1991, 05-22 Permit: 91002518 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260'
(509)456-3675
[certify that I have exam fined 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
r ,..
t"?'i!.!..!?::.f: i NUMBER= i!:�t'.:.t....• :± , �a!:l::::::'#t:i ISSUED PERMIT DATE= t::.:::: t:?::i % .:`::.. � � '1 PAGE= t:1?
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PERMIT INI"ORMA ..ON :a- -7�: -ik �ik •){• �Ji� ��+: a• •!+: -b; �ii• -)�; •)E �nr �},} .j,; •+4 •)+; •ii :,} •nr .,,..u..){• �:{• 1ri 1t.
SITE STREET= i 40 2 ::i t::. 26TH A t . ?- F:; R !.: t::. L -+.::: :.. ! ;:+ .... !: ? 't E•: i :: ° P t f v
ADDRESS=
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PERMIT USE= :J :. '' CONNECTION .... EVERGREEN POINT 6TH r•; ; a ?,: ?,
� ` E E NOTE
PLATO= t:JOOttOO PLAT NAME= !.!NK Nlt.!':•_$N
.
,...
BLOCK= '1 i LOT= ::: `# !:I ZONE= UR -3.5 DI:: -•
DWELLINGS=
( WIDTH= 1 as DEPTH= , t" :::: # :...._: #-`, : , �. .
!. S • 1 -... 07 yT j,. ♦ = l WATER DIST ._.
OWNER= 14; R S & ASSOCIATES .L N (:.". PHONE= 509 '?'.:.'2 0782 ..',;::.2
STREET= P 0 BOX i4084
ADDRESS= SPOKANE WA 99214
CONTACT #tlFii"#L':.= BILL SMITH ,','I[ii''• E NUMBER= E,)1� 9 922 (.}'r';•::;`:%
BUILDING SETBACKS: FRr $N = NA LEFT= NA RIGHT= NA REAR= Nf::•1
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SEWER P„"I"............. ........... .
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CONTRACTOR= la R ..:• ... ASSOCIATES #'' . !.. 509 922 0782
STREET= P 0 BOX 14084
ADDRESS= SPOKANE WA 9921 Y
ITEM DESCRIPTION QUANTITY FEE AMOUNT
$: I , i, $.. - r, 1; art o r"i
SEWER CONNECTION
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PAYMENT.. J SUMMARY U""ii7 ... .... .... .... .
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PAYMENT
DATE !... ,a(::. !.: L:. .. # :y: PAYMENT AMOUNT
't $aj Oi 1N..
05/22/91 3106 5%00
TOTAL DUE:::: 00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMt'.UNT. AMOUNT (' PstI AMOUNT ?"il:il:NG
............................................................................................... —.............................................. ----
PROCESSED BY: WENDEL, GLORIA
SEWER R!B AS—BUILT INFORMATION I�AVAILABLE :T ' I : COUNTY
UTILITIES DEPARTMENT MI::.i! T !.456--6'14
CONTRACTOR OR
APPLICANT IS TO FIELD D LO1:::r I E:. AND CONFIRM THE
ELEVATION N F. ND POSITION $..rt.. SEWER STUB PRIOR TO r:`$NY OTHEREREXCAVATION
TO LOCATE BURIED l.: 'ra ):; $... I::. � :• , L.r f•4 :::•PIPING , WATER ....i. ?�•? I':: ,:: I::. #�...�...
CALL BEFORE YOU DIG
8000)
SEWER S#..S - R tTO BE CHECKED PRIOR
P;::T! CONNECTION r CINSURE
$tAt THEY ARE CLEAR AND UNOBSTRUCTED
TO THE SEWER MAIN
CALL r- O R INSPECTION PRI:OR TO COVER
i!- i+.• ai- - N' )F It N. H. .: HOUR NOTICE REQUIRED h} ,:. }F l;.:i•'n: ti- iE li- h:
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:+: P: 3t i+::'+: •P: air •Nr •Pr ik
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* °
SPECIAL CONDITION CHECKLIST
Project
Address: __ Project# Use:
Dept: Date: Condition: mit: App,:
(in) (out)
Dept.of Bldg
Special lnsp.Final Report
Hydrant( )
Lock Box
Engineer's _— -_ RID/CRP
Easements
Road Plans/Improvements
Bonds
-- --
Planning _ Bonds
•
Utilities Double_ Double Plumbing
ULID
Other
- --
.
~^^^^^`~````^`~^~~^``~^`^^THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY ONLY.~^~^^``~^`~~~^~`~^`~^`
Date received for C/O procesing: Plans pulled for final processing:
Temporary C/O issued: Certificate of Occupancy issued:
Office file review by: - Date.
Filed insp finaled by: Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: Date:
Plans returned: Received by:
mo response from owner/contractor plans destroyed: