1991, 06-11 Permit: 91001667 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
E
LEONARDADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — NORTH KOKOMO
BLOCK
OWNER= OSBORNE
STREET E 2IST AVE
ADDRESS,, SPDXANE WA 99206
CONTACT NAME PHFt.J=.i NUMBER= 3964
CONSTRUCTION H":ONE:::- 7.'509 E:964
STREET- E VALLEYWAY AVE
ITEM .DESCRIPTION t•-•
EEWER CONNECTION
.. .... .. .. .. .. .. .. ...... .........::.........:..,.-:::. :: - .ji:;�.at.' H }i iit;'N.74 Nr'B.••Ri•fl'Nr d. ...i ii:!i:-A:?ft•
--..;._....:..... ... ..;,:9t:'N:]t tk;t.N:a A.4J..J};?i::�..tl.j,..a:afi v:•J•.N.;:irr:!{..1}i m r, .... ...i�hr..:. .. :. .
•
PAYMENT
:...: ".1::.x','.3.. 1... :,....i PAYMENT
TOTAL D:..1E ,00 TOTAL PATD
:PERMIT TYPE *--iMUUNi AMOUNT PAID AMOUNT
SEWER PERMIT 50 ,00 , 00
PROCESSED BY : JULIE SHATTO
" PRINTED BY : ...JULIE SHATTC
:•:•:• AT
4'{...1...::i"•. A.:- ..i.t'..i .. INFORMATION
l§!Ft...ti•t.fj{A..l..i {»{i) TS S••l tit i••t.. .. ... ... .... COUNTY
_
:.: t .L L...!. .L iT,.} 1)1::.; i":"r'•. i i{...i 4
CONTRACTOR i iii APPLICANT .1. TO FIELDLOCATE AND CONFIRM
ELEVATION th» POSITION rr . SEWER STUB PRIOR
. ANY OTHER
SEWER
.., ARE
i CHECKEDi
iNSOR
THAT - THEY i r s t'[ UNOBSTRUCTED � , f.#2J W t t* 23
:.N.?l• {.:l;.::i..*'t CALL FOR :INSPECTION PRTIIR TnCOVER :-N:'N.it.N.*-i!k !!^*
,J,.
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SPECIAL CONDITION CHECKLIST
Project
Address: __ Project# Use:
Dept: Date: Condition: Appr:
! | /
(in) (out)
� .
Dept.of Bldgs | '
�
--| 8peui� mmz�n�Repu�
---'----- --
------ | | --|
Hydrant( )
| '
Lock Box
-- -- --| � - '
! /
{
------- -- --| |
snginooro- __- ___ _| __/ RID/CRP
' Easements
---------- —� --' --i
Road Plans/Improvements
Bonds
- | --
| !
Planning Bonds
| _-/ _-} oonuo
( '
' | '
---' -- � --! —
{ � '
! ' '
--- -- | --
Utilities __' -_{ Double Plumbing
ULID
-- | --) |
----' — —| ---- | --! --- !
Other
------ { --/
/ / |
-- - | --�
_�`
''^-^'-``~'~^-~^^-'^THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE opOCCUPANCY ONLY```^'^~`~^-^'`^``^`~``~`'
--- -
Date received for C/O procesinn: - Plans pulled for final procesing: __-----_-__
Temporary C/O issued: Certificate of Occupancy issued:
Omcon|emviewby: -- ___ -_____'_- Date:
Filed inapnna|edby: Date: -___- --
_ ________________
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: _ Date:
Plans returned: __ -___-_ Received by:
No response from owner/contractor plans destroyed: _ _- _-_ -