1991, 12-18 Permit: 91007140 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= 91007140 ISSUED PERMIT M DATE= .1 /10/"r }lyE.= 01
q(..:ef i$!!-ti'i........................................ .FE EERmIT INEORmATION ')i-iui:7l•i!i�gt-:e•ii'c!i-)t•)e'iu•*ti-?!-7 -Pi iur i!C-'1+'It t+t 1:.j._.;._.(.*.ei..y.
SITE ,STREET= '± ._.2 3- 7TH f t'a::. . `;±•_•'I',E:. ...:;,:L.%: .......... 4 I R.j c.{'7•"r
ADDRESS= SPOKANE WA 99-z216
PERMIT USE=
•t = SEWER CCNiECTICt . % _ I903
*** SEE NOTE
*3X -.
PLATt=
001050 PLAT"" its(-tM,:.:::: GRAY iST
ADD
Bi...;.;E":P:'-_ LOT= 13 ZONE= f`'1i.YI;T ±:i 1 ;"O::..
AREA=A 00000000 I /A • F WIDTH=tjTH:::: 1)1:I• -i•i•-±= R/ :.i::. 50
4 OF BLDGS= 0 DWEIIINGS= 1 WATER DIET ....
STREET= 13323 E 7TH AVE
CONTACT
S < :AL " NAME= T L- RIGHT=PHONE
: ONE v w tER
0327 6760
BUILDING : trf - : , - FRONT= � f ± _ _j - �> ,i ' REAR= N"
7 .t P4J9 k k l7 PaP ? M1 P3 ; ; 7 :.,k. ?t ? ?*P4SEWER :ER: I_ :0-.-:k************* **************
CONTRACTOR= TLC CONSTRUCTION PHONE= 509 927 6760
STREET= 1 = €316 I i :?TI'•i AVE::
ADDRESS= SPOK f'7N'" WA 99216
DESCR1PHON QUANTITY± ,..,.. AMOUNT
PROCESSING_ `•(: E::E. :r: 10 ,00
:O
SEWER CONNECTION ! 40 ,00
,••t.t::,:F N».
**********************K******** �•f•i'f±"I t:.I'`7 I� «,: t..� ;•,..,.::
1.;±'1 •.z, f ****************K***********
PAYMENT Y'±ME.NT D7A ! E S I:,t..:±::.'F PT ., PAYMENT f•i±"lltIN .
12/18/9i `:>''. ... ... 50 .00
TN OTAL DUE:::: .00 TOTAL± Ai... PFA.i.f,::::: 50.00
PERMIT TYPE t-I:,E: AMOUNT AMOUNT PAIDAMOUNT OWING
SEWER PERMIT a 50.0 i 50. 00 ..iii'}
50,G0 50.00 . 00
PROCESSED::I::.D B'i : jULIE SI•IA i I_!
PRINTED F. D BY . DONITF Ois IisH, ROBIN
SEWER 'STUB AS—BUILT INFORMATION .i.:". A'd.r•'i"_.i...!-`±''i...i::. AT THE COUNTY
UTILITIES DEPARTMENT (456-3604 )
CONTRACTOR OR APPLICANT ,...« .,._. -,
.±.�: 'I +..! FIELD LOCATE A iw[i C::I.3 r'a:..�:i`t i•'± I ±•'i I::.
ELEVATION f ? : POSITION Or SEWER S ± tB PRIOR i ±..i r: N'r OTHER
EXCAVATION
TO LOt..:AIE:. BURIED CABLESi PIPING , WATER LINES, ECT,
CALL BEFORE YOU DIG 8
SEWER STUBS l B,:t• ARE TO BE:. CHECKED PRIOR TOi fNf Ei' _.f O y i i.! INSURE
THAT t I 1 HI::.T ARE CLEAR AND UNOBSTRUCTED ± i. THE SEWER MAIN
.7k 9k•7t 9k•1?•li•j?.•7,:y?..•O i•'±±...I-.. ±..:O 3"•: .t.±•'t:k±'t t':.i..•-I 1.r{1 y PRIOR 'TO COVER 'A•N:�+.••p:•P:h/Y•7k�?•ik
'H:1?•9k??'7.•9!:Y::4•.7!: 24 HOUR
t~i~i I"; t ±., ±._.i:» REQUIRED *** )i •t is*9:.
:!?•:+:•7k'P:9t•ik-N:•7+:•1?• 456-3604 ;'+:•7t 9+:i,:;+:•A:•A:9i ii•i+:
.......... iii: .........::.:a•t::.:.. _ :,:a{.a(.a(.:f.:,i.: .a.::.q..q:.a;.aa*-!.aaa:.*at.a*asi+i•a a?i-a*!i•i!!ii!!i
:n:it 9t•Y?';,?-;,,;•7r•9r}�:r-1t•t!.7•.}..9!t!F.':+i:+i•9!i iri:+7 J!r i}i)!r:St !r:y..jy.:7�..ji..,:. THANK you 1.......7...7,::,.............i. 7?.. .... ......::
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
__'
Dept.of Bldg
spnciu| |nsp.Final Report
_-
Hydrant( )
Lock Box
-----
Engineer's
_snginaora R|D/CRP
Easements
Road Plans/Improvements
Bonds
•
planning _- _- Bonds
--' --
Utilities _ Double Plumbing
ULID
Other
-- -
`~~`~~~~`'^^~^~`~^~~~^^THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY ONLY````'^^~~~~^~~~~`~~``^
Date received for C/O procesiog: Plans pulled for final procesing:
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: