1991, 06-07 Permit: 91003180 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
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STREET= , , F ? : _ : _ Q%
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^ _ M-- 23542-3109 - ..
ADDRESS- SPOKANE WA 99206
PERMIT USE= :i•?::.Lti}-•R CONNECTION .... NORTH�.'$1"•. ?•i i+.t.}i.,,}"�{ri t i
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PLAT.-2:= 001393 PLAT NAME= KOKI1M0 TOWNSITE
y I} v??'i
`r: DWELLINGS-
STREET-- 11115 E 22ND AVE
ADDRESS- SPOKANE WA 99206
BUILDING SETBACKS : FRONT-- NA ........ REAR-
.. .. 1. .... .. .......... .. .. ........ .. .. :•:�... .
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C.ONTRACTOR= TRW BACKHOE SERVICE PHONE= 509 926 9773
11223
1 ..} ? 16TH
ADDRESS- SPOKANE of�.:: }
AVE
206-0000
..... .... ......
... DESCRIPTION QUANTITY _...... AMOUNT
....
10 ,-00
RROCESEING EEE -
CONNECilON
40,00
06/07/91
TOTAL DUE- , 00 TOTAL PAID- 50 ,00
PERMIT, TYPE FEE AMOUNT AMOUNT PA.:•.D AMOUNT OWING
... E•S=_... PERMIT .I ... .. .. -. .. - 50,00 ,00
PROCESSED BY : JULIc SHATTOPRINiED
JULIE
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,
e INFORMATION
::i i.:.i!:=!..! STUB !..}:.: t ..!.!. ... ...
ELEVATION AND POSITION 'OF SEWER SIUD PRIOR IC ANy
EXCAVATION
CLL tE'O R:tYOU—DIG r: 61 :k0
rt
a?G:.WI::.I'-. ETUDE$.^?D::4 as}•:,.!::. TO BE CHECKED PRIOR TO CONNECTION INSURE
THAT ? ?E: < ARE CLEARAND ki!k $A ! $ .: ; $::,it THE SEWER ?f s?$ .
****K**** i-:A i FOR t v. $ j i..a..l.1 t 'ti PRIOR` •- COVER;� PP.) Jl PA A 11 )?'.x'
)e it 1r•r:-iti:-'::�: :';:: ... 24 HOUR W.., ! t=..:f:_ REQUIRED
.
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•J!: )t 7t ik 4!:)t:?';!:?t 9!:::' 9:'9?'k: c 9:'.!'',e;-9e 4`'t!::!:J}'.L rl.J:.+R 3.:. THANK 7` , :';.7!i 9!.,.JL'1t •.,..7.).3.i�`d. •�'
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SPECIAL CONDITION CHECKLIST
Project
Address: _ Project# Use:
Dept: Date: Condition: 'nit: Appr:
(in) (out)
D-ept.of Bldgs.
- --- Special Insp.Final Report
--- — Hydrant( )
Lock Box
En-gineer's_ _ RID/CRP
Easements
--- Road Plans/Improvements
Bonds
Planning_ Bonds
Utilities— _ Double Plumbing
ULID
Other
""'"""'""""""""""«THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY 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: