1991, 04-03 Permit: 91001561 SewerSPOKANE 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, oras a warranty of conformance with the provisions of any stateor local
laws regulating construction.
SIGNATURE OF y�� r �/ yQ 1 ::W It
1 / APPLICATION L
OWNER OR AGENT " Xl D.lo C CY Ai
Project
Address
Dept:
Date:
Dept. of Bldgs.
Engineer's
Planning-_
Utilities---.. _...._.�
Other- — _
L7
SPECIAL CONDITION CHECKLIST
Project #_..-._
Condition:
Special Insp. Final Repo
Hydrant(
Lock Box
RID/CRP _
Easements—
Road
asements___Road Plans/Improvements
Bonds
Bonds
Double Plumbing
OLID
THISSPACEFOR COMMERCIAL PLANSTRACKING,CERTIFICATEOFOCCUPANCY ONLY
Date received for C/O processing:
Temporary C/O
Office file review by:_ --
Filed Insp finaled by:—__._-------�_.-----._- --
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed:
-T. Plans pulled for final processing:
— Certificate of Occupancy issued: - ----- _.
Date:
Date:
Received by:
Date:
Init:
1;_1