1991, 11-27 Permit App: 91008246 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
• :<•.r..r..
PROJECT NUMBER= y4 +.r-'t+_tt:i '.<¢6Viii..,. . , .. ... DATE= 11 /27/91 PAGE= 01
****** THIS" ,* NOT ... .....
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PENALTIES WILL BE ASSESSED t..i.iR .t.:O!M iME..N ; .Ntr WORK WITHOUT fiA+ PERMIT
---------
1 '4:4(10 41 I; ::i V j: :A R t:•'r:.;... ::: 2 .i 4 2 .,.`3 4...
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION IIIiiCREST (91 —S92)
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r ? tT 4._ 001222 .lAT NAME= » : iir Err_ a .r . r1ST A„f
:f LOT=. , : T....
BLOCK= 14 ZONE= fA!!s,�>t.�tK ?.?.t.,4 :w a;;
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AREA= r ,�..,:�: (,.f.i.I? ! i-I:::: DEPTH= F ,. +::::
OWNER= priTi..ii:#iff #( 1...01.) 1.1: PHONE=
TREET= 124 8 E. :::I ;i'i_ 41
is D D ESE= I::=(.Ii;.PtN.E t(? 99 2? 6
CONTACT
: NT ;:T NAME=
fyE .:: ,I.,.� ,-( CONSTRUCTION
" VS {„ C "ION r•• t :HONE NI. "Ti -+ 50
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t' X48 3i ' ?
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1 F"ak ""APt* 1" !+ !? "9 !: k 3 ^ !* : K PERMIT ! n* *, A91 Rf ! t 1 t: : LY ! J: :` t !
CONTRACTOR= CONSTRUCTION .. +-'i.•I}..?N;::_:::: 509 448 7010
STREET= RT 'i. BOX 28
ADDRESS:-ti.... :,:», ,,., 99!.•, :
..A:?.:r'•:C:.a:r:_ �:•i••'?•�!lV tr;...l::. k.+t•.i `si'+',?,.'?'1
ITEM DESCRIrt .i.ON QUANTITY FEE AMOUNT
PROCF
ING FEE 10,00
.'E�WER` 'CONNECTION 1 0:.00
g
+.: AMOUNT PERMIT TYPE PI':. E" l::. AMOUNT AMOUNT PAID:D At"; NT OWTNG
•
SEWER PERMIT ';i j ?iti ,,00 50, 00
? t!i ;Illi! 50. 00 :
PROCESSED BY : DON.!. tRt.?b`ICHi ROBIN
PRINTED BY : t?t.3ii1. iR+..Isr.i.rH, ROBIN
SEWER t 1AS—BUILT T N " a
N
IS AVAILABLE a 7 i FCOUNTY
UTILITIES ,rf ", NT • 455. 360: ,
C:ONTI' Ai: f O t OR APPLICANT .i:,.`.• TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
.: , i E k N
TO t_? i. + _..:'iii::. BURIED +_:f-i B 1...1:..:• : .r(#:.:• PIPING, f..Y„ E:.:: ECT,
CALL BEFORE. YOU.! DIG (456-8000)4 a!:!.. .'::,,l i j
•••_ Wr : t _ : _ A41TO
BE tHECK: ? PRIOR T
rIfO CONNECTION
TO INSURE
THAT THEY tx ` CLEAR AND' UNOBSTRUCTED TO HE SEWER
MAIN
.x*n:•ti..R..y,..*}t: . CALL FOR R .l.P '•E'i::_l: 3 ION r'r': :i RCOVER •,6 3i'•ii'Pi 'it,•�i**•,t•
at'it'3+:*N:*3t-�tiri :'4 HOUR NOTICE REQUIRED Dr k)1ii'* iiatP ie-i
3=:9k•A:?8:n;•!t••i+:•:8•R•
456-3604 4yklR: kh1i
Na tf ) *) : 3*} * SN* i: : w t *t , ijtTHANK
iiNK YOU
****h****************,.************
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:__
Dept: Date: Condition: 'nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
--- — — Hydrant( )
Lock Box _
Engineers_ _ __. 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: