1991, 05-24 Permit App: 91002848 SewerSPOKANE COUNTY DEPARTIFENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
1 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
.;O_i?::. .. ? NUMBER= . 's 3•Jt.:J.:..84i:.� T"F1 - !Jf.:{ ? _. 05/24/9i PAGF=
THIS i .E 13 N t..? t f.:; PERMIT
PENALTIES WILL BE::. fAi;SE::.is•SE:.a. FOR COMstE::.NC.E.?``EI, WORK W.i.E1"EI_,iijT ?Ai PE.. s'M.E.'
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: I TE STREET= i002 E 29TH AVE E.: A e'. 1.: ?::. E... = 28543-4520
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION .... SOUTH K O Et f,l M O
PLATO=
1 •JC !., 1i...! PLAT ± A? '.5.......
11 ±_: ,'•, t_{ ?"t l.! ? !.! ±.k+ I'! ,.i J. ! ?:..
BLOCK=
sY _.
t... t 1 I ....
,.:! ZONE= "'{ t Y ,i C.? :?
?. J ? .
? 'tt::::: �..
AREA=
00000000
F/A=
F WIDTH=
DEPTH=
R/W= 70
OF BLDGS=
1 0 DWELLINGS=
.I WATER DIST
OWNER=
MADDEN
PHONE::::
STREET=
1080 E 29TH
AVi�
ADDRESS=
SPOKANi::. iiiA 99206
CONTACT NAME=
1•t' .: , -t . ± i..! "I t'- ::: ?.. j`*)
PHONE
i':}i..iiyi±
..:e'{:::: 509 458 93S4
BUILDINGSETBACKS:
F. ...?? ♦E-1';..' NA
LEFT=
NA RIGHT= NA
REAR=
y.:;
NA
j..y}::g. ':: j.::: r.: (.: ;.: i.: ;. 'j..j.:: nj.:
h'• %'- j!.: '. ' : j.:, :,{..}f. .i:: j.:
NEWER
::,: �j.:}j.:}j.:'..t:.
PERMIT ,.:}i :^: ,..... 7!
yj.:}y.:},::
., ......
::,:.: j..jj.:.j.: :.j.:}j..:j.::i..ij. .i.: '.: j.:vj. .};.
J .j,:.,,: 'it .. J..... n:• :... ,.:�.:... x 1.....
CONTRACTOR=
.: {t ,:: CONSTRUCTION
Pi..il ..
... 4
STREET=
6i55 E HAYDEN
AVI;��
ADDRESS=
RATHDRUM 1D
8385,9
ITEM DESCRIPTION
QUANTITY
FEE
AMOUNT
....................................................................................................
............................ —
..................................
----
,.,E.WE.R
CONNECTION
t
0.,0i'j
PERMIT TYPE
FEE AMOUNT
AMOUNT PAID AMOUNT
OWING
---------------
NEWER PERM011*
........._..........-....-
..- ..- ............ —
5 0 0 ()
............................................ — ----------------
1 0 (-)
5 0 1 0 (.111
-------------
5 0 0(_')
------------ ----------------
0 _-(*._'.)
9 0 0
PROCESSED BY: jULIE SHATTC.1
"TINTED BY: jULIE SHATTO
S
.............................................----
,.>Elt:ER STUB i.:::i A..>.....'i.iL.i.L INFORMATION .E.:.. AVAILABLE A T " H E COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD .?.ON ANDANDE"'a.?,: POSITION .i.t. N t. F SEWER R ... . '..}';.ii...t.±•, ±±,.±i,
E AND CONFIRM THE
ELEVATION r.:{NY OTHER
EXCAVATION
TO LOCATE Bt+t''•..±.!:_t% CABLES, GAS PIPING, WATER LINES, ECT4
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ;:.i t•i. ±::. TO BE t:. :.:} ?}._t.:?5:.A? PRIOR TO i t, .±. ,rq?v! C••.E.t_ it'`1. TO J ;`J S ,. ±: •. L..
THAT THEY ARE CLEAR
AND UNOBSTRUCTED TO THE NEWER MAIN
9': 4t• •H: •Pi 9i' 'hi �Jii •P: 9!'
CALL FOR INSPECTION PRIO • $ COVER
1} n n i' ii �i ji ie ji
4 HOUR , v { , , I I..: I... REQUIRED
.j}. �,:.:T}: +r •iii 'iR• Pi 'i}i Pi
456-3604 1i: 1'i iryr 1i• iti- iti• )k ti Ji..j}:
.. .. .. .... .. ..:... F..... 1--. J. t-. J. T. ). 7. J, ,. Jt Tt 1. 1. 1.: IC' )C' 9t''J!' $j' �(•
THANK j ± :' i )`. 7k J}i •ij• tik t'• i:t ji' )t 'ii" jt 'i i' a• )t'P' 9+: •.'i• id' ;7 ii- 'Ri •H• :R' itt• ii• )+t i4` >. 'Fi• 9(. i}i''ii.
Project
Address:
Dept:
Dept. of Bldgs.
Engineer's
Planning
Utilities
Other _
Date:
IN
SPECIAL CONDITION CHECKLIST
Project #
Condition:
Special Insp. Final
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plum
i ii in
THIS SPACE FOR COMMERCIAL PLANSTRACKING, CERTIFICATE OFOCCUPANCY 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 ins p finaled by: _ Date -
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned:
No response from owner/contractor - plans destroyed:
RACAIVP.d hv-
nate
Init:
(in)
Appr:
(out)
/zo e-z,�
JOB ADDRESS:
SUBDIVISION: L - LOT: BLOCK: -(
OWNER: PHONE-
ADDRESS:
CONTRACTOR: r PHONE:
ADDRESS:
LICENSE
INSPECTION DATE:
TYPE OF OCCUPANCY: