1991, 03-26 Permit App: 91001305 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
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and correct, and authorize Spokane County to m000u 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= 9i00i305 APPLICATION DAE= 03/26/91 PAG Oi
****** THIS I% NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
------------------------------------------------------
----------------------
SITE STREET= 12506 E 16TH AVE PARCEL4= 27542-O6O8 �, `
ADDRE%%= SPOKANE WA 99206 -�
PERMITUSE= SEWER CONNECTION - 8801
*** SEE NOTE *** -
• PLATO= 001841 PLAT NAME= OPPORTUNITY TERRACE
BLOCK= 2 LOT= 3 ZONE= AG%UB DI%T4=
AREA= F/A= F WIDTH= DEPTH= R/W= 60
4OF BLDG%= 4 DWELLINGS= i WATER DIST
OWNER= MITCHUM, QUINTON & CAROL PHONE=
STREET- 12506 E 161H AVE
ADRES%= SPOKANE WA 99206
CONTACT NAME= RON %LAN PHONE NUMBER= 509 922 8500
BUILDING SETBACKS : FRONT-
T= NA LEFT= NA RIGHT= NA REAR= HA
***************************** %EWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 5O9 922 850O
STREET- PO BOX 141562
ADDRESS= SPOKANE WA 99214
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- --------
PROCE%%ING FEE Y 10 .00
.%EWER CONNECTION i 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SE:1.4ER PERMIT PERMIT 50. 00 .00 50.00
------------- ------------ -------------
5O.00 .00 50.00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
;5:EWER STUB. A%-BUILT INFORAI
TION ' AVAILABLE AE COUNTY
UTILITIES EPARTMENT (456-3604 )
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLE%, GAS PIPING, WATER LINES, ECT.,
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 - HOUR NOTICE REQUTRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
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
""" """'""'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: