1991, 05-02 Permit: 91001825 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 NUMBER= , ;:tC}'i 5 ISSUED PERMIT _. PAGE- ..
:::ai. (.:ss.::..•::!.::.i.::::.:i.:i.:.C.:i.:::'.:'.:'..:.i..ai.:i.a::;.::i.:,i.:;.
!..:. 1,!t�.!{?, s.,!::-.?,}t!}.1}.}} }>.,:.,!,,t!...::,?, pERmIT r , E t.i 1\' i+`i iter a:+•r ar:}.:..�:!;..j;::,;.;iri�+��=+%' +.' .,...... .1`.'i'.. :.
EITE, STREET- 105 N WALNUT RD
i•+.iii,?? ?::. i•::•:::: ::?«f-iicf"ii4?. WA 99206
_. .M .:. CONNECTION
PLATO= 00-1854 PLAT NAME- OPPORTUNITY
f'it'.I..t'=}::. ;i};:pt•et.:?t,_!t. WIDTH- Ri!A ..
'ai:
•e� -...� ;;: ,:t:r,.r.... i '!r Dvit... . L. i.!�:'.+.,.,.... ') =-i ? .._ ._ _.,.
OWNER= c:U N:i:. t f:`; ,.;?•,1:,,,;•I f::M " K s:.:'.. ....
STREET= •-5
WALNUT
ADDRESS= SPOKANE WA 99206
CONTACT NAME—— B•. i^,. Oiy ._ .. 509 926
BUILDING ... F:: . S:IA{..•K... • FRONT=- NA LEFT= N . ... ...
NA
; ,it ¢ t:F: ;i : ::.:.. ::. : ji.AH f.;:,. :* ; :P ( (: SEWER i ? . _, { i ja1t.: a ? H ! .ai ri.' ..j :j, .f.
a i i
CONTRACTOR= SIMPSON SANITATION E
.,,Pi. KAN?::. 14A ? ...
.-. . E t'? i??::.,.. ..:?"•.i.. i .?.L., N QUANTITY FEE AMOUNT......... '
PRUCLES1N6 FEE 10, 00 —
SEWER CONNECTION 4 40,00
%.,0
.:..:...::..::...............:..... .....a..,..,.a..,.....,....:....,,..,..,..,,..,,..,...:,:.,.?.. :.,. ..». ,t. :t a,. ?t a.:..t. F•.a.,+.!,,+.7-.!+.,t.!t...!•.?-.,.:.,i.P.!,rt. : ' itSUMMARY , , ,.. . . .. .. .. . ijjij }j..A: : :*..
. :h f
PAYMENT t••t . i... RECEIPT4 "'
TOTAL .vi...,... " ,00 0 ? i.. YtAL. PAID=
PERMITTYPE i'•t, AMOUNT i'If,11_iNPAID AMOUNT OWINC;
.j
50,00 50,00
,
PRINTED BY : ii
SEWER STUB AE—BUILT INFOkMATION IS AVAILABLE 'A ; H-4;..
? .±,... DE.? fI'i?'°,•! f"??„.f ' j 4 5 6—.3 6 0 4
. •r
{j i?� i ttt"•i t.: i ,,,i, t,Iit r ,.: �•
EVATION AND POSITION OF SEWER STUB PRIOR TFli ANY nTHER
EXCAVATION
TD Lit}i• t
.}jl.i-y. it�t i.i...l% i e}+ t t::.:. GAS PIPING,. . WATER s } s::... .
f}; i BEE:! 'ORE E f:0i :o 4' /:..... c (:)9.. .
SEWER ,:r ? i-7Y' _, BE CHECKED _ . ....
1 ?"t1 I THEY f.i.._. ..:::....t-i . I`i`.... "�: ?•r i ? ..
,:
.....:......
i' {'ik'] **3+:3t:it AL. FOR d t ! COVER ,
i'j:ai +::!:'7 ?C't:^?{•Pi
456-7.5604
;.it:::.:; ..s{.i' :'i is;'isi c+'9'r:'•i•;Y'!r:....... .. .... .. ........ .... THANK .. _. ... .. ,. ...... :... ........ ......... :, ..t:•.J h...k'!Y!t
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 _
ULMD
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: W__----_-____-_____._.__—__-------
No response from owner/contractor-plans destroyed:_ ______._ --__.-__-.-_-------------