1991, 05-24 Permit: 91002839 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 issua e 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! • isions 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 /
_....u04S-- % C.,(7
OWNER
OWNER OR AGENT — .��� DATE
. 111111/
! R ^ E r ; NUMBER=
: BER- , - 0iri3 . ISSUED . ;ryi DATE::::
- . i }ty : A # i A G
... 01
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:,., T .. :.,..:.,..,'••i::'T= 07
-'H AVEF'Ai : '? P:::: 33541 —9004 .
SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — ::: ..D i.#...t.n i::. 6TH ADDITION
)t•*;: SEE NOTE *t!•'4:
PLAT4= 000000 PLAT NAME= UNKNOWN
AREA= '
! OF , ^ „ ! DWELLINGS= WATER DIST . MODEL
OWNER= s RE My INCPHONE= " l9 924
: y ryti ^ ..
..
STREET= 12212 E SIOUX CIR
AD,, f E4t5:::: S!•'[„[K±:I(`?#::. WA 99:::06
CONTACT NAME= FRANK
NUMBER= �
09 924 9406
BUILDING SETBACKS : t„ , . ,iLEFT=t y- ;? ,�! �F REAR::: NA
8k 3t:"7!:.7y..7t..7;..7!..u,.J,..7;..!?..7t..K..l,::!: •Pi tnt'P:”?k ¢•i!;;!:9,:.!!:.N..J,..P: SEWER '>."#::.i".#'i.#. it•a iGi•!t•illi"ik**iu::!i•Ai i4.9!i•it• +r•lk.7!.**.:!:t'ti•tt••i!i"!!i-a:i!¢?!:_7!:K'!t:
CONTRACTOR= GREMY INC PHONE= 509 924 9406
:S I I':t::.i::. 3 ""- .# :.ry !•• i i i i.{+Y 1.•.i.rt.
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
FR1.it•I" .#.NG FEE f 10„00
SEWER CONNECTION 1 40...()0
'"••••"'.':.:::.a:'.:'.:'.::s".::.**a,:.',,::::'' 7.,. ,. AR..i.7t....Jt F.A.:?P.!.J•. :.!.,. .:,t R. ...aJ.
.p!.,:..�... ., n;...,l.:,..7l..7.:y.:�.,..!' ''=f• `i:i±`"��'F I•• �..� _'[_;#"l i"}�i�'; :j.:,.:j.:t '.:n:•;.::.:j.:,!::•.
::„7!.P.it 1,7,7?1?,t Jt:!.„d.7 .•.,-. P. P., 1• t 7 ! ! 7. ?1 ...`e'• :¢::::,t..,..,!....,....!y:.,!.,y.
AMOUNT
PAYMENT DATE RECEIPT4, PAYMENT
05/24/91
.i _ 50,00
TOTAL '»t:E TOTAL
PAID= 50,00
PERMIT TYPE #"#::E AMOUNT AMOUNT i I D AMOUNT N i W I SMI.
SEWER PERMIT 50 .00 50,00 n..i'.74•'
:
PROCESSED !,:_....ter.#(_?#.:.#...7 GLORIA
,
PRINTED %ii . i.^�ENi,.?E#...J GLORIA ii
SEWER STUB :. t;,....':a;�.i ..i' INFORMATION .... AVAILABLE '•I"i E COUNTY
UTILITIES DEPARTMENT (456-3604)
.,. r.;T:.
! .!_;•;•1 # #•;.!•-±t.: # t.�r t.!:=, APPLICANT IS TO FIELD LOCATE ,��i�•!•i•'' :'i�lf�•I �°�'; % !._
ELEVATION
,...,.r.}. ;
,-. POSITION STUB PRIOR :'#.. ANY OTHER
ExCAVATION
TO•: , :)r:q.,..E BURIED CABLES, GAS PIPING, WATER
LINES, ECT ,
CALL
p:I:..OR::. YOU D••:' ( 456-8000)
SEWER STUBS i : fr O : CHECKED tRtO_ TO CONNECTION 1OINSURE
# l.f e # THEY! Ai;:E CLEAR . AND 1:,;Ni.}BE # Ri.fl.: #.{..t? TO THE SEWER MAIN
;!:"a:•7r"7r•n::r'it:•3!:.x CALL {:..i..!#'°: INSPECTION PRIOR TO COVER :1,..p.*.,l•*•il•JF R:"lt•i!:
: Fir u*7 r; _ :,„t ; N- l E. _ REQUIRED ri ) u3 *7 r*
"i::**•r:**§E !: !: 456-3604 K********:*
9?..".99 ? } 4 „, : ? ..:.7 7 : :7 : : .:. ? t: ; PR : THANK :. z_ 7tt7 7 ,j .:...:r. : : : : : `st jK , .¢*j ¢
,
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111'1
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4
SPECIAL CONDITION CHECKLIST
Project
AN
Address: Project# Use:
Dept: Date: Condition: [nit: 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
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: