1991, 06-14 Permit: 91002168 Sewer 4111111111.1
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
1 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
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' `FURTFUR STUB AS-FAUILT INFORMATION ION .i : AVAILABli_E At. AT THE COUNTY
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CONTRACTOR OR APPLICANT IS TO FIELD t:.L17 F...€:OCA i C" AND CONFIRM THE
ELEVATION r��i L x. POSITION ...;F= SEWER STUB F"F"•> ..f.R ,Nr', .;
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Itk****3t*3t CALL FOR ) &'E N PRIOR TO COVER 3i 3F 3E****•haft*•
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SPECIAL CONDITION CHECKLIST
Project
Address: _ Project# Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept,of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
Engineer's_— — RID/CRP
Easements
Road Plans/Improvements
Bonds
Planning _ Bonds
Utilities _ Double Plumbing
_ e 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: --