1994, 03-02 Permit App: 94001649 Residence1 i �
PROJECT NUMBER= 94001649 APPLICATION'
****** THIS IS NOT A P1
------PENALTIES WILL BE ASSESSED FOR COMMEN(
SITE STREET= 8215 E GLASS AVE
ADDRESS= SPOKANE WA 99212
PERMIT USE= RESIDENCE/ATTACHED GARAGE -
PLAT#= 005241
BLOCK=
AREA=
# OF BLDGS=
DATE= 03/02/94 PAGE= 01
RMIT ****** I;!:�aPE
ING WORK WITHT
--------------------------------
PARCEL#= 45063.9040PTN
FORCED AIR GAS
PLAT NAME= SP -798-2
LOT= 2 ZOJATER
E= UR -3.5 DIST#=
F/A= F WIDH= DEPTH=
# DWELLINGS= DIST =
OWNER= CHD INC
STREET= P.O. BOX 13717
ADDRESS= SPOKANE WA 99213
CONTACT NAME= WES CROSBY
BUILDING SETBACKS: FRONT= 35 LEFT= 10
****************************** REVIEW
E
R/W= 42
PHONE= 509 926 5225
PHONE NUMBER= 509 994 3972
RIGHT= 00 REAR= A
bS
RMA
TION *****************************
DE ARTMENT REVIEW REQUIREMENT
---------...............................................................
----------------------------- -------------------------------
ILDING REVIEW COORDINATOR - R BURRIS �_1Ge11 rl'�A
COMMENTS: A La,dot-0
LDING
COMMENTS:
JBU
LDING
COMMENTS:
N INEER
COMMENTS:
- AV .
PLAN REVIEW REQUIRED C2 �T
SETBACK REVIEW REQUIRED ,A _-At QT
"I -AVAdl g. -.. 'J�
APPROACH/FLOOD PLAIN/DRAINAGE'
HEALTHDIST NEW OR ADDITIONAL WASTE WATER
COMMENTS:
******************************* BUILDING PE
CONTRACTOR= C H D INC
STREET= P O BOX 13717
ADDRESS= SPOKANE WA 99213
�m
T *******************************
PHONE= 509 926 5229
NEW= X REMODE
PROJECT NUMBER= 94001649 APPLIC
DWELL UNITS= OCCUP. L
BLDG W X D= 46 X 30 SQ F
REQ PARKING= #HANDICA
DESCRIPTION GROUP TY
----------- ----- --
BASEMENT U R-3 VN
GARAGE M-1 VN
RESIDENCE R-3 VN
ITEM DESCRIPTION
------------------------
RESIDENTIAL VALUATION
STATE SURCHARGE
RADON MONITOR
SALES TAX
RESIDENTIAL SURCHARGE
******************************* MF
CONTRACTOR= BARTON HEATING & A/
STREET= 11816 E MANSFIELD A
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION
-------------------------
GAS APPLIANCE<=100,000BTU
GAS LOG OR GAS INSERT
GAS WATER HEATER
GAS PIPING
VENTILATING FANS
***************************** PLUMB
CONTRACTOR= ALPHA PLUMBING & HE
STREET= 5805 E SHARP AVE
ADDRESS= SPOKANE WA 99212
ITEM DESCRIPTION
-------------------------
TOILETS/BIDETS
TUBS
SHOWERS
SINKS
DISH WASHERS
CLOTHES WASHER
WATER USING DEVICES
PERMIT TYPE FEE AMOUNT
--------------- -------------
BUILDING PERMIT 708.97
MECHANICAL PRMT 75.00
•ADDITION= CHANGE OF USE=
ION DATE= 03/02/94 PAGE= 02
BLDG HGT= 16 STORIES= 1
1280 SPRINKLER= N
CRITICAL MAT= N
SQ FT VALUATION
----- ---------
1236 13596.00
484 3872.00
1280 70400.00
QUANTITY FEE AMOUNT
-------- ----------
Y 585.50
Y 4.50
1 12.57
1 1.01
Y 105.39
ANICAL PERMIT *****************************
INC PHONE= 509 922 5000
E #003
QUANTITY FEE AMOUNT
-------- ----------
1 12.00
1 10.00
1 10.00
3 3.00
4 40.00
G PERMIT ******************************
ING PHONE= 509 535 0727
QUANTITY FEE AMOUNT
2
12.00
1
6.00
1
6.00
3
18.00
1
6.00
1
6.00
3
18.00
AMOUNT PAID
AMOUNT OWING
------------
.00
-------------
708.97
.00
75.00
PROJECT NUMBER= 94001649 APPLICATION DATE= 03/02/94 PAGE= 03
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------- ---- -------------
PLUMBING PERMIT 72.00.00 72.00
855.97 .00 855.97
PROCESSED BY: CAROL BRADBURN
PRINTED BY: CAROL BRADBURN
******************************** THANK YOU***********************************
APPLICATION WORKSHEET
General Information
caner Phone
aimga r, tate Zip
9 9. -z
Site Information
Project Information
Buildin Information
e morts
UPS nt
ut in etg t
nes
w mge
Totalsquare
ar QOb
eq par ng
a mcappar ng
pto
ersys em
n mca a enssi3O
Square footage breakdown
