1991, 04-08 Permit: 91001639 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 L/` l DATE `7
PROJECT NUMBER=-
ISSUED PERMIT - DATE=E_.. :.1,_..,; PAGE=
pERmIT iNFoRmATioN •$*a a'.E fi.`•*a'.!-.Y,:. 3?i..::!E f., .:.h..1.Jt.h
PERMIT USE= EEWER CONNECTION - SOUTH KOKOMO
*K:k EEE NOTE
! L..Fi f •!!._. 001393 PLAT NAME= ,'•,l.i.. ...v}Oi-i I,ht F'J;; _
BLOCK= 35 LOT= ..t.;.,.1-E E
AREA= 00009750 }. i P. ... WIDTH=E.... "': DEPTH= _
W ;.,T;...:: '::' :. , 9 924
OWNER= ,.: ? +_+it•.f'.1...� ?'•? }... ..- .. 2961
STREET= 11005 E.. 27TH AVE
ADDREES= SPOKANE WA 99206
PHONE NUMBER= 509 924 2?6i
?.'•t,.?.i,i...`,%.l.NG �'E 1 r•;i::;KE : ..t..}",'",,T 'A LEFT=... i:ii- RIGHT= NA REAR=
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CONTRACTOR= OWNER
TIEN Di7..SCRiH : TON QUANTITY FEE AMOUNT
SEWER CONNECTION
? 40,00
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�::`t.:E ( ,?...!�: DATE I't.i::.?..:!::..i.�'T 4 PAYMENT ,..t 1'1 1..!...
..........
I_ PAID 50
PERMIT TYPE - FEE AMOUNT AMOUNT PAID AMOONT OWING
EEWER PERMIT 50, 00 50 ,00. ,00
PROCEEEED BY : JULIE EHATTO
PRINTED BY : JULIE EHATTC
-SEWER STUB AS-BUILT INFORMATION TE AVAILARLE AT THR F:gHNTY
+ .i.i i 'T IE.. 'ti tFi-pAt Ti ,..1•`_ i'4 y: 364 i
_. CONTRACTOR OR APPLICANT IE TO FIELD LOCATE{CA •AND t,,:t.1N -.•r,. •{•}..I I:.
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TO LOCATE BURIED !.:i^t.t:3i...i A:. PIPING, WATER ._.i.1'V t••.._ ECT ,
.- .f.f...t;, BEFORE- YOU DIG ( 456-8000)
i..i.J I' i t ETUDE E...... ... !t! .... TO' BE' OHEED' PRIOR TO i t i J f ? 3 i 1! TO I i:: HRE
:: -. ...
THAT HEr : - iCLEAR F N! UNOBSTRUCTED THE
- EE..... . . MAIN
. . irN. . . u6 . I _ FOR . a � r rI . PRIOR ({ COVER
O ;r ( i iX 1t ; niti i
yr}z.:t:':.6: .Pr P:. .k 24 r,•...'•}...+:i NOTICE. .. I :S".'iI}IR ....D 4CP.1Lu) .'•li•1i't':g
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'THANK :fe.:F:. .f!:: .ji..j..'.qe.:,j.:H: :j...:!!:'TL':![':.,.i/..;li:r..:'?'.':.'.•!"..'f: ':k'
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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
Double Plumbing__
U L I D
- --- ----- ---- -----
Other__
"" `THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY---"*" *."*"'."'""'
Date received for C/O processing: ,. Plans pulled for final processing: ____________.___
Temporary 0/0 issued:_.-___-_--_._._-_-_-__-- ----. .Certificate of Occupancy issued: -._-__--
Office file review by:
______�-------------__- . Date:
Filed insp finaled by: _ —.Date:
Ninety days after CIO issuance:
Owner/contractor called regarding the return of plans: ______ -_____ ___-.__.___-___ .__ _ Date:
Pians rail.+rued: _ - Received by. _-----—___-- - _-__
No response from owner/contractor-plans destroyed: _ __ —_-- _____