1991, 06-05 Permit App: 91003005 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
PROJECT t"`%i i?"1B 1...R._. 91003005 APPLICATION _ DATE=
THIS
,, : • r. PERMIT
*j}..j;•..it.*fir.
. . h ° - , i , WILL ? : ASSESSED
, : :Y } " " COMMENCING WORK } P" i , t
PERMITi. .
SITE STREET= 11326 E :
PERMIT „,F1JNANL WA
USE= SEWER CONNECTION — SOUTH i'':_f;<:a:.;m”{; .
L..5..E T4,:_: 001393 � i Nr • t _ OMlTOWNEITE
.:,
_
000000 ErA= DEPTH= R/W= 60
WATER DIET =
•r•.
OWNER= nte..i 1'C e`'. I}'-1... GEORGE PHONE=
::.. I I..I
x
ADDRESS=
SPOKANE
CONTACT,' :.::-.:..:,.. GENE Fr RY'•: PHONE NUMBER= 509 924
BUILDING "`:::..:..,...In:•:,: RIGHT= !-'v A REAR= NA
i : nis" .inri: inh : r .., rr. .i } iE E W .° PERMIT *****************************K
CONTRAUiOR= CONSikU0liON PHONE= 509 924 6182
SPOKANE Hd t`
99206
ITEM DESCRIPTION QUANTITY F E AMOUNT
PROCESSING FEE 10„ 00
. :.. ut::.R CONNECTION .PERMIT TYPE FEE
AMOUNT
AMOUNT PAID AMOONT OWING .
:•:•••, ?••}-• PERMIT 50 50.00
50,00 „ 00 50,00
PROCESSED : a , w. SHATTO
PRINTED BY : JULIE SHATTO
EEWER STUB AS—BUILT INFORMATION Ig AVATLATiLE AT THF COUNTY
UTILITIEE DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT
... " r
TO! FiEi
i " : " - AN. CONFIRM
THE
I , + v -mty : ;• POSITION F + �t4 , } , Y _ PRIOR TO `N7OTHER
y a :,F I , N
. .. TO
LOCATE
t>•"• .}-,Rvp.^ CABLES ,
PIPING , WATERLINES,
CALL BEFORE YOU DIG ( 9%C-,—8000)
SEWER
EWcFr .:.ii ; c tF : DE
CHECKED
f iE fk : D PRORT TO CONNECTION `
1
N. . E
' - M THEY rr ; ' CLEAR AND UNOBSTRUCTED T3 THE SEWER "A"
:r*•!h'1:••}:•'A:9t•'lk'R: ;.:t•:E•...i... -'t.; t: INSPECTION PRIOR } O COVER}t n•i>•H•**•ri••x*3::fir
:: 91 ? yF.x; h , trr �t1REQUIRED Vi * eat iic xi
i!: :•*'ii•*3!i R* t; '%';;,.:.... ,;Pe"i.ty :*********31:
. ........,...................':•: a:.::.:.:*a•*::a::r. :•.::;.:r** }K *******************************.K*.
,...,...!.9t.;....,.�:......:a...,.r...,...r:a 4k Ft•e..:-.?..,•.:,.?,.1'a�..,:!'.r:1..... I:*r�:;3�:•. YOU t.
SPECIAL CONDITION CHECKLIST
Project
Address: — Project# Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
__ Hydrant ( )
_-_ Lock Box
Engineers _ __ 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 C/O processing: . 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: --- —No response from owner/contractor-plans destroyed: — -- —