1991, 07-17 Permit: 91004291 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
certify that I have examined this permit/application,state that the information coritained 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 he 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;_!:.!E::.CT NUMBER= 9100.4291 ISSUED PERMIT
DATE= 07/17/91 PAGE= ;.:?-!
JI9 3k k t ik 9 `fl99 ? * :9 9Nk k) i !1 ) 9 'i zM „T I :FO t" e ! : 3 .A9i4 :1 ) t fi) 99NtRRiRJ4 ! 9pt: nf
+ .
STREET= .1 1 t 1 ., 1•• 17TH AVE E.: .,f.,1...,
........ 20542-3913
ADDRESS= SPOKANE WA 9920'
PERMIT USE= reE { CONNECTION K !Kt "O
)?-*)t- SEI::. NOTE E ***
PLAT4=.v..... t:11:}'± [:!5 : PLAT NAME= OPPORTUNITY SUBURBS
'':As,1
,
BLOCK= LOT= 16
5 DISTO=
ZONE= ,
AREA= 00000000 F/A= FWIDTH= sj i """ } : 130 j
.u - '0
•H• OF B±._!_?f;,3•-• '! •M DWELLINGS=I...i.l'i!t:i,t,= .t WATER ER- !.?IS ! = MODERN
OWNER= . t BUILDING
)i ± „ Et : + } rEi = 509926
r0 i
i"
STREET= i :: t'1 iso E SPRAGUE AVE t::. {"I
ADDRESS= SPOKANE. WA 99206
CONTACT ' - ' : : CHRIS ` J" ;.ON
PHONE NUMBER= 509 926 0755 BUILDING
SETBACKS : FRONT== ?j LEFT= 9 RIGHT= ii REAR= 70
) *)Fr-hi)t•...... . •Pi. ..a:.)Fi;n;•.•. ...F!)F:....C•.*)F:». i f'i 1 F::R o. R?4 T..; . ... *.......:f!•..)Fr*..)E•/{"JF:• .*•A'•!Fi•Nr....*. *tU::4•inr
CONTRACTOR= UNKNOWN PHONE=
STREET= UNKNOWN
ADDRESS= UNKNOWN WA UNKNOWN
ITEM DESCRIPTION QUANTITY FEE
AMOUNT
PROCESSING FEE i0„00
SEWER CONNECTION 1 40 ,00
... r::A N I••N f SUMMARY ),..p..jj..S,*a:in.:J,*'*****..[.:n..jj..1F.*•N1*•n:Fr;=::?*Fi*
Nr-Fi)f.k-1Ft)if)Fi.F:)r••5FL)F!.ti)i•iFk)i IF.-Ni.Fi:{)tt){••A')ti)5:'Pi•Pi)F:•-Ai it)i:•)F:
PAYMENT Dl ^ , : . . . .•:• PAYMENT h „_ , . _
07/17/9i 4000 50, 00 •
! E • DUE= ,00 _ t , PAID=
..!. .. •. l:1
1: _.: ?: _tTYPE: F_E AMOUNT
"O( { jAEEU` T PAID ?•ON OWING . .
SEWER PERMIT
FE {" . 1 ,r . 0; 50,00
r • ?t ,, 0
- 50,00 50:,!.',J':.1 „00
PROCESSED r,: Y . AOHN LARSON
PRINTED BY : jOHN LARSON
SEWER "'..TIT:{ AS—BUILT INFORMATION IS AVAILABLE AT ... COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR i OR OR APPLICANT :I.,`: TO FIELD LOCATE E AN!_J CONFIRM THE
ELEVATION A ilS D POSITION OF SEWER ST±..)!:{ PRIOR TO A r?7 OTHER
TO E._OC.::Ait:: BURIED [_:ABBE... :SJ GGA ! PIPING , WATER LINES, ;::.i..:1 .:
{.:iL_L.. BEFORE YOU ?t I G (456-0000)
SEWER STUBS r...R E _.... , BE
CHECKED "! EO1 TO CONNECTION 3tINSURE
THAT T FAM FAR , i. UNOBSTRUCTED TO THE SEWER MAIN
( kPRP) :Ai :ALL FOR INSPECTION . p
.{••!<i•Yi•IFr•Nt)!.:Pi•Ar•lti Pr
„J1Jt ) ) ;) 24 HOUR NOTICE ;1 . ' : i i1 ) . iBj . ) .
456-3604 :,:y.)F .:,.:,..p...*.0
.:,..F;..?F:;F:•?F:'A:iFJ.1!•9;..1;..t,.fk tF*1..1:R 1: t?,.,t:t:t?N.:•.i!:!Jr a;j,.:il.jF. THANK Y•+..!t.l .;='Pr iF'i iF?•1Fr:r.:*in.* iF7)Fr.k)..*.t..r.:y....:,:.a;....:,,.:F..............................
SPECIAL CONDITION CHECKLIST
Project
Address: __ ___.__ Project#_ __ _.___Use,______
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs,
—. Special Insp.Final Report_..
_________________________ yd rant( )
___________________ ._ Lock Box
•
Engineer's ._.__-_--_-__-. RID/CRP
_______ —___—. ______ Easements----._________� ------_.__--
-- .-_..__-- w Road Plans/Improvements —
_________________ ---- -- -- Bonds _ — .__-.____.._-__._.
•
•
Planning Bonds
UtilitiesDouble 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 __