1991, 05-02 Permit: 91001526 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON S9J6O
(509) 456-3675
1 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
o correct, and authorize Spokane County to u with processing. In addition, / have read and understand the /wnpscrmwnsuumsmcmTa/woT/os
provisions included herein and agreetocomply with same.All provisions of lawsand ordinances governing thistypeofwork will becomplied with whether specified
hereinornot. 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 state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER o9AGENT DATE
*********
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%POKANE
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%EW�ONNECTION
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KOKOMO TOWNJ
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PHONE= 5O9 927 O662
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� %EWER %TOB A% -BUILT INFORMATION I% AVAILABL� �- ��}F COUK
UTILITIE% DEPARTMENT (456-36O4)
,
CONT ACTOR OR APPLI�ANT I% TO FIELD LOCATE AND CONFIRM THF
ELEVATION AND PO%IT�ON OF %EWER %TUB PRIOR TO ANY OTHER
EXCAVATION
,
TO LOCATE BURIED CABLE%� �Ak:4 LINE�, ECT.
- CALL BEFORE yOU �IC. (45�-8OOO)
%EWER %TUB% �RE TO BE CHECKED PRIOR TO CONNECTION TO IN%URE
THAT THEY AREC AR AN UNOB%TRU TED TO THE �EWER MAIN
IN%PECTION PRIOR TO COVER **********
********* 24 HOU� NOTICE REQUIRED **********
********* 456-36O4 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: _ _ Project#_- ___'
Dept: Date: Condition: mit: Appr:
| | � (in) (out)
! -- -- -- --- --�
Dept.of Bldgs
Spooid |nop Final Report
Hydrant( ) ---------- - � ------- ) -- --
Lock Box
-- i -- - | --| ---' ! ------- -------
--- | -- ! -------
/ / |
- - } -/ - - -- --� -- -- --- - ---'
Engineer's - i _ | RID/CRP
Easements | /
-------� -- -- ' ----' ' --------
Road /
- -- � - ' -- - -- ------- | -------
Bonds--- } --! -- --- � -------
| --{ --� - ---� � ------- ! -- -
--- -- - � --| -- ----- -- / -- -- | -----
Planning Bonds
. __ ' _-! Bonds
. /
/ -- | -- -- — --
! | ----- � -
{ --/ -- - - ' --
-- / � --/ - ----- ' ------- i ----
� ! .
Utilities | / Double Plumbing
. /
UL|D
- - -- -- -- ' -
Other
/ {-- ----! -- - ---' ------� -
| ' |
. .
. .
`^~^^~~~~~~```^~^`'~~^~^`THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE DFOCCUPANCY ONLY```~^~~^^^~~~~^~^~`^```