amnQor�� v
Uncovered/covereddeck
econd oor
Other
Finished asement
Unfinished asement
au ceding
stage
R- 3
Contractor Information
Heatinit and insulation information R—values
Heat sou
�-
Plumbing con or
5
cam
au ceding
gra ewa
R- 3
R- 3
1
1`7
qty, stat zip
/gradewall
3o
Door u—vg ue
mn ow
urnace a tcency
, yo
Other Lender
Iota I window area
of floorarea
License number Phone
76
contractor
Plumbing con or
cense number
Phone
icense u one
adm ress0
/
atmga rens
qty, stat zip
-city, state, zap
Heat cont for
Other Lender
ice a number
one
License number Phone
a d mg a ress
a mg a—
qty, state, zip
qty, state zip
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
a
• REGISTERED AS PROVIDED BY LAW AS A:
REGISTRATION NUMBER -`-
ExPIRATIDN DATE
CCUI
CHDIMi- 12t5LC
0.510 1,.94
r '_ tC1IVDAT'7,
O6 03/8e,
C H D IPC
P 0 SOX 13717
SPOKA4 E
SIGNATURE �-.7
ISSUED BY DEP TM �F LABO AND INDUSTRIES
vD
R
T-
SOUTH RIVER
?--2 /
wM 0
�r
DRIVE i,,
'L f
(N LOT D
I `
Q
APPROX. LOCATION
OO
OF 3 BEDRM
FUTURE HOUSEI L'L-1 i/
i
REPLAI
PRIMARY BED
9F6-0
10 EASEMENT
rte.
rt
4e�
THE TRUE POINT OF BEGINNING (TPOB) FROM THE SE CORNER
OF GOVERNMENT LOT 12 IS N pp•gq 25• W, 95.79 FT, THENCE
S 89.97'19• W, 163,50 FT. THENCE N 02.38'4 E, 109.48 EN
THENCE N QO.4472• W 27.50 FT TO THE TPOD, THENCE,
N 00.99'12• W, 78.07 F�f, THENCE N 00'02'52' E, 3TUI FT,
THENCE S 76'30'50' E, 79.82 FT, THENCE S 00'03'56' W
33.67 FT, THENCE S16.56.09• W, 71.85 FT, THENCE
N 87.0473• W, 50.86 FT TO THE TPOD.
PN— Ll 5-363, t��Yv
7t/
G� O •� r .� tY-lro7� �- -
GLASS A E.
L
SITE PLA(
SCALE: 1"=30'
Pring & Consulting Services, Inc.
'terry Road
4.ington 99216
28-1707 Fax: (509) 928-2581
AD
Rn,".9 'ID T H:
REVIEV4E Iy-
Gt l'1 !✓. ��r�
DING
C'=={CE
NOTE:
AP DENOTES TEST PIT (5-26-93)
TP DENOTES TEST PIT (12-8-92)
WM®--- DENOTES WATER METER & LINE
NOTE: SITE PLAN DOES NOT REPRESENT A TOPOGRAPHIC
SURVEY. DRAWING INFORMATION WAS PROVIDED
BY PROPERTY OWNER & SPOKANE COUNTY, IT IS
ASSUMED SITE GRADING PRIOR TO CONSTRUCTION
WILL PRODUCE NEARLY LEVEL SITES ON ALL
THREE LOTS.
l
tPPLICATION AND PERMIT FOR ON-SITE SEWAGE SYSTEM l
II DISTRICT APPLICATION NO.
I DIVISION CENSUS TRACT rW
,E AVENUE DATE OF APPLICATION
X201=2095 (6091324-1560 INSPECTION RECORDING_ 324-1581__ __
(� 1 ,CRIPIION OF PROPERTY: PROPERTY WITHIN-: PSSA t i/INSIDE ASA)
GSSA (OUT/INSIDE ASA)
� RESS: ZJyPHX'ONJ: 7" [j SMA (OUTSIDE PSSA,ASA,GSSA)
%37 l - [] OUTSIDE All OF ABOVE
/ C77j/ `� [ j INSIDE ASA ONLY m
PROPOSED ll E Ur,. JY: SINGLE-FAMILY RESIDENCE UMBER OF BEDRO S
TYPE OF STRUCTURE: [] MOBILE HOME RANCHER [] SPLIT ENTRY [J MULTI-LEVEL
[] MULTI -FAMILY COMPLEX: NO. UNITS _ NO. BEDROOMS/UNIT
COMMERCIAL/INDUSTRIAL_(DESCRIBE�: _ EMPLOYEES/DAY: _ _I-SEATS/CHAIRS FOR CLIENTS/CUSTOMERS:
IS THIS PROPERTY LOCATED WITHIN A COMMUNITY PUBLIC SEWER SERVICE AREA? [] YES [] NO
IF YES, NAME OF DISTRICT/SYSTEM:____ _ _ IS ULID AGREEMENT RE UIRED? YES [1 NO
SEWAGE SYSTEM MP
COONENTS:
f 0 OSED SYSTEM BY APPLICANT:/' REPLACEMENT/FAILURE: []YES AD ALTERATION: [JYFS Q]1J'0
SEPTIC TANK(S) N0. _f SIZE ��/ REASON: [J RELOCATE - CONFLICT
[J OTHER PRETREATMENT FACILITY [J SATURATION/SOG [] CHANGE OF USE
(SPECIFY) [) OTHER [] ADD-ON
URAINFIELD [J LEACHBED
BUILDING SEWER OTHER DISPOSAL: SP.EGIFWILL THIS RESULT IN AN INCREASED SEWAGE FL W? []YES []NO
f� NA - NEW SYSTEM
Lf
WIIAT IS THE SOU CR E OF WATER FOR THIS PROPERIY- PUBLIC/SITARED WATER SYSTEM; NAME: _ //j�j�( ,
PRIVATE:_ [I WELL [] SPRING [1 LAKE [1 2929 APPLIES [1 2929 DOES NOT APPLY
I'KUFUaYu FLUI FLAN 1J IU ALCUMPANY {HIS APPLiCAIION, ALONG W11H ANY OTHER PERIINENI iNFORMATTOGW�_UCf AS LEGAL DESCRIPTION
PROPERTY.
