1991, 04-03 Permit: 91001565 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. s03 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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF r/ APPLICATION
OWNER OR AGENT -i_ .-_/'!.s,. _%% '"' DATE 1 —i /
PROjECT NUMBER= ... .....r i.:`r:::t.?e..,t 1 PERMIT DATE= 04/03/91 PAGE= ;1
*****K** ************ * ****9'• i! `P}•,.} .:'. ? .:!•d.�.., i3::s )�t•f�) t.�....
I' .......!.!. I .i{'v.� }}'•:I.. . ,,.; y,..,.....,:-?- ,i•,:•':f:li !:17 N.**ji.,,,..t!..,..}t.fi-i!t-ih'1t 9i"Ni't t!=r
S7TE STREET= -?iK:"I F 28TH AVE P :a{•;C E LA:: ..
ADDRESS= SPOK(^NE. WA 99206
j:.I':.'ia. t:. SEWER CONNECTION .... SOUTH fi.i......,+.'?t_i
?(••li•l EEE NOTE !i•Vit•'p
t...s••: ! v.._: .y(�3 } ::7 r1,^, PLAT NAME= i4{.+1�.3^jl�ii..i _^i'f t(xt'�il.� :•';"^•
BLOCK= ..f: ,r LOT= :3 is 0 20NE= UR i ,°5; t:s i : {•
i
AREA= t t•..... WIDTH= ..?t-.I' '
I 4 , aL :ti : qDWELLINGS= 1 WATER j t : t ,
OWNER=
; L . : t r : 1 FRED- PHONE=
�: ,
. .I
amu:'»:
<. :
1 F 28TH AVE
ADD3'{t::.i.i,:i.... it •...t•.i••i ltl(::. WF't 99206
=..:I..iI i f•i?.: i I`.?f•;i"I::.:�: ii , .ii 3::.:'�,i.:f-i'%, i i .i.,4is PHONE NUMBER= • ijq? 4r1.)
' BUILDING ':'!'„T B; :{. FRONT= NA LEFT=! .., t•J F} RIGHT= NA REAP= NA
:':a:-tk 1t'1.v-..t 3i 4•.a J,1t.t A A 1t',i•.i,!.it.,J3,t A 4-.•!k 9!:;k•i<.• g E iei{",{•?- PERMIT •Yr•Pr•Pr•Yr'Ai'1!i i!!••Pr:!'r'i7•ar:p;•}tj•pj?si•t!!f'3!i i!l i!t-ki•%!i•Pr t?..Bt'Ni'Ni•1C•H•'1!i '-i
CONTRACTOR=} 1,.t:;:::: ,`.v B EXCAVATING PHONE= 509 467 8787
ADDREES= MEAD WA 99021
1
ITEM DEECRIPTION QUANTITY F'•#::,E AMOUNT
PROCESEING i:.i::. 10 „ 00
SEWER ...O N, :- !i.;i\ 1 40 ...0
1 i!r;!r i!fi Ri is?}i-t!::R.a(.'••':.:1::?�:::;,;•.x;.:,:::s::,;.:;.:.-:,g.? :::'.:,1,* ;}.`•'M "'�.Y" vt s:,'-':, :[.:t:::
�... a A 1.1!.:. s.:>. .�.»?.s.�!... �. A N. .. .. : !t i ,i{._I? , ,:;i.i:,,,r--�i•+.:'} J.A!!.n..n•it..y,..„,j;..y,..tr y,..i;.:,!::tl:.;t: :u:•tE•ij::!!: (.:s}::t.3i.:,t:*
PAYMENT DATE i"':I::.;..:;::.3.! t •e' PAYMENT AMOUNT
rt•t t/03/91 I ». ... ...
50 .00
TOTAL DUE=.... ,•!f•r TOTAL PAID= .. , . .
PERMIT_i } Y F' . FEE AMOUNT i f•(Mi..li-{I',1; PAID AMOUNT OWING
PRINTED 1i t.i}IS^iN L i:Rt,.:}iN
SEWER STUB t-}}•i ,••i::i....l }_i I} i } }•-,r•}_ict:Mt••3 i 1-:.i i`:i ...._ AVAILABLE r,..t THE COUNTY
UTILITIES DEPARTMENT ,
CONTRACTOR s :
APPLICANT IS TO FIELD" 1j LijjAND CONFIRM THE
:.,
ELEVATION.I.i. N =••33"+?i.. POSITION N t..F SEWER ETUB PRIOR TO ANY OTHER
3•ER
EXCAVATION
LOCATE a . _ ? iCABLES, _ A : PIPING, WATER LINES, Ei_ ..
CALL BEFORE YOU . .... ... ',st:i }i
SEWER STUBS ARE t` CHECKED PRIOR TO CONNECTION
CLEAR AND -UNOBSTRUCTED t • 4� T t _ =
_ _
THAT THEY 1 ' I . . t' E . EW ^: ` ' i
•1t:r:•?t•**•ri n:*•A CALL t•,,,,r t: INSPECTION PRIOR TO' ..'i.• t...I+.: u•n•a***!i ii*'ie
1?•*Hai•*)t•}r:-*Yi• 24 4 I-{O }K NOTICE F Et:.°i.=.iI'SI::.D f?•i }t':W 12'4f•r)i•f!.!t.
:!:; !i-•A 7k!3-'ft••?t' 4..:... ._},', J 4 *****)****k
}.:. :.}...A.??.?:E..,-.?.},}{}..?!*!-. ,.Y.:!.:.:;?.,.,}.}..:•.?_. :!: THANK you ?t'4+:-}t..; -lir `..,i.:?...}3.'??'•?k 9!:9?'9t•a'}e.;!•?',•.?r..?..kt.$;.:;{.jf.}r-.ji.jr.,{.*:!;.;.*3;.
SPECIAL CONDITION CHECKLIST
Project
Address: --- Project# — Use:.
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
_______ Special Insp,Final Report -- ---- _.- _--- ---_—_.-_ __--
M Hydrant( )
__--- __ Lock Box----__._______ _--___--- ------------_—.___
Engineer's___ - RID/CRP
__________-- Easements_ Road__ _ . 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:___ _