1990, 07-03 Permit App: 90003103 Sewer 4 r
i
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W.1303 BROADWAY-AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/applicat on,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 Nith 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= <:i,••...'. ..,• ,,...
PAGE= 01
APPLICATION
jji.} jj ) N tJ ) kj :}L t ! t.g: : . # k** APPLICATION
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j.:?t}J.?;.;E,. , - SPOKANE WA 99206
PERMIT USE= SEWER! CONNECTION .... 00
1 a* SEE L' N O T E •tt•*1!•'
002962
.a LOT= .. :"O r I: ::::
i»}int!:?l?:1t (:} �=/`tic: t• WIDTH= .... i)1.....t.. , ...1— R/W= 50
,:. :
_ OWNER= #..I'=•.�a,•, � , is}t i' i` PHONE=
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ADDRESE= SPOKANE WA 99206
CONTACT tArE_ DONNA :Ot :ti A iEPHONE ' Ur ?_ :: 509 v'':%r.'$ 5405
BUILDING :.F ? B A i I' : FRONT= ..I:• ... N Pi ';{,IGHT= NA REAR- NA i::.
.......... .... .......... ................. :•,i..., F'... a.i..i' :h::,:: •::::.:.:::f:.:::'.:'.i,:::. ::::::::::.jj.::: J::,j.:j.:j..i,:.i',
�r x sr K:��r:++:•it�•tt�•!}:N:t+:�n:x•.�:st•;t�x::+:•i}:v:s►�}}:•?�:•?+i i+i:�i•?i•h::i}: s i:.?;si i::.i�: i'�::.���`C,.}. �} :.a.t+.�+.n a n n, r n tt n...n. �}.u at n>•...>s. a:.,�...t.t.:.�.
• CONTRACTOR= f.:i_JURy.••}Yf•?.i.eJi:. CONSTRUCTION PHONE- 509 :3,n.4 5405
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STREET—:.. •1 i .: :I n: i:' it(-f E...#...?::. (?xi¢.} 1
,ATALE WA :
•
ITEM EE"I DI::.,:y t.:i':.t i ! ON QUANTITY FEE AMOUNT
.'1::.t4i:.E°. !.?..J?`•iN?::I.: i .i.ti?',? .I 4i'':.00
PERMIT TYPE F i::E AMOUNT i i'i vjl_I{,nn PAID f:IMO ViN NT OWING
,:�'L W I E E k i•!.1. i ... .. ..ei%t'1 .. •:?'•:.? 50.,00
•
50,00 AO}'? 50.:00
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PROCESSED BY :. .............1::. j:,i-i.., } :
PRINTED BY : jULIE ,SHATTO
:::}::.id,i::.?r ,.'s i.:J:G Az •i'{?.? i INFORMATION .I.,.: AVAILABLE ¢i . THE COUNTY
:i
UTILIIIEE
MENT (456-3604)
CONTRACTOR OR APPLICANT IE TO FIELD LOCATE A I'd aJ CONFIRM THE
?",
ELEVATION ( d POSITION t ' SEWER � ITO ANY, is ; :?
EXCAVATION
TO? • E.. :u R I -i•? CABLES , r:: .}.} .I.N i., WATER LINES, ECT ,.
-..:i..}}...... :...::..a.-=..:!',C:. 100 DIG (456-8000)
i INSURE
THAT # 13 E:. PRE,i:. t.:I...I::.i•ii•': I"i t?J.: UNOBSTRUCTED TO} } i t.�. .. ?..i.1E i'; MAIN
**—:p:-i+iit•i¢'ttY* 24 HOUR NitI .I.#..:?::. ?':!::.=.r :.:
3(4,:.j(.p}•?,i:ti•v}:•.?}i ii� 456-3604 :.;..,r..;r.:::.:::.:::... .. ....
n*? xii•i ii *? } i i : ii s E i}�: ::•:1:: v*»i}:itinTHANK , i
rs ) ^ *i ;iix a r *: : t9t : 1 9tt J9949t
JOB ADDRESS: C < 0-?6,3 /�/1-11 CJS
SUBDIVISION: 0 s4 LOT: BLOCK:
OWNER: r_.--"1_0( PA k f��l-- /L P PHONE:
ADDRESS:
CONTRACTOR: �.-� �J`�Q C_
-!/lQ PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: