1991, 11-27 Permit: 91006553 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
1W. 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=
:itBC"R 94 ^,0:`„..5_., 'ISSUED PERMIT DATE= 11 /27/91 PAGE=
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SITE STREET=t13323 3::. 14TH {�?,�!::. .�'t:'{��t::'....,}...:. 22544-2144
F�#£fi.r#?ESe. SPOKANE WA 99216
PERMIT U SE'' SEWER CONNECTION "-• WI..)E...Fh:Ri::.:i,i.
:tt•4L•4t- :.;E::.F NOTE 7 i}:•1}:
PLATO= 002753 PLAT NAME= VERA
BLOCK=
AREA= 0000::::000 f:'f,..j= t.. WIDTH= 129 DEPTH= 145 R/W= s+F,r
-}r OE`.• ?:±!...I?lr,::.... '# :N. t_7 tr,?!».!...i...I N 4s,`:•.... :# WATER 'DIST
OWNER= } A!'tEi.y�•?#...#._; ROBERT �'. ..... ..... _. 1°7) :yr. .._ 9004
STREET= 13323 t.� 1 4TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT
ra, ; ,- NAME= : O Ni .O ( PHONE
" " i NUMBER=
iMiE .
509
. y 922
_ . 8500 y i
BUILDING : E s{ : : . • FRONT= ( A LEFT=. iA RIGHT=- 4A REAR= Nr
..... j : . jtjAi :... i. ;. j0Rjt1SEWER ; } # 4Pa* jjptP *P: n *Pca .* R ; ii
5
CONTRACTOR= - iaYSACTIVE
ACT. „E rtJ E,:: 909 922 ...... :{.
STREET= PO BOX s 141562
ADDRESS=}'= SPOKANE. WA 9216
ITEM DESCRIPTION QUANTITY FEE AMOUNT ,
PROCESSING t-1::.!T. 1 ?';, t'0
SE"W#: ; CONNECT IO 40.00
r ;
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3 F{-?•Y':,EN ! ltA # #::. ;:t••i..:'.. '"(.:j-T PAYMENT AMOUNT
11 /27/91 ; ; ' ra � .».
n L:j 4:7
4 TOTAL DUE= .00 TOTAL PAID= , N0,00
PERMIT} v!I I i '{P:::. FEE AMOUNT AMOUNT :-,At.,. AM,:UN , OWING
50,00 50,00 , 00
PROCESSED BY : JULIE ' HA :•t
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PRINTEDBY : Dfif"!% t'i t:iti IC:H; ROBIN
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UTILITIES E:;EF`AE Ti Ei T ( 4%6-7604)
1 CONTRACTOR OR APPLICANT IS TO FIELD ELEVATION ` y rPOSITION DE SEWER STUB LOCATE.}.��R T F`±N O T i--!i:R
�) EXCAVATION
tX Chti A I Ii N
TO LOCATE BURIED _ rli { GAS PIPING , WATER L
. .. . I E: ,
ECT .
.
CALL BEFORE YOU DIG
(456-8000)
..:•, ,•
a SEWER I t•??;S ARE E TO :t E:. CHECKED PRIOR d.O R _f';-) CONNECTION TO INSURE
THAT
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t ARE}tL::. i..:E._Y.:.{-t E: iAND E`t I,)�aE�)�.t :� i•t i i(;}} (1 t ! }#. SEWER#-i•i 1't{i} t
•r:i{.i:P:N:i.) al 4., CALL I r i Ei INSPECTION PRIOR ! i.I COVER •.n.••Rik i{..P:•i}:R-A:A••P:
i R4n ;; 9 p p , : h HOUR
Uv1OTrtE REQUIRED f{•9{•?`***•i *:n*
3
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SPECIAL CONDITION CHECKLIST
Project
Address: T 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: --__—