1991, 02-25 Permit: 91000697 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.1303 BROADWAY AVENUE
SPOKANE'WASH|NGTON 99260
(509)456-3675
/vom/vmut/ha,eoxummoum/o»mmwanpxoanoo.otommonoomm,mauonvontameumuunuov»mnmuvvmoonnvagennovomnnooumv rmit/application is true
and correct, and authorize Spokane County to n withvmvossm« In additionI 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 k ./.791 -iffre"" /PIS DATE - C? I
f . G`U CT NUM3E���= 9i O8O�`97 � I% ;;`E�MI
**************************** PEj:;f.MIT INFORMATION ****************************
%ITE �TREET= iiOj4 E 2i %I AVE PARCFL4= 8542-30O2
. ADDRE %= %pDKANF WA 99206 .
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PERMIT1U E= JEW� NTION `FOR RE%IDENCF
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' PHONF= 5O9 924 523�
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{CON-AGT —R &� % EXCAVATING `CONFRACTOR% PHON NUMBFR= �200- 773 4577
BUILD�NG % ��':� F�ONT= NA 'LEFT= N� RI[�HT=|WA REAR= NA
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PHONE= 2O9~ 73 457'7
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PERMIT TYP'
----------_-- --
cWER PERMIT OO
-------------
5O.00
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CO TRACTOR. Ot:;.• APPLICANT I% TO FIELD LOCATE AND CGNFIRM THE
ELEVATION ANn;; r;= TR TO ANY OTHER
EXAVATION
T�} BURIED C PlPINc, mATFR LINE%, ECT .
CALL^ BFriF*.ORE�rYOU)I)II..;-w.456rQ000)
%EWER %TUBJ ARE CH CKED RIOR TU �O �EC� ���M rO IW�7URE
THAT THEY C - -- T� TED TO THE %EWFR MAIN '
********* A�� L. AR OR TO Cn�ER
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********* 2/� HOu ' �E�"IRED -- ********
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********* 456-36O4 ,`�. * ` ~
******************************** THANK y U *********************************
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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 0/0 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._—_____ --
Plansreturned: ___—_ _._.__._ ___-___-- _----------_--_---_------.___. Received by:__—._____—____ __.__. ___ _______ ____.____ _____-__— _
No response from owner/contractor-plans destroyed:______—__ _ ------