1991, 11-01 Permit: 91005672 Seer 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
PCL . _ . NUMBER=_ . r ! � . i2I : r t ' ? PERMIT DATE= it ` tt , PAGE= !:}'?
:(.:,j.:,::;.:i.:,i.]:.:i.:j..li.:+;.:+r..j!:.j.'j..ii.:i.:,i..ii.:,i.yi.:, :i.:i.:i.:ij.:,j.:i. - 'j i
}.,..t F.S.:...?.t.........:.i.:.t.....:.....1./.t...:.f. €_>.,.: , a?..O^ ..f-.! t i N !!..j,.:}:.)t }'F!i i};.*:;..}i.**;!f.:}:._y.,y:.p•_!t•:!:.*i}Y i!G.1;.***:?(.
, ,.. STREET= .:.1 0 E 9TH AVE i.:Ai";l 1~E 'u:= 22944-1042
ADDRESS= SPOKANE WA 99216
PERMIT USE= ':' W#...R CONNECTION .... I t:1 r.:.i_.:i'{. ..,.
PLATO= 0..,:'404 PLAT NAME= :I i'%t i":j R ' ADD D i i; �,d i I D W ftx!% j PARK
LOT= ZONE= z:-a .
AREA= 00000000 i.• A::. t' WIDTH= DEPTH= ...•€,Ai::• ...!:.t
,
WATER DIET =
OWNER= Rt, t € ,v.'•.??r,} PHONE=
AVE
!•'i D.i i I i:1::. l E:::: SPOKANE t::i f"€ 99216
CONTACT NAME= LEONARD PHONE NUMBER= !::>':.•:'1 s'....... ... .
BUILDING :aE ':• :t(^Y K. FRONT== NfA€ LEFT= ti;:; RIGHT= NA REAR= NA
? : : / ) : i :iij} . ; {} : ;. : j (y ; ( (*: SEWER 'yY" ! # ij ;9 : i : j : j :ijij: : k j ; : ji : li ; jj
CONTRACTOR=
-N rfr ^ vR= H CONSTRUCTION .. .._.. 909
_
... .f...e.i,.i' SPOKANE.. ... 99206
ITEM ...!.. • ..:€'4.#. . .N QUANTITY !'E E AMOUNT
•
PHuUESSIN6 FEL 10,.00
40.00
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t. ,. "`{. 't ,!t...:'�? ? )t_t# "#::•`;#•+`y ",.!+._!,;.:,;.:!+:*:r:'i!:'R:'j+: +::!!;:}!;.N..ji•.j,.1,,•;!!;;{.*.j,.:J,..:t;e,;*;,: +:'j+:
PAYMENT !1A # E €'`•.t':.t.:€::. L Y: . ,• PAYMENT AMOUNT
•I ? • .. . .'`>'1 8264 50,00
TOTAL A/UE:.. ' ..!,.}%. TOTAL PA.t.... "• 50,00
PERMIT € Y?"E #...::.1::. AMOUNT AMOUNT ?"f'?Id 1 AMOUNT OWING
.....:.�r.:_:.t"•. I I::.:..RMIT
!:.50.00 150.00 . 00
50.00 50,00 .00
PROCESSED BY : jULIE SHATTO
PRINTED ... ..ii..i;..._.L':. SHATTO
!.i
: # ; , ; STUB A . U I, d INFORMATION + : it M AT
THE COUNTY
CONTRACTOR
N_ r . T •, tR APPLICANT
rPL :fN 1 _ _ FIELD
LOCATE
AND CONFIRM _
iE
ELEVATION f ?i }a € # . Ov OF EWER STUB PRIOR
TO ANY OTHER
HER
EXCAVATION
TO LOCATE BURIED i..:fa t.s i...t::.::i _r t•?E PIPING, WATER LINES, ECT.
CALL BEFORE Yf.i:€ i,? #,i.. 0456-8000)
E#::.€ €"tom: STUBS ARE TO BE CHECKE
D PRIOR #,; CONNECTION INSURE
THAT A THEY 1:Y f"#t';E CLEAR AND D t-,i#'l3 O B S # +.;i.;•{ #::.i-t .+..._i •# i'-E_ SEWER €A I
7t:'jj;•}!:•x..'r;**h:•* CALL F O �' I;J_ ;-I::.t.: I .t,i N 2 '•i•#_.,...COVER i+:m}.j,;.ri..n;.j,.p;..u;.};.:t;.
**:!!:tt!r:+t:,,,_,t.3,. 24 HOUR NOTICE REQUIRED }t f;.*.};•i !:;w 3i};..},.
'?!:T:i!{•'Pi"Ri +i 'i'}('}{' 456-3604 •j,t'*:++i•Pi-A•-tt•'P:'R••11•A:
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