1991, 04-01 Permit: 91000708 SewerSPOKANE COUNTY DEPARTMENT 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
r' R is :J i.: # NUMBER= _0;%08ISSUED
PERMIT
0.±DATE= 04
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PERMIT
INFORMATION
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CONTRACTOR= _ 4 ., fi+E
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STREET= , AJ.,4I'57
ADDRESS= SPOKANE .. ,,J
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ITEM 7?;1?,0,w QUANTITY i•' #..-0000 AMOUNT
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PROCESSING
FEE
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TOTAL .,PAID=
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PROCESSED 't::.+,•. . ,. - - ., ,
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SEWER
EWE.STUB a, {l. T INFORMATION
IS AVAILABLE AT THE
COUNTY
UTILITIES DEPARTMENT 's )-360;?
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CONTRACTOR
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ELEVATION
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!^i # st. N AND t.: t.�w4 .#. t i.ON OE•' SEWER STUB
T•i. BPRIOR
R .} O ANY OTHER .
EXCAVATION
BURIED
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TO LOCATE . ..! ? •, :. ii CABLES, WATER
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CALL BEFORE YOU D ` ?00000 5
- 0n,0u0.0„0r i.STUBS
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_
. CONNECTION
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THAT THEY ARE , N, UNOBSTRUCTED T; H- SEWER
PMAIN
ASN
CALL i NixlTI rPRIOR 1r'"c
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456-3604
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THANK
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Dept. of Bldgs.
Planning
Utilities
Date:
Date received for C/O processing:
Temporary C/O
Office five review by: -_---_-__.---
Filed +nsp finaled by:
SPECIAL CONDITION CHECKLIST
Project #-- --.
Condition:
Special Insp. Final Report--------------_ _.__
Hydrant { }-----------�_._.__ �.-------- -----
LockBox .-__.__._____--------------------_---__-_-_.._____.
RID/CRP__.-__—_-------------------.________-.---------------------______
Easements--------------__.__.______._-------------------
Road Plans/Improvements
Bonds
— Bonds ___--------------------__.__--_-_------------_____ .____.__
Double Plumbing.______—____. --- ____._____—__--�_� __-
ULID
Ninety days after C/O issuance:
Owner/contractor calved regarding the return of plans:
Plans returned: __-----__ __-----�._
No response from owner/contractor- plans destroyed:
. Plans pulled for final processing:
Certificate of Occupancy issued.Date:.. _-__
Date: — ----- -- -------
M
Date: