1991, 05-02 Permit: 91001827 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
t-=•`.O•E : N iMB ! 1 00 i r i.. ISSUED PERMIT DATE= 05/02/91 PAGE= 0 1
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.?. i I::. :.i I PtE { ,... 614 S itii..it..7+iR:.){"'t.. RD .'.f•ii'=..C........ •' 20542-1403"
ADDRESS= I ::l A '.... Wi"i 99206
PERMIT? f itt'I::.= SEWER CONNECTION I I...
):'** SEE NOTE I i,-, :..t*
PLAT4= 002208 PLAT Nt•}•,- I•'•.I::...f.T.f i•. ;2 J:t
AREA= 00000000 i-/A= r
'?!', OF L!?...A?is:.: d' DWELLINGS= WATER DIST
OWN to N f"i::::: :. A"%:.:•lt I:j; A t...!...:"} PHONE=
STREET= 614
ADDRESS= SPOKANE WA 99206
CONTACT NAME= TOM STONE PHONE NUMBER= 509 928 7710
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jfT r _ ... l = TOM STONE EXCAVATING PHONE= ? ? : 92 :3
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STREET= 1112 N HAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
FHOULSSINu FEL 10,00
SEWER CONNECTION 'I .. .,
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05/02/91 2505 50.00
PERMIT TYPE _: ? AMOUNT AMOUNT PAID AMOUNT OWING
SEWER :=i 1 ' a so
00 50
00 00
PROCESSED B'f : JULIE ; 1c.......I I .:
PRINTED BY : jULTE SHATTO
SEWER : : _ AS—BUILT INFORMATION 1 . AVAILABLE
AT
. "iCOUNTY
UTILITIES i.1 I::.1:A I t: i M E N.{
:. ,. TO FIELD LOCATE AND t..,t: NFJ,RM •'•(1":
ELEVATION f t i``!1.•'• POSITION t.?�' SEWER ,. : 1..... PRIOR t t.. ANY'; O { {••It••R
EXCAVATION
TO LOCATE BURIED CABLES, G(-}::S PIPING, iA A..i."•it LINES, ECT ,
CALL BEFORE YOU ? (456-8000)
SEWER BE STUBS ARE TO ..t. ;.{'. .N..`.j PRIOR ..t CONNECTION ..t
THAT { I•t r- i !--?±.{::. CLEAR I-•?I'd f_i UNOBSTRUCTED !�t•i ^?i SSEWER MAIN INSURE
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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/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:
I