1991, 12-18 Permit: 91006074 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
', ,.?,.t t"'..: , NUMBER= ''!0 6 0 . ISSUED PERMIT DATE= , ..../18/91 I''!?1;,E-_ 01
*,!!•*JF_N•*1i• `f** i•'tt:fl.•)":!':N. .yy:_!j.****.i._t_.)f•.il.:1j. PERMIT INFORMATION *;!!:*;!r:!r 9!:7l jf-:t>•*7i•? •!ti**j*;n;•it*•1`•+t•:ej J'r):•) **!•
SITE sTpErj. .13125 E.. 'I t E'i AVE Y`A t• 1,...._......-.. 22544-2364
,t•' tY1 { SPOKANE i A : : :
•
PERMIT USE= f:l::.?+•;t::.t': CONNECTION - wtil...i'CRSS i
3"3 3 SEE NOTE x'**
Lln_ 002753 ? FT
NAME= 4'i::.t":{••!
BLOCK= LOT= ZONE= '•T t•^ az•p e,^-.e..... „..
AREA= 00000000(tai F:•,:A F WIDTH= DEPTH= ../W= 40
„ OF TtIs = a. hE.... 1... « ;, c. WATER ? ? ` 1 :::: VERA
t,iWPfF_F.:: LILLY; _r';c:IBEPG I PHONE=
STREET= .i , 1 t''i !- 16TH AVE
ADDRESS= SPOKANE WA ':921 6
CONTACT NAME=- (E...0 PHONE
FH [ NE NUMBER= > : , - . .
BUILDING SETBACKS : FRONT. r = . ? _ j ;E `: NA SR:
NA
: k k; Ak NH*1Ni*Rpi {i : i :9jH : 4 : : k SEWER. i
......
kPkPPr :k. .k 97}AkA ?•P31.'R:•N•:'+:
CONTRACTOR: C CONSTRUCTION PHONE= :::09 927 6760
STREET= 13816 E=: 12TH AVE
ADDRESS= SPOKANE WA 9921
ITEM EM DESCRIP ? IOv QUANTITY FEE AMOUNT
UNT
PROCESSING Ii it E=E::E:::
10,00
SEWER CONNECTION 1 001
: a *M*?Pjj: jNjjj :... . :yjj. . jii PAYMENT
bY ENT SUMMARY : ( j4 :**K d** ** 4i *P . :...P9
PAYMENT DATE E::. PIECE.E;.: i O PAYMENT AMOUNT
12/18/91 9533 50,00
TOTAL .... .00 TOTAL PAID=
PERMIT t' . : FEE AMOUNT awOU "rPAID 1MO NT OWING
SEWER PERMIT RMI T 50.00 50.,00 .00
50. 00 50,00 00
PROCESSED S. Y . ..........:[E ,S t-1{• I i i„t
PRINTED'fIa
t I:.t. i E::.1,1 E.{Y1j O M.t.(R t..i ST'i,i,,.l••1 ROBIN
SEWER STB AS—BUILT INFORMATION i rAVAILABLE { i - COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR O APPLICANT ! » TO FIELD tt { fl " N. CONFIRM „ ! •
ELEVATION AN I_T POSITION OF SEWER STUB I-!1., L:RIt.ER TO ANY OTHER
EXCAVATION
_.
!
:
O LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT
CAL i... it:.1-UR:t:. Y ut.J V16 i, 450..-800!;1)r
SEWER STUBS
i� af ;ETO
5tCHECKED PRIOR
r . iC TO CONNECTION T
.tJ, I R E
THAT THEY ARE CLEAR AND UNOtS _rj "TED TO THE SEWER = { I
•n:a+:*i}:•x n:*3i•it:• CALL t..t_1 E';:
HOUR IN r P E { tO N PRIOR
CIOR O COVER *K**3 > ? : A0.
ri *it � t *x . i J T . 5 : REQUIRED
.. r:-::.-r..i,::,,.::::*
k. T 1 456-3604 99 . jpt 1k TP
: RIITi : 1a t ttt *NiPJiV? 9 tAj1M: y , F ; THANK Y * ) s } ry } i*1j .p
: 1t . i? Nlifuaj ; 493Ji
SPECIAL CONDITION CHECKLIST
Project
Address: __ _ Project# Use:_ ___._
Dept: Date: Condition: Init: 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: