1991, 03-13 Permit: 90005576 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= 90005576 ISSUED PERMIT DATE= 03/13/91 PAGE= 01
JC'1?-,?•,r**,?-3*;*3i•it 3*3*3*3*3*3*3v 3**3;.*3i'*;}'31 3+.-* !-'E Ri"i:l:T .!.t-d I-•t.I R N At .i.t.?rJ •*3*J?•9l•*3±.*.J?•*.N.3,.f,..J?-•J:ft R..J,..fi*•}):•3±-:il::R••J?•7*3)•})•f?•9*
SITE STREET= 3ii S Wil•i:I:PPI...E:: RD PARCEL4= 21541 -2405
ADDRESS= SPOKANE WA 9921 .:..
PERMIT USE= SEWER CONNECTION i:ON .... 0001
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BLOCK= LOT= LUNt= DIET4=
AREA= 00000000 ;••/f.y= I::' WIDTH=t..t:::: i}#:..I"` ! !•'{:::: R:, !A!::::
4: 0! I...I?Cr S:::: :Y: D w#:t...i....l:I'd(T,:;= t Iii r' T E:'R DIET ....
OWNER= NEt-SEi`W, iHY'E{1... E PHONE=
STREET= :.'1 # ,.. W t'i.I.l''I: t..t::. I"'..fi
:,?92
ADDRESS= ,:;E'CII#Fa i�E:. {hI F?f > s'::..'1 i?
CONTACT NAME= LEWIS .... TOM STONE PHONE NUMBER=:::: :09 920 7710
BUILDING SETBACKS : FRONT:: NA I._1::.I" ) - NA RIGHT=:::: !Jff REAR= NA
'!B-P:•R-'P:'P:9k-){-'hi*h:'Pi)t-3*'P:'P:•hi 3*tp'Il iii 3{••i*'P:3*3*'}{•3*'Pi•R• SE:IA)is:.E.t p::.ft!"j.I. ! 'P:'Pi•k 3?•Pi•i!i Pi'Ai•i*:v:Ali 3*'Pi•R:••3!i•Pi 3**3t•fii'il:•31i iii$*3*•}+.••hi'hi 3*•}E
CONTRACTOR= TOM STONE _YCAVA ING PHONE= }� T928 { ! ! :
STREET= 1112 N MAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
----------
PROCESSING FEE `?' I0:.00
SEWER CONNECTION i 40 .00
. �..*.3.:*.::_. ,.. :.":: - • ;•,
Jt•�1?•p,;�}¢Pi•f*Tl•'N:tti 4k•1{•3r 3}•N:••bi 3*b.•;{•.hi 3+i A•!?..A..1 n'n 1*}?�.h n ,.. - .. .. ............ ........ .....
I''f•!•(!"!::.C'. . '•..l!''t{"1 f•! t� •P:3*3*R••P1•A••M•R'P:•Pi 3,:9k jl:4k•Ik•A••1*'Ni•ii-91i 3R•1±•it•it 9*'R•:±••lk
PAYMENT DATE c :iiE : PAYMENT AMiat
03/13/91 '! 22.6 0,00
TOTAL DUE= ,00 TOTAL Pf' I?_1:::: 50 .00
PERMIT Tt "t1E E AMOUNT A' O . , PAID AMOUNT iT • ,
SEWER PERMIT 50,00 50,00 .00
50.00 50.00 00
PROCESSED BY : JULIE SHATTO
PRINTED BY :: :.1 t.i I...I E:: :`.s F I A T• C)
SEWER STUB AS—BUILT INFORMATION ION I, AVAILABLE AT
..I.#..IE:: ('i::)%.fit_(.,,:
UTILITIES DE a '1 1• (456-3604 )
CONTRACTOR# OR OR APPLICANT ..S TO FIELD LOCA 1 E AND CONFIRM THE
ELEVATION AND POSITTOr
OF SEWER STUB PRIOR TO ANY OTHER
.
EXCAVATION.I.ON
TO LOCATE BURIED CABLES, Ti: PIPING, WATER I1flS . ECT,
CALL ?:BEFORE: YOU E D.I.G (456-8000)
)
'>`I::.Wt:.E' STUBS ARE TO BE CHECKED PRIOR ..CO CONNECTION TO 1:NSI.;RE:.
THAT TF'IE:'Y
"EE CLEAR A IUNOBSTRUCTED IO TE " IA =R MAIN` iN
rrnn * ** rnCALL FOR INSPECTION PRIOR TO ( 1W:I: 1r i
n
3!i 3!•3r•3r•3?'*3*3r•3!' 24 HOUR NOTICE RI::.i i..?.I.#"-.t::.I,! 3*3*3*3*3*3*3*3*3*:u:
•P:':±••JI:*P:'1!:•JtP:9±• 456-3604 *.P:3l 14'-P:)k 7t:•!k it:'?:
*.:i1:•*****ri i,:N::1,:)1.*3E 3i....3i'3i"'Ji-h:. .ir.Ae 3e._,;.3;••'r,':u 3i ri 3!. THANK Yt_i U JE:)!•3!;.N.:Jj.:P:.********}):'Jt'}':N:'J+'i*3*****3Y*-34*3*3i-3i-#:
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 _ e RID/CRP
Easements
Road Plans/Improvements
Bonds
•
•
Planning Bonds
Utilities — Double Plumbing
ULID
•
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:
No response from owner/contractor-plans destroyed: