1990, 03-30 Permit App 90001215 SewerSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. i303 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
OWNER OR AGENT DATE
* * :;..l,.* * jl..i,. * r,,' *.it.:J,..i:..i{..i(..i,. * * ;r;
ANE WA
00000000
rt U l_. I .!. O la:!
DALE WA 99037
ITEM DESCRIPTIC'
SING FEE
SEWER ,:•i:.ONN1:::% ION
PERMIT TYPE
SEWER PERMIT
r.:•I::• • AsiO!t.1NT
50,00
50,00
APPLICATION
)t. i,t. * *:J1. 77 J i i::i ;.' *:..: -:.: a;. * * .J`: ir.*.;.... c .i,,
.FINE aii IM •;I. - 509 924 54Ft5
: )* :;• :$ 7'ii *)(: illi * *'i!r 1G !} .- K F .._;l: :,,. It •) :�. :J4. .k. .1i• iui a. i{. .i�.
QUANTITY FEE AMOUNT
10,00
AMOUNT PAID AMOUNT OWING
BY: ...1 U !....!. 1::. SHATTO
ini E R STUB AS —BUILT INFORMATION ......
I I ; .l. !....I. I .!. ES DEPARTMENT (4 . l:y .•_ ...! •.".: f -::4 )
CONTRACTOR OR APPLICANT IS Tr
ELEVATION AND POSITION OF
EXCAVATION
DCATE !...BEFORE , ,Y
-------------
,00
AVAILABLE AT THE ni....JHT
..........
LOCATE AND CONFIRM THF
1UB PRIOR TO ANY OTHER
CHECKED ,.:: O R TO i i •` l,.! i••i i•:% E l..: i U N
AND UNOBSTRUCTED TO THE SEWER N
(:1i1. I`I:.:
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.;S _S r.y .... ..'):"5 t.. xd .-. l * L t Jk .. 1. 1.
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4 JOB ADDRESS: 1 O d ._/J ( C_-
SUBDIVISION: /p53 "` v CJ / LOT:
OWNER: U�C�
ADDRESS:
PHONE:
BLOCK:
CONTRACTOR: 0_,P)-titA0--Li____,L2 . PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: