1991, 12-18 Permit: 91005755 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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER- 91005755 ISSUED PERMIT DATE— 12/18/91 PAGE= O j
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SITE STREET= -13223 E 6TH AVE PARCELO= 22541 -0426
ADDRESS:- SPOKANE IdA 9920.6
PERMIT ._:'* 1..:::: ::. W •t? CONNECTION in ID L3,^
c ? y- , _ 001808 PlATNAME=
vH"i cN `; ! SUB,
BLOCK
LOT- ZONE- AGRI DIST4
'tr OF B?...rixE::.. t. ': DWELLINGS= I WATER DIST T ....
OWNER= SEVERANCE ' PHONE=
• EtREE
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ADDRE ;; .. SPOKANE WA 99206
CONTACT NAME= TLC PHONE NUMBER=
I• 509
BUILDING SETBACKS : FRONT= NA'? LEFT= NA•! RIGHT=H ... +,tA REAR= �Jr•:,
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I••t•i r' i!=i?ti 7ti i#!:•}t:•3?••;i:'Pi i1i i#!r 7ti 3,r:N..}ti.yti 3ti 3G.P.iyi.N..11r.yr-1+r**3ti*1i- !;}!;
CONTRACTOR- TLC CONSTRUCTION PHONE=.t.-!Nr::::: 50? `?'::.. . 6760
E 12TH AVE
At:ODE:`.E;: ,.. •' SlP`OKANE WA 99z16
ITEM D::.S .:R.I.f` ? .#.t!N QUANTITY FEE AMOUNT
PROCESSING I::'l:: :
10, 00
SEWER!:`. ! l !'YI'll.`t: TION 140,00
f`I
***************k*************** - ( f ' : NSUMMARY ; r ;: jr3iq: A ; ;: ; ;: ; y1: jj* lns
'AY f ! DATE REEFI : + r PAYMENT hM: : ,
12/10/91 5 50,00
o
PERMIT TYPE i E A EE AMOUNT AMOUNT PAID I'3 -i?",t,!._!Nu ? OWING
---
SEWER i::'t..R1If 50.00 50,00 ,t'3i 3
50,00 50,,00 .00
PROCESSED ;:S Y : ,.!U t....t.!`. :t••?t..l ! t t-,
PRINTED {:i•Y• • .l i O}vi I TR C)4.l.i"::f l, ROBIN
,::EWER STUB t...lB AS.....BU.TLT INFORMATION IS AVAILABLE E AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THEi::.?...C:.V f•7 t .?.tJ?'$ t'rt?v i.? POSITION SEWER ,.r PRIOR TO t�i 1`'Y OTHER
EXCAtiA (•ION .
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT,
C::Ai._L. BEFORE:ARE. .=U DIG (456-8000)
SEWER STUBS h•t't: .. TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT ; rY rR! CLEAR `N i UNOBSTRUCTED TO THE SEWER u - • " `
,
•ii•i!:;!:h !:Y+:•ii:1;• : CALL 'O R .INSPECTION PRIOR ? O COVER x 'fie•'P:***r:•it•ii'
***)1'*9i•9 •f•:i!' 14 HOUR NOTICE REQUIRED **j:.*7t'1t':ty.•y.i.....
Tilt Tri•Pi?+i•i t:*t'j••?•M!• - 4 56 �fii 04 *****K****
? 3 a : s *stl * r r ixri rr "} a .. 3 **a 3THANK , .„
****************************K ***
SPECIAL CONDITION CHECKLIST
Project
Address: __ # Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs
Special |nap Final
-- -- | -- �
_— Hydrant( )
Lock Box
_
Engineer's
— ' --|
— |
-- | —' --'
) --
snQ/naerm � � / RID/CRP
Easements
RouUPianaxmpmvemenm
' .
— —_
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 afteC/O issuance:
Owner/contractor called regarding the return of plans _ Date:
Plans returned: __ Received by: _____-_' ________
No response from owner/contractor-plans destroyed: _— ___----- -----' --- ----
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