1991, 04-18 Permit: 91001914 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' ;ntained 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 prov'sions of any state or local
laws regulating construction
SIGNATURE OF 1 ( l // APPLICATION y el/
OWNER OR AGENT �� �i �k 111% /y DATE
PROJECT r ! ) 1t : 91001914 + i :i ; PERMIT DAL04/18/91 PAGE-
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:fI : I ' , . 10716 i { i ; - : :; •' -L . 2R4:7‘—441i
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WA 99206
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OWNER=i.
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' REL. 10716 E 28TH AVE
{::i' Kc1NE WA 99206
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BUILDING Ei t'�{•-{, FRONT- .?{-. -� I�4 i•: i� � REAR- �•.! Y;..
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ADDREEE= EPOKANE WA 99206
-------------------
ING FEE 10 , 00
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EEWER CONNECTION 40,00
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PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
...............................................
PERMITTOTAL DUE- ,00 TOTAL PAID- 50 , 00
TYPE ,.. :.. AMOUNT AMOUNT i i:'± i i.! AMOUNT•
.. ........ R PERMIT 50 , 00 50 ,00 i''UTILITIEE ..
50,00 ,00
PRINTED BY : jOHN LAREON
EEWER ETUB AE—BUTLT INFORMATION IE AVAILABLE AT THE COUNTY
DEPARTMENT
l' ANTPATOR OR
APPLICANT
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I:.,...!.:.`p F'! I !.,.J,'-. (.:±;",.:_J s !.!:.:• ...'..;.i.JI"•! ±..+. gFWER g } I...... PRIOR TO ANYOTHER
LxuAVATION
TO LOCATE BURIED CABLEE, GAE PIPING, WATER LINFE, H., ; „
CALL BEFORE YOU DIG ( 456-8000 )
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CLEAR
ED
INEURE
PRIOR = CONNECTION `
THAT T3t { - !Iea _ UNOBETRUCTED TO
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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_
•
•
Ut I t es 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.
Plan'i returned. -- -.___-- —_--- __ _ __. Received by:
_ .
No response from owner/contractor-plans destroyed: -----