THIS APPLICATION ANO PERMIT APPROVAL IS CONTINGENT UPON MEETING REQUIREMENTS SET FORTH IN THE SPOKANE COUNTY HEALTH DISTRICT
RULES AND REGULATIONS FOR ON-SITE SEWAGE SYSTEMS. APPROVAL IS BASED ON THE ACCURACY OF THE INFORMATION SUPPLIED BY THE
APPLiCANI. IF YOU ARE DISSATISFIED WITH THE DECISION OF THE HEALTH DISTRICT, YOU MAY APPEAL TO THE HEALTH OFFICER WITHIN TEN
10 DAYS OF DENIAL OF THIS APPLICATION (SEE APPEAL PROCEDURE OUTLINED IN THE REGULATIONS).
CONIACj�ji$ON: PHONE($h��HALi1RE OF OWNER OR AUTHORIZED REPRESENlA7[VE:
MAIL t II I AF{� CORRE'PONO CE 10:
aF
i NCVFrTInN rAll_1N nATCc
TEST HOLE INSP.
PARTIAL INSP.
FINAL INSP.
REINSPECTION
EXPOSURE_(RENEWAL
2929 REVIEW -1 _I _ I
SCHEDULE OF APPROVALS
FEE PAYMENTS:
APPLICATION
PERMIT _
REINSPECTION
CRITICAL MATERIAL USER: []YES
SEWAGE MAINTENANCE AGREEMENT REQUI
ASA/SCHD DENSITY REQUIREMENTS:[]YE
OTHER AGEN (J.e. Utilities,Plan
D? []YES—,[&q I SEG. DATE:
:I-3nU _q/ k_4%._4 EASEMENT_ RE UIRE
ing,DOH) APPROVAL/DATE TEST HOLE APPROVAL SIGNATURE 1 DAT
ED? IIYES
47
FLOW RATE GAL/DAY
1 ' MINIMUM SYSTEM SPECIFICATIONS BY DISTRICT
DOSAGE VOL.
GAL/CYCLE
DISPOSAL FACILITY:
TR�ATMENI FACILITY:
[� SEPTIC TANK SIZE:
GALS.
NO.
[] DRAINFIELD SIZE: FLOW RATE [SOIL
GALS./F12
LOADING RATE _
x TRENCH WIDTH] =
LINEAL FT.
((] GREASE TRAP SIZE:
GALS.
NO.
[] LEACHBEO: FLOW RATE : SOIL LOADING
RATE
rf[�PUMP CHAMBER SIZE:
SAND
GALS.
NO.
GALS./FT2 = SQ. FT.
] FILTER BED: FLOW RAT
: 1.2 GALS =
F1
ALTERNAIIVE: []MOUND []PR SS.DIST.SSAS
[]SAND FILTER`
[] HOLDING TANK:
GALS.
NO.
` [1011;ER (SPECIFY):_ -19?
t,rye'sS._c_
[I BUILDING SEWER [1OTHER:
SEE ALTERNATIVE SYSTEM SPECS. AT
I
OTHER E.H. PROGRAM APPROVAL
AND DST ,j
/ n
APP` !TF{'ROVAL SIG ATUR
VREUIRED
UMBING REQUESTED - DATE: BUIL I G 0 E SE DATE: INI
[1 RECOMMENDED [] N/A L S E L�PLANIREMENTS RCV'D ULID 10 APPL. DATE PE I D T __ EXP ES•ITIALS:
l SEE PLOT PLAN ULID RCV'D DATE: (PHONE NUMBER) (INSTALLER SIGNA E) FINAL INSPECTIO SIGNATURE AND OATr: [
REMARKS AND APPROVAL CONDITIONS: (see reverse side also)
� 1 __
SCHD-EHO-0532P(REVISED 5/92) FUTURE SEWER SERVICE AREA FORM: FOLLOWUP DAIS: - ._: