1991, 03-18 Permit App: 91001148 Sewer 1
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 " _R 91001148 APPLICATION T 03/i o% i PAGE= Ti'f
3!.jt..ii.aaa THIS NOT A PERMIT t *as ji.**
PENALTIES WILL :tASSESSED COMMENCING $:R< WITHOUT " PERMIT
SITE STREET= 12507 E: 16TH f•i tT E: F';:1 F!:t.:t::.1...„i..... ........::>s S,'!....1 4 1 ..
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — 8801
.i,;ji' ' S F::F:: NOTE :.ji•ji .
L..A T:E;:= 001345 PLAT NAME=:: jt.?l" ..Y .:.Nr.. ADD
BLOCK= I LOT=. 12 ZONE= t::j 4.Y,:i U B D:,,,, t :i,::::: t..
AREA= 00000000 P'/A= F WIDTH= DEPTH= R/W= 6
•„• OF r: !LY::i.... 'l .4. DWELLINGS= i WATER DIST =
i-_:AWN'•.t::.i::::: t..Yt... ..1.?t.?rii::. REALTY PHONE=
7 E i6TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LARRY COOK PHONE NUMBER= 509 466 2128
BUILDING SETBACKS :: i-t•,,oN E :::: NA LEFT=::: NA RIGHT= NA REAR= NA
-n:-i+:-,i..i,;.;i..,i..ii..;i..i,••!,:}i.:p.:,:..i;.i,:•i{•fir:ni*•n:•!,:•p:.i,..;;,.p.•!!•.n•ft:•!i SEWER PERMIT :F:*-!r-n:•!+::+:f!-•!r-n:•n:-n.•x*.i;.*.i,;•i,;),i•ik>i•ii•'ii*)k*)t•*•i+:•i+i:n:
CONTRACTOR= LARRY COOK OK I::.Y}..AVA I .t.t'•t'ta PHONE= 50 466 6 ,.- 18s.;
STREET= ,''-}::'.'•:? ,+# „#!,1t lral'`i' ::.ti RD
ADDRESS= NINE MILE i AH...I...S WA 9902A
ITEM DESCRIPTION QUANTITY F:F::F:: AMOUNT
PRO
MOUN'T
t
10,00
SI::.WE•.R CONNECTION 1 40j-10
......_.....-
PERMIT T .T..'[ PE I-EE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 .00 '';+<i . ii•; I
.:%i+;:! 50:.041
PROCESSED t/ :oY • ..!!.11...Ii::. S(-At ti.J
PRINTED BY : JULIE SHATTO
,:`..1::.Lc:i::.Ft ;. t I,;t: AS—BUILT INFORMATION I AVAILABLE I I I �.i..I I COUNTY
i.! [ :i:I...I t .I.t::.,:; ?_!i::.t''A P[: i M I::.N f (456-3604)
CONTRACTOR OR APPLICANT i .I.::: TO FIELD LOCATE AND CONFIRM THE—
ELEVATION $ e POSITION t ! SEWER”P , iPRIOR 1rN i OTHER
. .
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT .
CALL BEFORE • t r• DIG (456-8000)
SEWER W R , t U B S ARE E t O BE t".I..I::C E i'i PRIOR TO CONNECTION 'MAIN
f f'1 !'•1.�"4.R
THAT A r 1 H E Y ARE t' E ?.,t...I::.1"R (^N i% t.i t`OBE 4•i r,C i I::.._� t r_1 THE t E ,:3 E [:.? !j.i A I t`'-:
CALL FOR+!'t > f..}..: t .t.i..i j•y PRIOR TO COVER •h:-ii'r-n:3,:•n:-ar-: ! •! 'x•
*a * 24 HOUR J7rIC` REQUIRED if•*ii•*ii•'r•:•ii•i;•.i;.t;.
1'$r:+i•i+i;u;;i••j •hi* 456....,: t().tl .p.:p'..i+..1,...p..i:..j,..i,:.P.:;F.
K*************** *************** .. ..:i i................. ..........:......
.!,. THANK E f��#P'•J � '' t,�,t;.,t '!!•!.!?•:i!•i!•9?•:R•i!-9!•9!-9?-'R-3!•9i'9'i iMi'i;al�N-•iY 3:9r ik�!t 9t gt at..t..�?•r•*;te•*
Y'a
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
•
•
•
•
•
********************* *.**THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY** ***************************
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: