1991, 05-02 Permit: 91002254 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 .stirde I DATE ��- (-7/
PROJECT NUMBER= : 1 ; 022_4 'ISSUED05/02/9i PAGE= 01
:,: : : Kt ,rt i ! ,A J ? :JPM1 3 : u ? 3 ., : rpERmIT INFORMATION ****** ******* *********K***
SITE'.E :.;T,..•,.......;. ,...
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STREET—t... { 3333 ± .. .. :, ...: .-:: AVE ..
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ADDRESS=
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WA
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PLATO= •�.:-,;:3333
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BLOCK= rz.
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{••1131 i/?:t«.r.}:.} SPOKANE WA 99206
CONTACT NAME—33 33
_ ! e RUSSELL 1-
_ . : °.
? t • NUMBER=3 509 . . _ 0717
BUILDING : ? A: , » FRONT= N : - F2 : NA RIGHT= 34 . ^( y :
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CONTRACTOR= 3333. ..
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STREET=
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ADDRESS= :" ti -N3 WA 99205
9: `ITEM
DESCRIPTION
.,. �..
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,..,3333.
QUANTITY
.t. ?333±3 �r:...:.}t.::,.}.t ± :.t.!,J is:.3333 AMOUNT
............._......:«_.............................:....... .3333_..33_33....:.....3333 3333 ................................ ........................................
PROCESSING : E E
" Wii CONNECTION i ri;
00
:'.::.::;.a:. :'.:r.. ::,,,—, "'.::.31.i
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PAYMENT i" , , " : ; : , _t PAYMENT 3333... ..AMOUNT05/02/91 2516 ...0.,0!:.3
TOTAL DUE— ,00 TOTAL PAID= 50,00
PERMIT
i . R . .
TYPE
Y L {::.t. " i,.. r . AMOUNT
{N_ ; • AMOUNT
i i i`ai.:
.............................._..............,.........3333 ......................,............................... .................,.........,................... ...,........_.......«-----——
SEWER PERMIT 50.00 50 , 00 ,00
.................................................... ..........................................«— —_...-.............,.............-._.........
50,00 50,00 .00
PROCESSED
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PRINTED 3 :333 ai �, ± 1333
TTO
' SEWER
: E : t : AS—BUILT : j , C ^ : I; I AVAILABLE
AT THE COUNTY
! UTILITIES i. ? (456-3604)
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ii 3333.. .tt .. ,�., ..,. t
t.:i,,4 t ?'i.i•'1 l.. i_!?": i'l....L'~.•f'1?v. ....i ? .. ?" .?.5...}... ?...i..!!.:{"{ ? AND... «:L.?•v.ti' f 3333.
3333 + !+..
ELEVATION f• ?-.?:' POSITION . . SEWER STUB PRIOR 10 ANY ..:I {'??:...'S
EXCAVATION
TO LOCATE VtJ _ 1tri : _ : : „T" _ PIPING, WATER 3 : 5 .. ECT.
CALL BEFO••RE Y i.. U DIG... . 3333,,?'_r}'.!0
SEWER STUBS
t . ' - TOBE
t: 3 :'E_ PRIOR i CONNECTION T
� 'INSURE
THAT Tt , 3Y. _ CLEAR AND UNOBSTRUCTED - - THE SEWER MAIN
: trk 8 1 k h 3CALL " i INSPECTION C t TO Ci k PP ! Na
$9lk
113131 x ,ii24 HOUR
” i .w ! . REQUIRED
� « L :r
? 3rr *ryki
g:.ti..:
1k:k;1..1;..p.jt..1i,.K.K 456-360 4 •it;•11'•>R'iR•')k$k.R. :Ai
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1
SPECIAL CONDITION CHECKLIST
Project
Address: -___- — w-- Project#_.____-_ -_—Use:
---__---------___..----...____._______-__
Dept: Date: Condition: Init: Appr:
(in) (out)
D-ept,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
*--*---- --*•—THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY—•"—*************--'—
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:__