1987, 06-30 Permit App: 87001997 ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
' NORTH 811 JEFFERSON
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. 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 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
PROJECT NUMBER= 87001997 DATE= 06/30/R7 PAGF= 01
********************************* APPLICATION ******************************
SITE STREET= 3816 S LORETTA DR PARCEL w'µ 33541-3003
ADDRESS- SPOKANE WA 99206
PERMIT USE= RESIDENCE.
PLATO= 004158 PLAT NAME= MIDILOME 4TH ADI)
BLOCK= 3 LOT= 3 ZONE= SFR D:CST0= F
AREA= 00000000 F/A= F WIDTH= 85 DEPTH= 135 R/W= 50
OF BL_DGS= 4 4 DWELLINGS=
OWNER= NORTHWEST HOMES
STREET= P 0 BOX 141295
ADDRESS= SPOKANE WA 99214
PHONE= 509 926 0978
CONTACT NAME= TEI) ARNOLD PHONE NUMBER= 509-926-0978
BUILDING SETBACKS: FRONTS= 30 LEFT= 15 RIGHT= 12 REAR 66
****************************** REVIEW INFORMATION **************************
DATE
IN/OUT INITIALS
DEPARTMENT NAME REVIEW COMMENTS
BUILDING & SAFETY PLAN REVIEW REQUIRED
COUNTY ENGINEER
Cc»'J i JTI (1VLD
ENVIRONMENTAL HEALTH INCREASE IN LOT COVERAGE
870630 GMW
NEW COUNTY ROAD APPROACH 870 30 GMW
X17 /WAo3D
c
349
870630
GMW
******************************* JUILDING PERMIT ****************************
CONTRACTOR= NORTHWEST HOMES
STREET= BOX 141295
ADDRESS= SPOKANE WA 99214
PHONE= 509 926 0978
NEW= X REMODEL= ADDITION= CHANGE USE:-
DWELL UNIT'S= 1 OCCUP. LD= BI...DG HGT= STORIES= 1
BLDG W X I) = 24 X 52 SQ FT= 2329
RE({ PARKING= OHANDICAP= SEWER= Y HYDRANT= N
OFFICE OF SPOKANE COUNTY ENGINEER
N. 811 JEFFERSON / SPOKANE, WASHINGTON 99260
(509) 456-3600
APPLICATION TO PERFORM WORK ON COUNTY ROAD RIGHT-OF-WAY 7 - FNA3o8
6/30/87 Permit #
NORTHWEST HOMES
PO BOX 141295
SPOKANE WA 99214
(509) 926-0978
The applicant hereby applies for permission to
CONSTRUCT URBAN 208 APPROACH TO NEW RESIDENCE AT S 3816 LORETTA DR, L3, B3,
MIDILOME 4TH ADDN. CONCRETE APPROACH CURB DROP IS IN. 33541-3003
Date work to start 07/01/87
The estimated time required for completion of the above work is 90 days
,hick the petitioner agrees to prosecute with all diligence and speed with due
-egard for the rights, interests and conveniences of the public.
Petitioner further agrees to perform the work in strict compliance with the provisions enumerated below and states that he
has read and will adhere to the general provisions applicable to permits contained on the reverse side of this form. The
undersigned guarantees that if the backfill, street surfacing or improvement fails within two years from the date of final
inspection by Spokane County, he shall pay the cost of the County for making repairs or restoration of the roadway and
improvements. In consideration of the granting of this permit it is agreed by the applicant that the County of Spokane and any
officer or employee thereof shall be saved harmless by the applicant from any liability of responsibility for any accident, loss
or damage to persons or property, happening or occurring as the proximate result of any of the work undertaken under the
terms of this application and the permit or permits which may be granted in response thereto, and that all of said liabilities are
hereby assumed by the applicant. It is further agreed that if any part of this installation interferes with the future use of the
highway by the general public, it must be removed or relocated as designate. • = -ngineer at he expense of the permittee
or his successor in interest.
IGNED
PERMIT
Subject to all the terms, conditions, and provisions written or printed below or on any part of this form.
PERMISSION IS HEREBY GRANTED the above applicant to:
PERFORM WORK TO COUNTY STANDARDS AND IN COMPLIANCE WITH APPROVED PLAN ON FILE
IN THE COUNTY ENGINEERS OFFICE. TCO, TOP OF SLAB 1 FT. IN 30 FT. INSPECTOR
TO CHECK FORMS PRIOR TO POUR - 24 HOUR ADVANCE NOTICE REQUIRED. ALL CURB
DROPSWITHOUT APRONS, UNUSED OR ABONDONED DRIVWAYS - SHALL BE CLOSED WITH
STANDARD CURB. 208 DRIVEWAY APPROACH IS REQUIRED AND SHALL BE CONSTRUCTED IN
ACCORDANCE WITH APPROVED PLAN ON FILE IN THE COUNTY ENGINEERS OFFICE.
Permit fee $ 10 Inspection fee $ 20 Total $ 30 Paid by CH # 5380
This permit shall be void unless the work herein contemplated shall have been
completed before 10/02/87
INSPECTION REQUIRED — 24 HOUR NOTICE REQUIRED
Call Permit Office 456-3600 or 4 .-3604 to notify when work begins and schedule inspection.
