1991, 12-18 Permit: 91006666 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
trt
Pr•-:i:;:_t!::.t.: ? NUMBER= 91006666 ISSUED PERMIT DATE= 12/18/91 PAGE=::.. 01
pq:.i(..J.. :r : *:JJ :.!:..: }: jy: j4:jjJ : J :.,j..*} : PERMIT tV^ „ " ”ArOr : 4iJj *n : a *J *:JJJJ7 *: J ,9 i jJAi
--
SITE ? 14
S { i:;`..t.. - 11403 F 17TH AVE PAF E{...O-- ._'8542 "1� ,13
ADDRESS= SPOKANE le; WA 99206
PERMIT USE= SEWER CONNECTION .... NORTH ,.•,,,t':.OM i:)
E._ NOTE
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t.WELLING��:::: •! '•ttt f.:!T C:.t'ti DIET
OWI'4':.{',.:.•: »:!.._. I L_!4 L:HONE=
114wo 1 ! 1H
AbD E; S= t`POI<ANF WA 99206
CONTACT NAME= t t i..: i i t i• r•tt:P,E NUMBER= :,•.,..;.;. 92 .;0
BUILDING SETBACKS : FRONT=
`ON•1•= NA LEFT= NA RIGHT= NA REAR= NA
:!i V 3!i*-+!'r );:*•t!r i!:-t6 9L•i!!i 9,i*9!*-1!r***$!i*•Pi 9t•Pi:!r•J!i'Ar SEWER t-EI'••:{"iIi *****K************************
CONTRACTOR= TLC CONSTRUCTIONU» t1N PHONE= . � 927
6760
STREET= 13816 E 12TH AVE
ADDRESS= SPOKANE WA 99216 ,.
ITEM DESCRIPTION QUANTITY FEE r•!,•Ff'I;l-1.T.
PROCESSING i'I::.{::. `{ .I !'.;i ;i•:t_;
SEWER? f"i:ij3;iF:.t; .i.E.?!`, 40A00
.},. !..i)*.h..*.$!.;(...•Ai..•!U k•I4••!i•hi•Pi 7!r i+sr.It.•j!t:J!:3t.:Pi.t+.it:.*•P.yi•:J4•itf-• PAYMENT SU'F"i A !i**al.....•a:•7ri.•!4•*.!k. ...•... ..........1!i ft•
PAYMENT DAZE R::.I..:EIi` I •e' e'''t• 't !"!!: tyI AMJUNI
12/18/91 :.;f )3:.i 50 ,00
{O , Ai... )..•' J•!::.' ,00 tOtAL.. PAID= 50:.00
PERMIT? ? Y F's:. FEE AMOUNT AMOUNT{ `r3 :c AMOUNT OWING
„00
50,00 50.00 .,t 0 ,
PROCESSED 1:+Y : :.?U I....{.I::. :::•H i! ! I I.
PRINTED .:t Y• - t!+.#1"? t i'{i:i 5'.!:P..'•I"1 r ROBIN
SEWER UB AS....BUIL..i. INFORMATION IS AVAILABLE AT THE
COUNTY
UTILITIES DE -f•:F ,fr . ;604 j
P' ±.
CONTRACTOR LOCATE AND AND
ON I RAC ? OR OR APPLICANT? IS •c:i FIELD ?...t..,t.:A t E C ..;i.?" I:•,r! THE
ELEVATION AND.1.% I'`t I:.; t ? .;.t.IP,t OE SEWER STUB PRIOR I i,i i•:,r•.', OTHER
EXCAVATION
TO LOCATE BURIED CABLES, !.r f•!::3 PIPING, WATER LINES, ECT,
SPECIAL CONDITION CHECKLIST
Project
Address: Project#___ _—_. _____Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept,of Bldgs. — — ------ — -- -- - -- - -- ----------___ Special— ____ — 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