1991, 04-15 Permit App: 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= ?• ; ' it2 > lf ffI CA T I O N DATE= 4ji5!9i PAGE= r `
,rr•->•:•3i-)'* THIS IS NO.t.,:; 1•t?.! i A PERMIT ii•k ai ii•ii ii
PENALTIES Wii...f... BE ASSESSED FOR COMMENCING INI7 iC:±±EK WITHOUT A PERMIT
SITE:: STREET= -f 05 N WALNUT RD PAR:C:E::L4: : 17544-2712
ADDRESS=>-.. ,.;FOKANf:: WA 99206
PERMIT USE= SEWER CONNECTION .... A87-1
i*** SEE NOTE ***
PLATO= 001854 PLAT i`•f r a i•i E::= OPPORTUNITY PLAT :h
BLOCK= LOT=
ZONE= ACS? . DEET„-
AREA= 0000:000 F, F - . WIDTH= I?E:.i:=-•f•{..i:::: •:.E ,'`W=
•„. OF BLDGE= i 0 DWELLINGS= WATER DIET
OWNER:::: CUNNINGHAM, MARK f::={.'i(:ii`{E::::::
STREET= 105 14 WALNUT RD
ADDRESS= SPOKANE WA 99206
CONTACT
ONTACT NAME: BILL
SI
MEON PHONE N.UMBER= 509 926 4 ?81
BUILDING SETBACKS : FRONT=
NA LEFT= NA RIGHT= ±J A REAR= NA
*Jt•14•*ll•*•P1 Pr,k 1,i•F••P•****:P.*•R• :•hi**•11.*•A•-11•}t•* SEWER PERMIT n*•P'•P•*..•R•**•A•..-}t i,:. •F'. •..•..•P:-..•..•..'..•P:•P:•F:-.. ..•..•},i
CONTRACTOR= S SMP, ON SANITATION PHONE:::: 50 926 4781
STREET= 7812
ii ' f::: BFaf...IiW.1:i•; AVE
ADDRESS= ,`rt`Olt.haNf::. WA 99212
ITEM DESCR1F1N QUANTITY FEE AMOUNT
f {:tfir::E::"'c ING FEE :T i 0 .1t.
SEWER CONNE_( r:EON i 40,00
PERMIT TYPE: f::•E::F: AMOUNT AMOUNT PAID raMfiUN(' OWING
SEWER PERMIT 50.00 .00 50,00
50.00 .00 50 .00
PROCESSEDr`'! : JULIE SHATTO
PRINTED JULIE S{..{A•r'r(.I
SEWER STUB AS—BUILT l..'T' :f:NF'OEt:i'1f'iT1:(:ii:{ IS AVAILABLE AT ..f'E•fi::. COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO I: ANY I I l i'T'i•Hf:”l
EXCAVATION
TO LOCATE BURIED CABLES, CAS PIPING, WATER LINES, ECT .:
CALL BEFORE YI tt' DIG (456-8000)
SEWER
± , ER Sr( r < FE : I i BE CHECKED PRIOR " ( CONNECTION TOINSURE
THAT THEY `R- CLEAR AND UNOBSTRUCTED _ O THE SEWER MAIN
:11.:,;..1,;:..n:•>,:•n:•,,.•*• CALL F O R INSPECTION PRIOR TO J t.:±_1a a° *•n:)+:.u..n*„-..},,.t,;.N.
24 HOUR ±-J(1'T'.f:?.:f::. REQUIRED 1.it at.l,..lr•n-!r)~•iE e,:
•p..},:-h:'>*•}{.*.R..};. 4!:56-3604 •n.••*•n:•n:it•N:n•**•n:
r i **u !r1 ** 4} 1y .r „ , A*9 * .; , 1 ** ? r n , THANK Y( „ sir: rYi: rr : r r*1reri *N) a **3 i } r :*: r
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/CHIP
Easements :.
Road Plans/Improvements_ __-
---_— Bonds -- —
Planning _ _ Bonds
Utilities_ .; Double PlumbiFl
ULID
•
Other •
•
.
"*"****"*********"***-'''''''THIS SPACE FOR COMMERCIAL PLANS TOAGKING,CERTIFICATE OF OCCUPANCY ONLY**-***"—*"*—"*"**"******—
Date received for CIO 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:_—
1 (- 176:),
FO.. T _ --..... 1
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PHONE -
NUMBER EXTENSION
AREA CODE
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MESSAGE
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SIGNED A
LITHO IN U.S.A.
TOPS 9 FORM 3002P • J
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