1990, 10-31 Permit App: 90005801 Sewer•
SPOKANOPOUNTDEPARTMENT 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= 90005801
:*************************§*** A P F' L. I. C A T I O F.I
:I:TE:: STREET= 112 N WILLOW F?fl
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION .... A87-1
*'**• S E E NOTE •**•
BLOCK=
AREA=
.. OF BLDGE=
OWNER::-
STREET=
ADDRESS=
001E335
142
00000000
.x.
PLAT NAME=
LOT=
DWELLINGS=
F'tCiE::C;K , A R B M1
i i2 N WILLOW R
SPOKANE WA 99206
DATE:::: 10/31/90 PAG—,E= 01
APPLICATION
3{ 3i• * * 3i-.• R- 3l- 3t- 3!' .) .: 3l-.• . * * •P:.•.• 3i• 3E 3L- X * * •il• X-.• * X- *
PARCEL4= 17543-1504
OPP..••rR.. 1....3 4
2 ZONE= I...:t/R(i
F• WIDTH=
CONTACT NAME= DONNA ( OURC::HAINE:
BUILDING SETBACKS: FRONT= NA LEFT= NA
.-.-3k.•h:'3i'3t•.:'.4'.•'P•-h:*-H** ****-)t-*•.'.'.•.'** SEWER F:'E:RM.. i
CONTRACTOR= COURCHAINE. CONSTRUCTION
STREET= 16402 F AL..L..E WA r
ADDRESS-. VERADALE:: Wry 99037
ITEM DESCRIPTION
PROCESSING FEE
SEWER CONNECTION
PERMIT TT'T'F'E. FEE AMOUNT
SEWER PERMIT 50.00
50 ., 00
PROCESSED
PRINTED
PHONE=
Di: STx=
DEPTH= 1.. = R /W=
PHONE NUMBER= 509 924 5.4Ci5
RIGHT= INA) REAR= N A
.• :p: -p) k..:.::» 34 3: * *: 3':.• 3..•.- * 3(- *.• .. 3!• *.• 34 ••u:..n:
QUANTITY
AMOUNT PAID
.00
.00
PHONE= 509 97;4 ri4Fir.
FEE AMOUNT
10.,00
40.00
AMOUNT OWING
50.00
50.00
BY: JULIE SHAl-TO
BY: : .)UI...I E: SHA T TO
SI:::WER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTi.1..:ET:i:E:S DEPARTMENT (456-3604)
CONTRACTOR c:l:i: APPLICANT IS TO FIELD LOCATE AND CONFIRM THE:
ELEVATION ON AND POSITION (11 SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO 1...00::ATE:: BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL I:tIEF• OI -ii:: YOU DIG(456-8000)
EWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED T) TO THE: SEWER MAIN
3•::n:•:N: •; **3t :n:.• CALL.. FOR INSPECTION PRIOR 'ffi COVER .:'•x.'.•3C3E..:3*
.•.•.•j ..•...* ?4 HOUR NOTICE 1 REQUIRED .•.- .-*3E.•*3;;;
:... G
*****************,*****x-********* THANK T O t.1 ***************************.K****
SPECIAL CONDITION CHECKLIST
Project
Address: Project # Use.
Dept:
Dept. of Bldgs.
Engineer's
Planning
Date:
Utilities
Other
; : •
I n ":31.4•1"I•c*::
r; 1, .11/21 (
Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
; . . f• 4 ;lt -.1t. 4 It •).: 4.: 4
••; ';:l
RID/CRP
Easements
41nH'iw
AW AOAW'L.
Road Plans/Improvements
t-in77.13000:J ..r.3i,111;:, =37
:• : •SS`!•••
Bonds
=1MAIA TAJq
• ; =T0.1
F-".EG1'00
nit:
(in)
F!••••:,
Bonds
1 1,4 A W1
4 >1'1
0 ,3tt
AW 3mAALr7v/.
1
Y. (.4111 i 1 (4 V 4 tx A :::: I '•
AW 3JAGA9•3v -Z7
;)
Double Piurnbtog
ULID
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(out)
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971W--.12. 7.31-17. OT GAT3INT7AMIU awe., qA3J3 1 d,YJHT Ti T
4444444.44 qn15,11 0OIT:13c.;OT 510-4
411A,SRO,CE FOR COMM& bblIATLIPIPATNS T4 AtA11EOF OCCUM4Y: 4'3':*************** *************
•
3t:. * ****.**:<+:• : i s!' •it 4 4 .4:4 -4 ;:it 4 .4 4 4. ;:ft )t .*•;q: •:,(••:.1:•*;*
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:
JOB ADDRESS:
•
//(3,?),(L
SUBDIVISION: / L 5! './564 LOT: Q,
BLOCK: /`
'Yr'
OWNER:CW ) /l e £ / PHONE:
ADDRESS: n
CONTRACTOR: l PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: