... .......:...::::a:.:: ::{.s,.r-. . i.:,(. .:t.31. .:...3 '. ')'4 :�G'}1':}':y'k•
:+C yr;...!r:::'::`.9r:•h:s::+•.:?•;:•4:v::`::':L•9.}:;.. t-. t.lii 1;' ii'i7.);. THANK{•'•:F•.�}{, .Y i,t i,j ){ft J?•')`•1:•P•7.:.1?)i•'}`:Jt)4 '}...� t.i...1. r.)<'1�`)v'i.
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: