1991, 04-30 Permit App: 91002135 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::: APPLICATION I')ATE::: 04/30/91
':.L,:r IS NOT APERMIT **iE::i?is
PENALTIES WIL L BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE . TreT_ t V 7h I19TH A ;E - -r ( rE : : 28542-4406
ADDRESS=.. SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION NOIR° i I-1 KI..:OK0
•)a)r fa S E i:: NOTE:. ;,i..)F)i•
F'L AT e-= 002393 PLAT NAME= '-I':''r''t:i:E:: + ACRES S 'i -I ADD
)K i._Ot«•��-:. i} LOT= {:+ ZONE= A tr.\'t.1 ht s.+I..+ a .,+.....
AREA= ';?kJtJt.:rt_i000Y F fi;_ F WIDTH= DEPTH= R/W=
;;.alis:.:.... - :r. S?V,Il::.I...L...i.i'd!x::•:_: 'I W Pi TEF DIST ....
fER:::: WOOD :'r l±:)N E::
t-:t::.E:.I ::.. 10704 E: i t%TH
ADDRESS= SPOKANE WA 99206
CONTACT NAME= RON SLOAN PHONE NUMBER.:: 509 922 8500
************#**************** : _ W: R PERMIT it** i t*i *H * Y] iA1 APAqPiP3it 1AT
t
CONTRACTOR= ALWAYS
-4AT ) f ,T . vE PHONE= :0 i 9: 2 fC
o
STREET= BOX 14-1562
ADDRESS- SPOKANE WA 99214
•
T - iM ' l—, : i1FTt " a QUANTITY FEE
AMOUNT if7vy
PROCESSING FEE • r' 10,00
SEWER CONNECTION `i 40«00
PERMIT TYPE ; ErAMOUNT AMOUNT Fr ! ? AMOUNT " ; IN:SEWER PERMIT 50,00 ,00 50,,00
50,00 ,00 50 , 00
PROCESSED BY : ,.i?.ic...Ft::. \t,A=`t t T :I
PRINTED DY!:! JULIE SI••IA i�i O
SEWER I•t C:l.. t!.
,_ f ., AS—BUILT INFORMATION IE AVAILABLE AT THE tE C':OUivTT
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR+.
f "P
. C A N Ii FIELD LOCATE AND CONFIRM THE
FL ' 1 « iIO AND POSITION OrSEWER STUB PRIOR O ANY OTHER
• EXCAVATION
TO LOCATE„:. 1BURIED CABLES, GAS PIPING, WATER I...INES BEFORECALL YOU DIG is. 56__8{.;0 �:_. : ECT.
::i...:.T.
:.
CALL
SEWER STUBS FH t",.::. TO. BE CHECKED PRIOR t..l CONNECTION i•{..i INSURE
THAT THEY ARE CLEAR AND
* *it••k*•n.•,..:4•'x COVER T i,; I t .
CALL L I••t..I't I,f4.]F•E:._: + i {,i�,r PRIOR t f x•x•ii ii'it•u•yi••a:N.;•u'
i(•****** !7t d HOUR tt`:( tE.- r w REQUIRED
._,«Ei_ :-i ;, aEii•)iifi+:•iE)eiE)[ii•
'N:>t•:*'F.'*:u*}{•k• 456-3604 •)i at••ii ii i':N:3;..u.x..h
t*.;..:u;**:*:,t.y:.:,:..,,•..,:....,r..,,.p:::,.. :) ,*:_+:..y,.....i++i....i„:_,,.i. . THANK c:t u 9t. .'x'al.**is}{')k}k•)t•*******tt J:..y..jf.:t *'.:.
SPECIAL CONDITION CHECKLIST
Project
Address: _ 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 y_ _
"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: ___________