1991, 06-11 Permit: 91001337 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
PROj
:..: NUMBER= 91004337
{
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PAGE= 04
PLAT:T= 002397., PLAT NAME= .7KYVJEW AflPF!.:.! 1ST ADD
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ADDRESS- 3POKANE WA 99206
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CONTRACTOH= H PHONE= 509 926 8964
ITEM DESCRITION- —QUANTITY FEE AMOUNT
1
10 , 00
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PAYMENT AMOUNT
Sint x •
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, 00— ..... TOTAL A1. t -A ,
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50,0-0 -5;0. 00
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:..;1,: ; R fa;; O,t, ,,.t,. F'}i'i L. .?.f.:C-i}'t } IS TO FIELD .. AND CONFIRM THE
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AVATION
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SPECIAL CONDITION CHECKLIST
Project
Address: __ __ Project# Use:
Dept: Date: Condition: |nit Appr:
(in) (out)
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Dept.of Bldgs.
Gpeoiv| |nap.Final Report | �
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Hydrant ' |
< )
Lock Box
-- --- � --! --� i
/ ! '
Engineer's-- _| _ i __! RID/CRP --
--- — _| ' __' Easements
_______ Road Plans |momvoments
Bonds !
_ |
/ ! �
---- | -- ' --( ' — --
nonning 8nnUn
_ .
{ ' |
-- --- } | --/
` }
| --
/ | /
Utilities DouMonmnbing
/ --|
ULID
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Other
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^~^~~``THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE nFOCCUPANCY ONLY`````^````~~~^^~~`````'^
Date received for C/O processing: Plans pulled for final processing:
Temporary 0/0 issued: -- Certificate of Occupancy issued:
Office file review by: _-_'_ _ Date:
Filed insp finaled by: . oate:
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: