1991, 07-25 Permit: 91004511 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
]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 orcancel the provisions of any state or local law regulating construction, was a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF / APPLICATION �/
OWNER OR AGENT -'7 5
I:::Iri!::R S UB t-tr3....Bl.!j.L!• iNjiRA-10
JTILITIES'DEPAOTMENT (456-3604
CONTRACTOR OR IS TOFIELD
LOCATE i
• CONFIRM THF
ELEVATION AND ^j}NI?:Y OF SEWER STUB
" T.!TO
ANY f 1'• .
EXCAVATION
O LOCATE BURIED CABLES, GAS PIP:NG,
WATER LINES,
FC...
:i_L BEFORE YOU DIG(456-80001
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' E: W E R ` J U B S ±'? I��•° E:. T & B E:. •. s~' H E" �"• K E: D ; i'' i•�r..i. E i R
T CONNECTION
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..�. O INSURE
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THAT ? i—t• E Y ARE CLEAR AND UNOBSTRUCTED
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MAIN
rEr.�.:
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:ALL FOR INSPECTION PRIOR
i:•�1it!. i�r?1�•
TO COVER
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.1. ... l` :: } .: �....::..:::• )t• • 9t) ):• i a!• if Vit• �Y 9!• 9l Vit• Yt 9`:• ;R:' 9' HANK YOU I, I .j(. �!' ]t..P- il' 1!• M- It 3!' 9r !t
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SPECIAL CONDITION CHECKLIST
Project
Address: ______ Project#_'___- __- Use:
Dept: Date: Condition:
� } � mit: Appc
(in) | (out)
Dept of Bldgs ' / / --- --------- --- � - !
------ / ----' --/ Special Insp.Final Report |
Hydrant -- -- '
'( )
-- -- 1 -_|
Lock Box
| --
/ --- ' --{
Engineer's } / _- RID/CRP -- ----
Easements - -
Road Plans/Improvements --
Bonds
| _--
' --�
� --}
Planning ___ Bonds -- -
-- '
' --
. --
' --
-_'
-- } --� --
Utilities
Double Plumbing
ULID
' --/
Other
--.
-- ' -- ! -------
-- _-
� --- --
-_ .
_- -
-- '
_- -
.,..,,..,,...,..,,,~..,,
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE 0pOCCUPANCY ONLY~`^^^'``~^`~^^~`'````````^
Dxte received for C/O processing: Plans pulled for final processing' ------ _
issued:/ompo �C/O �-' -
Temporary
-- Certificate of Occupancy issued:—
Office file review by: ____ . ome:--- _--__-_- ----
Filed insp finaled by:_ _--'_ . Date:
Nlinety days after C/O issuance: ---
Owner/contractor called regarding the return of plans: Date: -_----
Plans returned: -
m
� _ __ Received by: -'_-_- - -- ---- �
No response from owner/contractor plans destroyed:
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