1991, 03-18 Permit: 91001147 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
1 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE O
OWNER OR AGENT ,✓ �� DPAPEICATION_
-`•!'t !„ I NUMBER= 9100 4... ISSUED D .i.T DATE= 03 -i: }i PAGE= O
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PERMIT INFORMATION
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SITE STREET= ! s E 24TH AVE I''f•YI•{f,1-.1...O= 28542-3230
ADDRESS= SPOKANE WA 99206
PEqM;T,USE= :I:Nt'T!"YL..L.. SEWER CONNECTION FOR DUPLEX
001393 PL..F4_i. t`•i±-YI"'1E::== 1<:r•NKOt`'1... TaiAaN,`.•..7:';'1::.
OF BI...Dix;:= 0 Di,1l::.1...1....ENG.>= i WATER DIST ::::
OWNER= I..IfiN,"s` N, in{AI...DO E.;.. ;::=E'IONE::== 509 926 2239
STREET= 100810 N MAMER RD
ADDRESS= SPOKANE WA 9906
CONTACT NAME= ,.? A t.. O T:i ,'• EXCAVATING PHONE NUMBER= 509 924 ::..., } :::'s
BUILDING 1`}i=Ti::id'aCKS : FRONT= NA LEFT= NA E<:l:±:;;..;'T= NA
REAR= NA
P: R' '!C 'P: '1C ?+: 9+: •#: •P: •P: 'P: '#:.)!• j,...1}i ';=r '#i tit' '14' 'Pi ti4 ti!i •Pr '}�:..j,,..j,: 'Pi tit• •F:
SEWER PERMIT E:.'tMT.i.y,..�..y:.j�..p::)i..jt..j�..jt .j,...jt..K.:,,: �Pi �;i• iC -Pi :,: -#:• �;l iu: 9!..J!..}{..jt..j{.:n:.)!• •Pi •P:
CONTRACTOR= :.? A t.: t... ?: { ,: EXCAVATING PHONE= 509 . a 23555
STREET= i3420 E SALTESE AVE::
ADDRESS= SPOKANE WA 9906
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------ -------- .........._.._......_....._._..--
PROCESSING FEE Y io'00
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PAYMENT SUMMARY P: 'P: 'P: '#: 'P: 9{ 9,..y,: i�: 9!' P: 9!: 'Pi 9k •;l• •Pi 91• :4 j=i •#i .j,, .J�..M..,,..J,..�..J,..J,.
PAYMENT DA t E RE:.C1::..#. P O PAYMENT AMOUNT
0308:'9i 1303 50100
TOTAL DUE::% .00 TOTAL PAID= 50,00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT 1' i,ii 'i'••ii(
50400 400
PROCESSED B Y : JOHN N I...ARSON
PRINTED BY: JOHN LARSON
SEWER STUB AS—BUILT :N"!E~ArLfN IS AVAILABLE "T THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE A N t:; CONFIRM ••L•;..I I::.
ELEVATION Af'•:I) POSITION OF SEWER STUB PRIOI? Tt:::i ANY OTHER
EXCAVATION
TO LOCATE BURIED t.:r•";SL_E:.S, GAS PIPING, WATER LINES, ECT.
CALLT.:;E::E� ORE:: Y !..iii T I (: ;_�r;.... s0!:j0
:.W.:.'ti STUBS i_Ij: S i'•YRE TO BE:. CHECKED D I::'I":.LiiR TO CONNECTION TO .I NS{.. RF.
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
CALL FOR INSPECTION PRIOR TO T (:;t, i:,;I::_E;=
4 HOUR 1'+I[ iT.ECI.:: REQUIRED
•_•56—,^,60-:;
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THANK i,.t 4,.1 ...............
c�.:)!• )=i ti,.• ti`i 1t tiE'r• iii •hi 'Pi ti=i 'R• tiC iE 1t til• il- iR• $=i Y• )� tiE :��: ii• it •J=::=r :�r, •tr :�r it •J=:
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
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: y.
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:_ —