1991, 12-18 Permit: 91008464 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
herein or not.I 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
understand permit/application
tsucsent ntion aitvshall gve authoriity to volate oancel the provisons of aystator llocallaw eguaingontructiooras a approvals
of conformance with thepoisons of any state or local
laws regulating construction.
SIGNATURE OF
OWNER OR AGENT APPLICATION
DATE
PROJECTNUMBER=i{..: x1008464 ISSUED PERMIT ,... # ;a;'-• PAGE= car'+
??•ik 9!•;!'i,ir.!•it.?'.ti!t•.k it•.t'9i•.r,•.!:N.);..M.}:..r•.i•.i.*fir.:::!!. •..r-r•.,:•r•.- •,•:.r-•z r.,.. : -.
n.. F€:.;• {':�, # I#v{..€,t#•c:Mf: { :{.+..!i:; *:tr'J!'**•r•.•**1;•.K**'...:v::!:.....:t.:+?:N•i,:....u•ii.
ADDRESS= SPOKANE WA 992.16 PARCEL0= :' ::>•i.::....: ::.E:i':
€; r t E= SEWER CONNECTION
PLAT0=":.•• ,; 0 9 . ... PLAT NAME=
GAIL ' SESTATES
BLOCK= OTZONE=
• r .AREA= + Of : a% t " _
Ltl
0 OF ,., ! 0 A?.6t L..€._t....,.1 J G�t::_ 1 WATER DIST .... . .. ..
.::
OEpiN :.It= 3i.;•: ..{N H 11
'
. 4 E 23RD AVE.. SPOKANE 99216
CONTACT NAME=
. +" ON PHONE NUMBER= " ' y .
ti r "tti # r . r " SETBACKS :
. " Avt : FRONT= � a , _r -. N/A RIGHT= REAR=
................
'Hr 9..J!..A:9!'9C 9?.•i .f;:.}i••j'•i!;•jt;••j,;..•...Pi..:yi....•i,;•j?:•j,:.f!,..!;...!,.j(. SEWER
vWER ^E : ;
IT * {.:p.**•lt*.**.**•Ft•*•P*9!:.*lt•Pr•**i,ia,*i!ri!`i*?r T.*
CONTRACTOR= t+,". t.: CONSTRUCTION
s i j to S
- STREET= RT BOX 88
ADDREr`-S:::. SPANGLE
WA .;9!`':7 1
ITEM E:.r€ i?I::.::.•CRIE iION QUANTITY
:
FEE AMOUNT
PROCESSING FEE
10,00
SEWER CONNECTION 1 0 .
********K**********************
C. ? {7uG ! .. ..H .. . ?NN ..ht ; .4A .3 . � Li1 ' _MMAR
**Pt.1'.{'•ai tti•Pr a*•R•'h}.i*'Pi.tt..j,.**•R•*.k'•,i i»..1,,.*.7{ ,i
PAYMENT DA -r - - r PK „ PAYMENT 12/18/91 c.P7.5:30 50.00
TOTAL DUE= .00 TOTAL PAID= 50,00
- PERMIT Y',.:i. FEE AMOUNT PAID i t i V T OWING
PROC€ , i.:. J t;:'.'
DOM I I I'::,_,;:' t.H , ROBIN
PRINTED r;{-il - DOMITROVICH, ROBIN
SEWER STUB AS—BUILT
INFORMATION '•t' AVAILABLE AT ..
COUNTY
UTILITIES DEPARTMENT (456-3604 )
CONTRACTOR OR I': A: ,• »r ...
FIFVATION AND POSITION OF- FIELD TAND O
EXCAVATION
SEWER STUB i.? :S #'r{ rf1i t TO i f1t N Y OTHER
TO LOCATE E BURI :.'J CABLES, GAS
PIPING,
CALL BEFORE YOU Ai i ; (456-8000) WATER LINES,.... ,
n TO SEWER STUBS EE CHECKED
"F ,Ki . PRIOR!
T ! € ``y
j € i - V. •r INSURE
N
S( i h : r », ARE CLEAR AND UNOBSTRUCTED TOTHE SEWER " . Cw4NkF. tN :. .{ FOR INSPECTION PRIOR TO COVER kn** itiiiH _ I = NOTICE t Rrufiji . =i " aiii . kF45,6-3604 j
.`.'.4'.f'a•**•,'-»:!i-*-a.i!;7r.*r!:.r,:_f!:y?:.ti.if...inr 7f•.}..}:.;ii•.k.i•.!,a f!..i• THANK
,
€'{f•7{V tt. y!,•F U -if'.{'*:J...!•}".{••j!;•j?:***1`..>.•.t•. :!':.?•.!;..Y..jr..!{.N,j:.Y..;.�...}:.;h':+':.S•.'..,.
SPECIAL CONDITION CHECKLIST
Project
Address: —__ —_ Project# Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs. _ - - - ------
--------- -- - A 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
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:__