1991, 07-25 Permit: 91004507 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 his permit/applice ion amTan subseq nt inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisio• of any state or, la regula ng c'n truction,oras a warranty of conform4pcewi h the provisions of any state or local
laws regulating construction. /
SIGNATURE • \ /� APPLICATION 2 J /Cj l /
OWNER OR AG ` / An DATE (( l
PROjECT NUMBER= 9-1004507 .#. .::t!t::.!:i 1Et'•:M S. ? :A T ±}•!'. ..._. . 3'" PAGE= 01
:7 * ? ppR a R s s R a±-. ±R: ?9 g ?F : :: k sPERMIT t }r K '^ Y . i V : li: i*ViaR R aR i .aial ?aaR a :i:iii
SITE STREET= 10921 E 18TH AVE PARCEL4= 28542—4e27
-ADDRESS= SPOKANE?::. :,•tf 99206
PERMIT i.tSi::.....
SEWER CONNECTION, , NORTH t't
.
kiiSEE Ni ? iP :p
1"t...i.:?
BLOCK=
.n-.... 001857 PLAT NAME= OPPORTUNITY ,,.-i,; ',
i-Yi'?'.I:'f-i= i r f:•t-•= 1II1 l:T I•'i 1 0?•! ... ::.P 130 . ..:.vi::::
t i}t,r [!tla}...;...i Tr•:I I,•: ;r,i t•a T
•t.,tai#'t •rl-:: SMITH, MICHAEL PHONE—
.._!i`• ;:."• 509 ....... "1i a
STREET= 7 ..i.i ^?r E
ADDRESS=
DDRr..-..• '.P•',I,tK -`i'''![:• WA 9920,f
CONTACT Nf•?i:'?I:.== i"?IC#"If•ir•.i... ::>tvaT_"I.= . PHONE
NUMBER= "%!:?`'y 926 9181
BUILDING SETBACKS :
FRONT= NA LEFT= NA - RIGHT= NA REAR—
±:i. p* ::-i..:,�!•..:. :K::ppPi :± i; ¢R ; s i 4 ±? ySEWER r . rr - , , . ii :jriRi:*R fai**apk k: *ai
K e :a t* :
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION QUANTITY AMOUNT
,;•, ^tat,:-•PROCESSING'--u i'.,t i,., _::5 i+
4e a.t:.d.:..: Ri .a :.. . : aR sqr:p? :: irpiRhpPAYMENT \ MMA: T u; j *npnf*3Pf*N* inf C 1 } 4 i? •, P
PAYMENT ffI : , • r r
" :4 PAYMENT AMOUNT
07/25/91 50f,-.,tit
TOTAL DUE= ., ••r
OTAL PAID= 50, 00
PERMIT TYPE
r ,.. ' r..... AMOUNT
.,tOiii` i AMtai,iN t !ATD AMOUNT
OWING
SEWER PERMIT 50. 00 50 ,00 ,0c)
50,00 ,00
PROCESSED BY : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
SEWER STUB[.JB A::.—Bi..i.1.i..-T INFORMATION is AVAILABLE AT THE COUNTY
± ay.-rw_..,,. ..w,:
CONTRATOR OR APPLIOANT .IS " fFIELD LOCATE AN,
CONFIRM THE
ELEVATION AND POSITION !1SEWER STUB PRIOR TO ANY OTHER
!'x:AvA IiN
TOLOCATE.' BURIED'ii 'A] Ii fA ' PIPING, WATER LINES, ECT ,
: ptLBEFORE YOU DIG
(456—,a!,'15;_!?T:Jri (•�
I:::Ij E:R T ti 1. `;r. .I a,t R I l I ORl i f 4`. 1."Q I'. .i.",:•�I '.i•..
STUBS'
i :. ?.. 7 � ?i :?..1.,?; ; E::ss 'TC) J J ii t .l .i '' i:;i i; itt:.:
THAT i HE.Y ARE t,.:'•...,E:.f.:;t•,; .r.:?NT} UNt,}rt::: #'C..?t_: E7,! . i?..l THE SEWER MAIN
*.p.q,..R.•st•3t.;,..k* CALL FOR R .i.N,3PE':.i_: i .#.!_ii'•: PRIOR TO i C[, V1".R 3i:3i** (- s••is:*•k'tt:
:n•n•*jf,ie r•n?-».:u• 24.
...°' ",f-,?'4 .: t'J,_1? .?.._!._ REQUIRED r:•R•r:r•v•::i,;?>..:.$r.
,,:•p:.;±••a:•n:-t,n:•n 1>: 456-3404 •tr*:!:.1,,.;,.tr i::*-;,},yk
:a : : a : ct : ia !**: r*ai: iqaaiTHANK YOU tt ; . ; 7 .9...a :*jj *iaw* F*•J : stE ; ; `*
1
Aim
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 OFOCCUPANCY 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: —__ _ _.— —__._______— _________—