1991, 06-11 Permit: 91002156 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
•
.. NUMBER=
:iiiBE 91002156 TEEUED PERMIT DATE- 7 PAcs,E= 01
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..;TRECi = 11414 E 17TH AVE PARCEL4-: 23542-2002
ADDREEE= EPOKANE WA 99206
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CONNECTION
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OWNER= MENDHAM PHONE-
ADDREEE .ri.' WA ''Ie
CONTACT NAME- LEONARD PHONE NUMBER= 509 926
LEF7- NA REAR= NA
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CONTACTOR- H E CONETPUCTION PHONE- 509 926 8964
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PAYMENT DATE ;, EOETPT4 PAYMEN-1 AMOUNT
06/11 /91 356e 70 ,00
TOTAL PW;D- 50 , 00
PERMIT
TYPE
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ELWER ETUB AE—BUILT
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EXCAVATION
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CALL BEFORE YOU - (456-8000)
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SPECIAL CONDITION CHECKLIST
Project
Address: _ _ ___ Project# Use: _—
Dept: Date: Condition: 'nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant ( ) _
Lock Box
Engineer's RID/CRP
Easements
Road Plans/Improvements
Bonds
Planning — Bonds
Utilities Double Plumbing
ULID
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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:_