1991, 03-18 Permit App: 91001141 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
2.. ,.., ,....;.......
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?+:i!:i!::!!_,,..,,. THIS Nui ra r'`t *KK***
PENALTIES WILL BE A, :i"' .M::.. i..l.!i"•. ._ .. $''i I'i rN r.T.Ni..7 WORK WITHOUT A P .
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i = 11011 E '261H AVE PARCEL4- 2O547)-3027
IIA)%!:`.r.E... '• SPOKANE WA 99206
PLHMil :.....
USE= SEWER CONNECTION .... EOUTH . ....OIb'i t
PLATO=EEE NOTE
001393 PLAT NAME= {'•.t._I.. .-iM i TOWNEITE
BLOCK= 30 LOT ZONE= AGEUB DIET4=
ETREET- 11011 E . 26TH AVE
ADDREES- SPOKANE WA 99206
s.,it`.' , tt is .... :! t-'! 1:i ii El.,f i ..i t–�...t''f t,.
... .... .t.: ! , .tl",:.. .. it NUMBER=PHONE
09 924 54M:J:
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CONTRACTOR= •..:t.,,;rc:i.:!" t`?a.N;:_ i..:i;«i„f.. -i iii... ....t: i..rO
ADDRESS- VERADALE WA 99077
ITEM DESCRIPTION ''q' FEE AMOUNT
'itit'i,:i•• IN FEE :I t:
,:>t;,!!I::.i<' CONNECTION 40 , 0(:)
PERMIT TYPE AMOUNT AMOUNT PAID AMOUNT OWING
EEWER PERMIT 50, 00 , 00 50 , 00
50, 00 ,00 50 ,00
P I':t t 2. '-;.•.S't::.D B'Y : ,.i U_..I.E ::'I”I t.:;..i_ ;;-t
PRINTED BY : jULIE SHATTO
EEWER ; I t i;; AE—BUILT (:l('13 i-;.$':fia.` i t,,t['! TE AVAILABLE AT THE COUNTY
DEPARTMENT i i't , ! i i ...I::.:i `.?Ei»'r"ti"`•: MEi"'i I ::.,j.i:;. i
CONTRACTOR 2-tr•: APPLICANT i.::': TO FIELD LOCATE AND CONFIRM i i–i!::-
ELEVATION AND t' t ?t.:. t. I i.?!. O?- :I::,i,S.._.–. STUB PRIOR TO ANY .
EXCAVATION
TO LOCATE BURIED CABLEE , GAE PIPING, WATER LIWEE , ECT ,
CALL BEFORE YOU DIG (456-8000)
ARE TO
PE CHECKED
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, :: THEY : _, CLEAR t 1 itt ' ' IH MWLN
Uq :t33r ; : t FORINSPECTION ' :1i . : 'Sy ! . . . Gi!:.
n oi
:*:k:pf:K** KK 24 HOURNOTICE _,t.�;..,:.if'ii'JY;>.•i?L' ±r i?:i
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SPECIAL CONDITION CHECKLIST
Project
Address: _ Project Use:
Dept. Date: Condition: mit: Appr:
� / !
(in) (out)
Dept of Bldgs } | |
| |
Special �mgRono�
-| - � -- - - ---- ---- ----
------ -- | ---- -| --
Hydrant( )
Lock Box
--i | ---- -- ---- | --- --
----- ---| --- -- !'--/ --- �- • -- | -- - --
� ^
------' ^- --- | -�| - }�- ----
Engineer's___ i � RID/CRP
Easements_ -- - - - | -
------ ----| - -_|
Road Plans/Improvements
--- --- ----' ___ | -_|
Bonds .
--------- --� -- —| � -- -----� -- -- ' -------
--- -- ----- --| ---' -- - - / --- ---
--- ------| ----- - --! ' -- { ---
-------- -! �----------| --/ - ---- _ ' __- _ ' ____-
Planning Bonds ! -- --
____ | -- - ' ' � -- i -------
---------- | --| - --- -- _ | __ ___�
------- -{ -- -' -- '� | (
•
| '
------- -| - -- - - - -- ! ! --
-------' 1 - -- -- ``|- - ---'
---' - -- ---- � --! ' -- i
Utilities__ | ~^/ Double Plumbing_
! `
UL|D
-----' ---| --- - --
----- - --' --| ---- - ' --Other
THIS
------- -- - - -- -- -- ---- '
-------' -- -- -- - } ---
| | -- -- -
--- ----- -- | - ` - ! --- --'
--- -------| --| -- ' -- -- '
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^ ~~^^ rx|SSPACE FOR COMMERCIAL PLANS TnxCK|wG.CsnT|px�ATeDFOCCupAmo,Owc/~^`~^^^~~~`~^~^^~^~~~`~^
Date receved for C/O processing: . Plans pulled for final processing:
Temporary C/O ssued: __ _ __- Certificate of Occupancy issued:Office file review by: ____- . oete:
Filed insp finaled by: __ . Date:
Ninety days after C/C issuance:
Owner/contractor called regarding the return of plans __ Dat*:______-_'__-_
Plans returned: __- -__- Received by:
No response from owner/contractor plans destroyed:
-
JOB ADDRESS: 1 l /
ET . (..D2 +11.
SUBDIVISION: LOT: BLOCK:
OWNER: vL<.__.�� PHONE:
ADDRESS:
CONTRACTOR: 0PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY:
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