1991, 05-16 Permit App: 91002654 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 NUMBER=..... 91002654 A!"t'!_.d.t.:A1r,,,,;j'v DATE= 05/16/91 PAGE=
01
.. .............i.
::7 1.1...1. THIS .t.;�. f••}i..; ? A PERMIT .;,;:Pi irf•:1*!,.:u}
PENALTIES WILL r:1-. ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
................................................................................................................................................................................................................................................................................................................
SITE STREET= -s •} r :': ::. :
WA
••, i .t i••{:�!::. ?.:F•1{'':t.:!::.!...:n..... 28543-4410
ADDRESS= SPOKANE WA 9920
PERMIT IT Uai.:'= .;,,,±±!::.R CO'•1'j•:1..:_: ..i.7N .... SOUTH I<'{:ii<;I,ii°O
:}i ji ji NOTE ji ji k ....
'E...A . -rr•-- 001393 't...A i NAME= I•'•.O?t•.O 1`'1 O t {„1±:J N,:r.?. I !::.
BLOCK= 44 LOT= r.:.+..;NE:::: AGEUB DIST4=
AREA= 00000000 0 F/(..= ±.. WIDTH= DEPTH=
I"I :: 1•:°%j;,t:::.
0 OF j::...t_}t:r..:•.... 1 DWELLINGS= WATER DIET ....
OWNER=I t.:R1. t':.t'' i ''G {.. PHONE=
STREET= 10722 E 28TH AVE
ADDRESS= :.:1''±11<..F•?!`!E ?'jai 99206
CONTACT NAME= .J :::• CONSTRUCTION PHONE i{{..1e1i.{I..r' ..l:!?' 4!7,8 Y664
BUILDING SETBACKS : FRONT= NA t ..±.. .. ;!A RIGHT= NA REAR=
****** ****************:k***** : ? aF± PERMIT A *P1p1k PC Fk k aRjiPH9:nC ! 'R i
ADDRESS=CONTRACTOR= j E CONSTRUCTION PHONE= 509 458 9384
STREET= 6155 E HAYDEN AVE
RATHDRUM ID 83858
ITEM E.. t•R I,I:::..i ! {_t N QUANTITY L.?..?::. AMOUNT
PROCESSING FEE 10,00
SEWER CONNECTION 40 ,00
PERMIT TYPE FEE AMOUNT AMOUNTf'....f": AMOUNT OWING
SEWER PERMIT 50, 00 „00 50,00
PROCESSED BY : jOHN LARSON
PRINTED BY : JOHN LARSON
::r?::.V:+1::.Rt y,...tlt; AS—BUILT INFORMATION LS AVAILABLE A1 THE COUNTY
UTILITIES j..!!::.I''S:ii'•. ! {"tt'_N ? (456-3604)
CONTRACTOR OR R AF:{..t... •._..:b.N APPLICANT t.; FIELD LOCATE ±i.t i'H i i CONFIRM 11.•11::.
ELEVATION
A = t. :v :. j POSITION OF• ty; STUB PRIOR TO r•+,r:t'r OTHER
EXCAVATION
1..i LOCATE! E BURIED t.:;..±\•{L..I::.S GAS PIPING, WATER LINES, ECT ,
CALL BEFORE YOU?U f! ( 456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO 'INSURE
THAT A t ? #r E::..._ ARE E::. C #::.(^±Iy.: AND I I U?•'*l.,a.=:': I ?':1 11 I tv.;,1 TO I { i••I!::. SEWER MAIN
'h:;ri:rr**`R'•jt:** CALL FOR INSPECTION LRit TOCOVER i * iip y ; i
NOTICE
•jr•ii i:�:9z••'!r•r•:-!v str?r: :•�, HOUR REQUIRED ? ) ' ) l )i:,4::*
§******** 456-3604 A*-j{--j!:j:i'Pr**,h*
.....r..!}..1....r..,..,..,.. THANK N'' •' t t )r.9}.*'}h _ri.y.:t}.*)l'!l'•j,.•P.•jr.:*jr:j•.jr jj..jr..jj.j{.:}(, �j.:tr:'j,::,1•}[.
:r:-1�•-!r::�?tr�!-:�,:�!t�•:;r:�r:::rr.1,:;�:ar.,t •!r•t�•!t n t:.::i:t 1.t..t 1.r. 1 t t±. .{•. f ..!...
SPECIAL CONDITION CHECKLIST
Project
Address: ___-__ ____ -- _ Prmject#_ _ __ Use:
Dept: Date: Condition: App,:
in) | (out)
| `
--------- --| -- --- --- - -- - | ------- | -
Dept of Bldgs
Special Insp.Final Report
_
xygmnt( ) - - ---- - - | -
Lock Box
���
----------� -_} - ' '` `'
] /
Engineer's RID/CRP _ .• � ---� | -- ---
Easements'
Road � mm
on^/mp "emon
Bonds---� - ----| - - --! --- ' --
-------- ---} -- ---- --| -_ �! _ | _-_-___-
( ---- -----� --� --� ' ^ - | -
| --- - --. ---- - --- - ------- . -
--- -------- ---------- --| -- - { - - ' -
Planning _- __________ -- Bonda____
! !
--------- -- --------- -- --- / -- - !
| ------'---'| --| ---- � -Utilities Double ooub|eP|vmbixg
UL0__ __ -_ `
! i /
! -- ------'} -- - -- ' ` ' -
------- --- ----- _ --/ --� -- --- -- -- !
------- -�-- --| --/ - - - |Other
.
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-- --------/ -- -------� -- | -
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. .
^
^^^^~~^^~^~^^`~~~^~—~`^THIS SPACE FOR COMMERCIAL PLANS T9xCmw3.CERTIFICATE opoCCUpAmCvCwLv^~~`~~~~~`^^~~~`~~`~^`
Date received for 0/0 processing: • .Plans pulled for final processing' '
Temporary 0/0 iesueu._____- _________ __ _ Certificate of Occupancy issued:
Office file review by: __ __ ___-_-_- _ Date:
Filed inapfina|edby:_--___ -__-__ ____ _ . Date:
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: _____- __ _________ Date:
Plans returned: __-____'___-_____'_____-___ __' Received by:
No response from owner/contractor plans destroyed: