1991, 03-28 Permit: 91000505 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
:. _ JL :T
NUMBER= 91000505 ISSUED iP
i" JDATE= 03/2@/91 PAGE= `,'i'.
t* ;* *: : : Jt . ytFa : ) k *7? t1f ;YPERMIT . w C :v r t N ***K*************** **:,*****..
PARCELO= 28543-2924
ADDRESS=E;tS:::: .;: ;"i#{,{"!i' #::, i.4{:! 99206
PERMIT t ;# : ELuN„: r CONNECTION – NORTH ,c...3 K._:!`^#..,
*i+ Ni SEE NOTE H•)`i9t'
PLATO= 001393 P .A ! NAME= K i_ Et,i;i i:'O TOWNSITE
BLOCK= 29 LOT= ZONE= AGEUB ,
AREA= 00000000 F•;i r::= i• the T,'iJ I I.f- DEPTH=# h•H:::: y,°,,' j:::: ,
'it' I t;•• BI..it1.+..S::: 1 4 t,/Wr', , .Nt t .: WATER DIST ....
,
HANKS, TED PHON =
STREET=OWNER= 10713 I:` 26TH {';•t l,I"
ADDRESS=;1...S t::=j'?ii..f•1N3::. WA '.>'9206
CONTACT
••.,t....: C••I :.;.t,r LEONARD .... H PHONE NUMBER=tT:{t"E'l=::
09 926 :.'71964
BUILDING EETBACKE : FRONT= ' .NA �RIGHT=�•:::: REAR= t.ry-
'
a,.K •.:i.s•.:,:.:ii.;i•*;[1 K:i:9i•*i+r i{K*:*1!:•**:!i: i+k'*r7=: SEWER PERMIT :n••Fl:'P:•F:.it:P:•P:•P:*•R•:n:'A:.*:@-P:•Jk.'!•9t•K•+:•R:":•P:Jt'3 * is iti P:
CONTRACTOR= ,! ,_ E CONSTRUCTION PHONE= 509 926
8964
STREET= 1 .1017 E
cEYWAY AVE
AAit DRE;' "= SPOKANE WA...?:3.,`»;x:}.17
ITEM DESCRIPTION
PROCESSING ST.NG F; E. Y, 10 , 00
SEWER
CONNECTION .'i0_ .. ..
: ;Jn: : i :.*sr .: J77 . !. : . fPAYMENT ;
" 11 *hn.. (*h P.** :n , . ? iiFR * ) 7 *
PAYMENT DATE t`'#::.t-.._..#.. Y: PAYMENT •::•i#" t':/.
..... 1610 50..0,,:
TOTAL PAID=
PERMIT: FEE r:. ,a#"tt•1`tN(• AMOUNT PAID J Ar+i t OWING
.SEWER ?''#::.E'';!`":.I. ? 50,00 50,00 ,00
90 . 00 50,00
PROCESSED o , . ..t.;. .i.!.:. :,I It, ! # i
f PRINTED BY : JIJL.IE I—IA,.TTO
SEWER STUB AE–BUILT INFORMATION IE AVAILABLE A T .i t'!__ COUNTY
#
CONTRACTOR OR APPLICANT IS TO FIELD i_,oc:ATI": AND CONFIRM THE
FiEVATION AND POSITION OF SEWER <<Tt ' t'H I,,"!R TO l r':!t OTHER
EXCAVATION
TO LOCATE BURIED _,A,t',E...#_.::• • 1.r�3 S PIPING, WATER LINES,
CALL BEFORE YOU DIG
–8000)
SEWER ::> # tai:iS ARE TO BE CHECKED PRIOR TO CONNECTION TO .i.t .... .. -....
THAT # H'::. 7 as E•°i!-- CLEAR {=t# i3 1„!1'V:,i BE # ?';1. t.:F #......
INSPECTION
TO THE gEWER MAIN
{ iJt # tJ : CALL « �C ”R- t " TO ....$};d'i...1"•'. N:.:Jl:••h:•*ii k•* i+:
•7{*3:•:!: +i A:•X* i 24 HOUR 1.O ? I
REQUIRED
E. ? # R# J ) 999f ) 1
*******K* •4L6.... A:t } PhN**A*: *R
............... ............ .......::.....t'..:...:...: ******************************K**
,..,. t.............................,..!..}. }.�..,..} + +, !, 1., t 'r..}..!.:i..}. ,"•.'•.t tl `.'i t t
3•.7-.3,.. ?t J. t-.t,.:..i•..:J.J.i. i 1• 7.9.1:, R}z ?:).1.):):7.}: THANK t-•,!'.,t-: i:,..._,:
SPECIAL CONDITION CHECKLIST
Project
Address: _-- --.____-- _--__ --_ Project#_---.___—_— _._-- Use:_-- --
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept,of Bldgs.
Special Insp.Final Report__.___- ---------__-_-- ----_... .----__-_.
Hydrant ( )
---__---- a 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 0/0 processing: Plans pulled for final processing:
Temporary 0/0 issued:-_.__ .__-.Certificate of Occupancy issued:
Office file review by.
___-- --- —.---.____bate;...—.__ ___------__—_._-- _-- —.
Filed insp finaled by: __ . Date:-�— —___---.—_--- - —_
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans .-___._-_ Date
Plans returned. ___ Received by
No response from owner/contractor-plans destroyed