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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: