1991, 05-08 Permit: 91002349 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 processin.. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same.All provision/.f 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/a.plication•.any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel theprov'•ons,fa sta • .r loca/a, egulating construction,or as a warranty of conformance wit he pr visions of any state or local
laws regulating construction.SIGNATURE OF APPL
OWNER OR AGENT .iL�Ii� DATEICATION ( Q Q J
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NUMBER=s i r I
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1.„4.-:E=, SEWER CCNNECTION — EHIRLEYS 1ST ADDITION
SEE NOTE
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PLAT NAME= i ! I fi
LOT= 6 ZONE= UR-3,5
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T., OF BLDGE,,, DWELLINGS • 1 WATER DIET = MODERN •
OWNER= HUFFMAN, DOUGLAS EARL
PHONE= 509 922 1260
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AVEADDRESS= I,HLLNAUREE WA cl-Y016
• PHONE NUMBER=
• 1 .260
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-CONTRACTOR= Iiai`.,F ... _ _. PHONE=
ITEM DECRIPTION QUANTITY FEE AMOUNT
PROC
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SEWER CONNECTION - .. .t:te ;•1
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PAYMEN— RECEIPT4',: PAYMENT AMOUNT
TOTAL DUE= ,00 TOTAL PAID= , 50 , 00
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PERMIT { AMOUNT AMOUNT {7`;1•,111'0.. OWING
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t.!,'= •:N {1�' ...1«f_'i t ` j i:i',+1- PRIOR TO { ':'•,v,'
AND ' t S OTHER
EXCAVATION
YOU
AR t '. T 0 BE. •O 3-1?...L:to E T 1 •PR t .._'OR. r:O cc:t'N E.-_ Tt_ `.` .• NE1.:JEZE
THAT THEY ARE r"! FAP AND UNOBSTRUCTED TO THE .SEWER MAIN
" CALL FOR INEPECTION PRIOR TO COVER ***-Y..****-**
:. - _ yrs REQUIRED x'JF.1 .Y*9r f¢*k`?i
:.1.•..,r. .... ..:.J.:.r-. ,..- . .i };Ji•:..... - -.r Ji'Y'Ji'Jj:t±i THANK you 1!-7 J!'Jt.: '':!t Ji.s,1:'*:tj.*J{.:_.JF'r: :j.: ::(.: :±.';.:
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SPECIAL CONDITION CIICK-LIST
Project y .`� •.�'
Address: ` Project# • y u
se:
Dept: Date: Condition: !nit: 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
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: