1991, 05-13 Permit App: 91002530 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
P'ROJEC'T NUMBER= 91002530 APPLICATION DATE-:: 05/13/91 PAGE= 01
****** THIS IS' NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 2205 S VERCL..E"R RD PARCEL.:x= 27542-2809
ADDRESS= SPOKANE. WA 992.06
PERMIT USE= SEWER CONNECTION - DRY LINE ONLY
*** SEE NOTE ***
PLATO= 001223 PLAT NAME= HILLCREST ACRES 2ND ADD
BLOCK= LOT:- 9 ZONE::. AGSUB DIST: = F:.
AREA= 00011000 F%A== F WIDTH= DEPTH= R/W-:
0 OF BL..DGS= i 4 DWELLINGS= i WATER DIST =
OWNER= ALI)E.RSON MARCUS PHONE=
STREET= 2205 S VERCLER RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEONARD -- H & S PHONE NUMBER= 509 926 8964
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= H & S CONSTRUCTION PHONE= 509 926 8964
STREET= 11817 E: VAt...I...E:YWAY AVE"
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE 'r' 10.00
SEWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT F'AII) AMOUNT OWING
SEWER PERMIT `. .00
50.00 00 50.00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS-BUILT ]INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIEL.I) LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT,
CALL.. BEFORE YOU DIG (456-8000)
SEWER STUBS ARE: TO BE: CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER 1AIN
********* CALL. FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 *****x****
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
?t : f T
T
Engineers RID/CRP
77t,
Easements
Road PlonsiiirnpromMents',.- ;.; 7 7;
Bonds
(;:I • 11! ..j
•-! f t. ,
i . v
.
Planning ;171 Bonds • ;.•3
("; ; :..•
: ). i 3: 4
1 ,
1,;! •
Utilities Double-Pfurpldir}g T AO.
UUD """ "" " ""-"' """ • '"""""' """"
Itl
•
c.ri• 1 j -; T •
• •• • •• -- ••
Other
7".1 .
A ' , i••• . T A ii 1"
1 v. 41
045 •i
•"
0 T‘c. V!•..4
. • i./
I 0 "' 0 0 .117‘.1:73
f.if 7. (.3"i" T ." .. > " ::il... : 74 i I
,.; 7.; I i• Eis csi,i I (.1. 1-) :71
'.! .• i11 l II II II
*****"*""*****"******* ,:11:"Vt1 ,1".1-titsS64PACE FOR COMM eFf4ALPLA-14$TRACIKIN:"WCOIT(FlATEOF OCCUPANGY-0#1ti**•1(*******************"********
••••••••', •:•••• •:•••.• 4,•••
Owe.received for:OIXO:•pitiCessirt* :ps• ••;f:•,(•••st'• pidteitHdf finttitOtOcestirigt ;!.. i.
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:
c-ti — a *3u ( eAk_aJ4'
JOB ADDRESS: Ca4 v6 ( ilLeLLL
SUBDIVISION: a-7 ,--/cD "D- v 9 LOT: l BLOCK:
OWNER: 4 / Pr? PHONE:
ADDRESS:
>
CONTRACTOR: I/ - PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: /1 /