1991, 04-08 Permit: 91001504 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 t 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 OFAPPLICATION
OWNER OR AGE >19 1d06‘ DATE
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ADDRESS= SPOKANE WA 99216
PERMIT
:_. NOTE
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AREA- ;- /A= F WIDTH= 104 DEPTH- io6 Pfw-
,y ,y,;.,.... .,}• D jai y .. .... ..... 1 WATER
e
" PROGRESS�
ADDRESS= VERADALE WA 99037
CONTACT NAME= FRANK MADDEN PHONE NUMBER- 509 924
BUILDING—SETBACKS : FRONT= NA - LEFT= NA RIGHT= NA PEAR- NA
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. . FR E ,, •:- c:A 'y:A:!F;.t1:i}:•' AA :yj.CONTRACTOR= KEVIN :.
MADDEN
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ADDRESS= 1 .t tl"!:.:'t":,...'..... WA '::::90"37
QUANTITY
SING ,
i CONNECTION .i
40 , 00
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TOTAL DUE= ,00 TCTAL PAID- 50 , 0D
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SEWER PERMIT 50 ,00
50,00 , 00
AT THF OoHNTY
< s SEWER STUB AS—BUILT INFORMATION ... .. ) ............ ..
UTILITIES DEPARTMENT (.. 456—3604)
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ELEVATION _ POSITION i : SEWER - . irPRIOR TO
ANY _ ._
EXCAVATION
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SEWE
. H r.T .Y.i.:.«r, y. CLEAR AND—UNOBSTRUCTED 's;•IE.. .`y_«i. i I. KAIN
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1 ; •.r::..r.: :9:..:: ! : . a J .}.: sssa .:u.. r : uar :..r.:::. ::.. t ;. THANK _
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SPECIAL CONDITION CHECKLIST
Project
Address: — Project#_.__ ___._.__-- -----.____--_._Use:__.___________.__
Dept: Date: Condition: Init: 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-__________-__-_-_
-- -- U L I D__
Other------_-.�__
-"""'*"'"'"' ---""THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY"""" ""'"""" """`
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:_.A_---
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans:__________ Date ___. ------
Plans -______- . Received by:
No response from owner/contractor-plans destroyed:__ _ . ._-______- ___________