1991, 12-18 Permit: 91008392 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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
?"±":k..:.ii::._:T NUMBER= 91008392 ,.::::::UED PERMIT pAi' - 12/10/91 i.:AG = 01
9!-*:!'it:i!-**4+.'•Y!'4•:*a!•yt:k Vit;tt:*9!..Y`3!•):'ji.7i*{+t**Jt: PERMIT INFORMATION *************k**************
STAL i::. ::r # #'4?::.t:. # .... 12524 E::. 20TH :a 1;'E ?-`A F'a`i.?::L..0-:: 27542-2349
ADDRESS= SPOKANE WA 992.16
PERMIT I ES,,:: SEWER CONNECTION .... .I •I ',T (91 —S110)
ji')':9: S E:�t:: NOTE .}t::}i,:ti-
PLAT4= 001222 PLAT I )R 1 T' I..k.: t. 1' ACRES I S`1 ADD
BLOCK=i f.''`:::: :. LOT= .. , .n......
OWNER :: Itt:.5i...E::.E'' , ARTHUR Hi tic t..t..?t,tNE".=
STREET= 1 .'5 4 E. 20TH fA't 'E::.
.AIit)I"•°E.S >:::. SPOKANE WA 99216
6
°:F:iNt t s N,• ,...-.- OMEC CONSTRUCTION PHONE NUMBER= 509 44 :'s 301 0
BUILDING SETBACKS : FRON i :.. N/iA? LEFT= N/A RIGHT= NSA REAR= N/A
f k i3Ay1 ! :" PAR YE r y (R*, A *9 , i? ASEWER ' : + " J - .y.......A4 9Ypt} i f7N7tAAk 1 78An ! !m
*xii
CONTRACTOR= i "LkCONSTRUCTION
J RUrT „OP - ' E - 509 448 3010
REET RI i BOX Co
ADDRESS- . A `: WA
99031
ITEM i” : : : E , _ N QUANTITY EI „
AMOUNT
PROCESSING , r „
`t i tv:.+::Y�':>
,E 40,00
.. .... „•,;,,",:y�E N..r
•u•+p;y,..},..n..},:�}i••Yk'}!':!•Fi tt:.)i'•}+i'pi'F1]i:.},:.A:.Yi.y;.:ti.:Y,..},,.}(.,},...},,.t,.,,,;•ji•1!' i"p.t , t,r:.?'? # :::l.;#" •1!•a;•,._Y *•,+.-;+:•A::+:•k 3r:•};..},;.u;:;;..k..u..}i••}(• +i?+i ni.{••}t;*.;,..;..i+i i'+i i'+i*•i+:
PAYMENT # fi.....,- ,r PAYMENT AMOUNT
12/18/91
50,00
# t,t t A?... DHE= TOTALPAID- !^:t; 00
PERMIT TYPE F:F:.E.:. AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50, 00 50,00 ,iy0
50. 00 50,00 , 00
PROCESSED B`?: : DOMI i•ROV:i.CH , ROBIN
PRINTED BY : DOMITR:tiVIt:::H ROBIN
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE A_E" E'HE::. COUNTY
UTILITIES DEPART ME::.1`'f T (.456.._,1,604)
CONTRACTOR
IN _R( t t - : # FN e , i FIELD. LOCATE
t „ CA IF_ND CONFIRM
OVFit "
T .
# 1 # t " # .OAND kSE ? IkV OF " : ; ? ESTUB 10 ( xY OTHER
EXCAVATION
TO LOCATE E !ik:?R1It:.IT CABLES, GAS PIPING, WATER Ef', LIN :::• , ECT,
CALL.
As , • - , DIG ( 456-800E);
s L'.t�• :.#": t i_!i:i; •?1''•:,... TO BE CHECKED PRIOR t!#", TO CONNECTION TO INSURE
1 1"E f•'? I i 1"1 t.:. T f-?E'1 1:.. k.:1...I::.f•'?E•'v AND N r h f V f. i i-,T t i k.!k.: ± ±::. + i k.t #Y i"±±::. ,:}E::,L.I Y_'.k MAIN
.}+;ai.:a:A:'**n:x•'A: CALL FOR INSPECTION PRIOR TO COVER ;,..A:.}t***N:•h:•'}i••}i•
:+s ii';;.i:• ,::E*ii?;. 24 HOUR NOTICE Rt-.F:U.IRE::: } .0**ii• .*.i,..} *y.
**** *** ****K************ ** THANK T ttiL a : : ij :*Ysgj. YpY *. Y }n i : . : Air ; !
SPECIAL CONDITION CHECKLIST
Project
Address: _ __ _ _ __ Project __ __ Use:
Dept: Date: Condition: mit: Appr:
| �
(in) | (out)
--- ' /
------- - ---' -- --| - -- - - - - - ---
oocx.nfBldgs.
| Speo�| |nop Final Report
----'---- -- -- ----| --| - | -----'- -----
*yuran ( ) - --- / - -
� }
_ _ Lock Box
}
__ _-__ _ -_-_ __�
------ -- -- -- --| - - -- - | ------ | -
_______----�|
----- -- � ------- --{ -- ----- --- -- ----'--
_ ! -- - '
--' -'----- ---- --! -- - ---' '
Engineer's_ -_ _ 1 --' RID/CRP
-_- __-_-___ _ __{ Easements
-------- } ! RnauPlans/Improvements
| --- --' --|
aono�----' -| - -- | -- --'
__
_--'
_
| | ! |
|
-------- -| ! --| | -- --
Planning_ Bonds
-- ----� --i - - ------'
| ! /
------ - | --' --| ---' - -- �
� | '
--- -- -- --� --i - - � -------
- --- - —| � --! -- -- - --
Utilities� ___ ' -_ Double Plumbing
' ! ULID
--- | -- - ' --
-- -- i --( '
Other
| i
- ------- --/ | -- - /
-- - ---- | ----! -- � -- - � --- | ---
- - i -| -- | �-- ---- -- ---' |
----- � -- / -- ' -- ------- -- - - |
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY
----- ---- ---- ----- --- -----'Date received for C/O processing: - _____-_- _______- Plans pulled for final procesing:__
Temporary C/O issued:._ Certificate of Occupancy issued:* __ -
Office file review by: ____- ____ _- ___ _ oato:
Filed insp finaled by: Date:
_____-_-__ ________
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: -_____ __ ___ ___- Date: _______-
p|uno,otv,"vd: _________ Received by: ____ _
No response from owner/contractor plans destroyed: ----- __-_- _____'__' __-_--___ ________-___-__-_