1991, 06-25 Permit App: 91003550 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= %'i 00, ...,..y,::j :t E.:{..:E 'i i::, i'i,It i`• i'ir•`t"i i-'.... i''i;•y:' PAGE= 01
:,,.:?'.P.-*lk it THIS I . N ! ; {•t PERMIT !i.:,,;.jl:.**!,.
PENALTIES L2.:LUM RE ;•'1,•:.'.•E:'.``'`E::..+J FOR COMMENCING WORK WITHOUT HI..iI.iT t::=EE''•'M.i. .
EITE STREET= 12700 F -16TH AVE PARCEL4= 27542-0441
(+Ii,t[JE'CI::.,`::;'= SPOKANE !$/' 99216
PERMIT USE= EEWER CONNECTION - 0001
.„..1,..J,. S..E NOTE t.. .1?•'r:J!.
....e'i I -n'-' 001042 PLAT NAME= OPPORTUNITY TERRACE
00000000 F- t.}:::: 1.. WIDTH- DEPTH=
. OF S t ;` c : _ tt F t , _ . WATER ) t Gi .
E::'
.f fTil AVE
ADDRESS= ,.. . +...iK AN-. !,IA 99216
CONTACT J . DONNA 111 I ! E2 EPHONE NUMBER= ?r9 924 -
4 5
BUILDING Ii ; c FRONT= , A LEFT= NA REG} : . NA REAR= NA
* j ( ( ( { { { ** ( {nn : {n : h P **3P : i { SEWER
• :R pEYb , i Pi1tj **3P3pip (.,c.�,..::. {iA :PylPA
CONTRACTOR= t.:t..!E„t E•tt..:HI,;. t IJ, CONSTRUCTION PHONE= 509 924 5405
STREET= 16402 E VALLEYWAY
ADDRESS= /E::.I'=•:r=E?..`•'f t i...E WA 99037
ITEM !.+;::.::.-:c::F;.i.!.: IION QUANTITY
I...,.:T i••i.•E-. AMOUNT
E..N
PROCESSING FEE 10, 00
SEWER CONNECTION 40 ,00
PERMIT T? ; E E - AMOUNT
M i _ f •tt ' PAID AMOUNT i,itaii.NL,
SEWER PERMIT 50,00 „00 50 00
50 ,00 ,00 50 ,00
PRINTED BY :: •...i..JLIE :...... :
SEWER ,..,Tt EB AS-BUILT INFORMATION E. : AVAILABLE ('•rt THE I" _O1_tNT.{_
t t , .I.L t t t i::.:: DEPARTMENT (45,':::- ,:.i'.: 4 )
CONTRACTOR 1„!E•,,. APPLICANT IS TO FIELD t...00A t EAND CONFIRM THE
ELEVATION AND PE..t.::.i. ! .I.E..!N E..!}' EE::.WE::.R _.:".T i_I .: PRIOR TO ANY OTHER
EXCAVATION
` i..! LOCATE I::. BUR .c:D CABLES , GAE PIPING, WATER E.F'•: E....E.NES` ECT ,
:
CALL I BP:Ft IP`'E YOU DIG ( 456-8000)
SEWER Y ?.11r S ARE E E , BE E H -•I•'-.1 D PRIOR TO CONNECTION OINSURE
THAT t H:._ ! ARF E.:}...Fi.:E;,. AND HNn : ; t.;t.: t E::,t) •j•O '1 HE: `:`EWER MAIN
CALL F i.:i`r'.' INSPECTION PRIOR ! t.! COVER *a:•j4•i4 ai*:u..,,,i,..i;.
.J,..,,.r,;._,,..,:.:,;'fir•n•yr 24 HOUR NOTICE t'C?;:.f aE..!.1.t'{:..._1 is 1.. t;..J,;
.i,. 456-3604 'Pi.pr:Jj..1t-•;,i,•'itr-P.'iq;'!i:'P:
.......................::........•. :::•. ::{.::. THANK :f:{.:,::{.'{-.j.:j..{.:,i.:j.:..'...:}':��'P'.%?•:,?•Y '!':ii':_!:?:'7'•)1')k M':,i: :,;.:J,..,{..i,.
}?.t?•'J`...J?-t?.9?.je;:n..p.�,._,?L.:�?•97'1t•P.:-.:.A J? ?'9k Jti ji•:,{•itFr•)F 3�r'ii''R!.J-. '{E.S t„t 1.1.:?!.i.1.1.i...J.
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: |nu: Appr:
(in) (out)
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Dept.of Bldgs. ! !
Special InspFinal Report
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Hydrant( )
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Engineer's • RID/CRP
Easements
Road Plans/Improvements '` �� �` `�
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Bonds
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Planning_nning_ ' __ -_ , ~ '
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Utilities DuubloPlumting
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^`^~'~~~~`'^``~~```~~.°^`^^THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OpOCCUPANCY ONLv`~~^