1990, 12-04 Permit: 90006024 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
•
ist/}{ .:ir DATE=I 0 PAGE= i} i
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SITE STREET 17220 E 22NP AVE 27541 -2327
ADDRESS= SPOKANE WA 99216 .
PERMIT CSE= SEWER CONNECTION — 3801
PLATO= 001341 PLAT NAME= C- R R r}+.
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OWNER,-, GORECKI , RICHARD PHONE= 509
ADDRESS= SPOKANE WA 99216
CONTACT ?:th•)f'i{" N A i-i PHONE NUMBER= :7;09 922 ..
BUILDING SETBACKS : FRONT= NA ,
;(. : {. .:i''.:i..i:: { c £ 3 .i ,r: t -t: a t i!,; } ,) SEWER PERMIT } .. . . rPt '?... t:4 . . . i9 : P `9 .. !:.. : : :fi
STREET= PO i.f i 141562
ADDRESS= SPOKANE WA 99214
iiLM DEScRIPiluN QUANTITY FEE AMOUNT
PROcESS
SEWER -CONNECTION 40,00 •
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JULIEPROCESSED BY :
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CONTRACTOR
^ Str: iAPPLICANT
PiLI : N i , TO FIELD LOCATE _ y: CONFIR
ELEVATION AND POSIT:ION OF SEWER STUB PRJOR TO ANY OTHER
EXCAVATION
. TO LOCATE BURIED CARLE-7 PTPT.NG . ECT,
THAT THEY ARE CLEAR ANa 1.4,!OBSTF,:AJCTED TO THE SEWER MAIN •••• !- '1 .a ? tli? ?: } CALL f _ vJi' '-Ii.. :. { V PRIOR i COVER? ! ° iFl3 : i7 *A
_
:?..}!:*K:R.*:C 3k'fit 456-3604
.. ...-*:............ .......:•'..s•:r,:':Y.:--: :::-:c.i.::..::r-:.. • THANK K- 7.. .:f•..-.:.:;:•i.:r-3i•;Et•:¢.:{f-}.,'-. *j:.}:. �:.:;...)3(•3 3 )'iui-ii ii•iri'i{{i'}=i {i
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SPECIAL CONDITION CHECKLIST
Project
Address: __ Project# Use:
Dept: Date: Condition: mh: Appr:
(in) (out)
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Dept. mBldgs.
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-- — ___ --. Special Insp.FimgRenort
______ __ ___ ' __ Hydrant( )
Lock Box
- __ __ -|
-_-- / -- _
enginrors-_ | _ ' ' RID/CRP
Easements
__- _ ! _-' Road Plans/Improvements
Bonds
-- | - --
� . .
----- --' --| - -
- -/ ! -- ---- /
---- ' | -- '
Planning ! _ { Bonds
| �
- - --/
/ |
-- ---! - i --| !
------ -i --' --/
-- - ! --i
------ / --|
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Utilities Double Plumbing
ULID
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Other
! --�
--- ' --i '
} i /
----- ! ! -- |
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY ONLY`^```^``'`````^~^^~``````~`
Date received for C/O processing: ______ . Plans pulled for final processing: -
-
TompomryCx} ioovou: Certificate of Occupancy issued:
Off ice file review by: ______- -_ Date:
Filed insp finaled by: Date: '
_ _
Ninety days afteC/O issuance:
Owner/contractor called regarding the return of plans: __ Date:
Plans returned: Received by:. -- _
No response from owner/contractor plans desmyno - _-