COUNTY ENGINEER
DATE
Itis the respon Ility of th- - • plicant to otify all utilities and private property owners when such pr. •erty is I' • ble to njury or
damage thro . the performance of the above work and the applicant shall make all necessary a angem- is relative to the
protection 9such property and/or utilities. Traffic control signing and barricades shall be furnished by Permittee in strict
conformance with "Manual on Uniform Traffic Control Devices". This permit must be available on the work site and is valid
only for the dates shown above.
..�., .�..... 1.. l.r in r.�n-ri v i -N Ai 1 OCC(lDC VC I 1 fll(, - ARA -AIN'T,'
G
INSTRUCTIONS FOR APPLICANTS
Applicants for permits to occupy county property with utilities, or holders of granted franchise rights contemplating work upon, along, over, under or across
any county road, bridge, wharf. trestle, public place, street, avenue or alley on property in the County, shall first file with the County Engineer his or their
application to do such work.
Such applications shall be in triplicate and accompanied by drawings, also in triplicate if required by the County Engineer. Drawings shalt be to a workmg
scale showing position and location of work, names or numbers and width of roads, streets, etc . showing their location in plats, or subdivisions of sections.
township and range. showing the relative position of such work to existing utilities constructed, laid, installed or erected upon such roads, streets or public
places.
The applicant shall specify the type of construction by submitting plans showing the class of material and the manner in which the work is to be
accomplished. All such materials and equipment shall be of the highest quality and the manner of excavation. fills. construction, installation, erection of
temporary structures, traffic turnouts, road obstruction, barricades. etc., shall meet with provisions of the County Utility Accommodation Policy
(WAC 136.40) and shall meet approval by the County Engineer. Signs, barricades and traffic control in the vicinity of the work shall strictly conform to
provisions of "The Manual on Uniform Traffic Control Devices to Streets and Highways.' The applicant shall pay to the County all costs of and expenses
incurred in the examination, inspection and supervision of such work on account of the granting of said permits
The actual location of the work to be done under this per mit, its depth below or above surface or grade of any County structure, road, street, ave.nue,, alley or
public place shall be approved by the County Engineer before any work shall be done by the petitioner
PERMIT CONDITIONS
1. The petitioner designated herein as the "grantee". his successors and assigns, shall have the right and authority to enter upon the right of way of the
County road, street. alley. public place or structure as indicated on the front of this form, for the purpose of doing such work as applied for. and
approved by the County Engineer.
2. The location, type of work, materials and equipment used, manner of erection or construction safeguarding ot public traffic during work or after doing
same. mode of operation and manner of maintenance of project petitioned for, shall be approved by the County Engineer prior to start of work aro
shall be subject to the inspection of the County Engineer so as to assure proper compliance with the terms of this permit.
3. The grantee shall commence work within one (1) week after the granting of this permit. If at the end of stated completion date grantee shall have not
completed the installation, then the rights herein conferred shall cease and terminate. Grantee will then be obliged to apply for a new permit if work is
not accomplished within allotted working days.
4. The grantee shall leave all roads, streets, alleys, public places and structures after installation and operation or removal of utility, in as good and safe a
condition in all respects as same were in before commencement of work by grantee.
5. In case of any damage to any roads, streets, public places, structures, or public property of any kind on account of said work by the grantee, he will at
once repair said damage at his own sole cost and expense.
6. The County Engineer, his agents or representatives may do, order, or have done any and all work considered necessary to restore le a sate corid:tor
any street, alley, public place or structure which is in a condition dangerous to a life or property resulting from the Grantee's facility or its installation as
permitted herein, and upon demand the grantee shall pay to the County all costs of such work and material.
7. If at any time the County deems if advisable to widen, grade, regrade, plank, pave, improve, alter or repair any road, street. public place or structure, the
grantee upon written notice by the County Engineer, his representatives or agents, will at his own sole cost and expense, raise, lower, change, move or
reconstruct such installations to conform to the plans of work contemplated or ordered by the Cot inty.
8. If upon written notice by the County Engineer the grantee fails to relocate any portion or ail of the project as granted under this permit. rhe County, its
agents or representatives may do any work at the cost and expense of the grantee, and all costs to remove or reconstruct same, shall be borne t:), the
grantee.
9. All such changes, reconstruction or relocation by the grantees shall be done in such manner as wilt cause the least interference with any of the
County's work and shall be subject to the same provisions which control an original installation. The County shall in no way be held liable for any
damage to the grantee by reason of any such work by the County. its agents or representatives or by the exercise of any rights by the County upon
roads, streets, public places or structures in question. The grantee shall have twenty-four (24) hours written notice by the County Endineer or his
representatives or agents of any blasting contiguous to the grantee's permit rights in order that he may protect his interests
10. This grant or privilege shall not be deemed or held to be an exclusive franchise, nor prohibit the County from granting other permits Or franchise rights
of like or other nature to other public or private utilities, nor shall it prevent the County from using any 01 its roads. streets, pi INK: places for any 01,0 all
public use, or affect its jurisdiction over all or any part of them.
11. All the provisions, conditions, regulations, and requirements herein contained shall be binding upon the successors and assigns of the, grantee and all
privileges of the grantee shall inure to such successors and assigns as if they were specifically mentioned.
12. The County Engineer may revoke, annul or terminate this permit if grantee fails to comply with any or all of its provisions. requirements or regulations
as herein set forth or through willful or unreasonable neglect, fails to heed or comply with notices given hire or if the work herein permitted is nut
installed or operated and maintained in conformity herewith or at all.
13. The Board of County Commissioners may at any time, change, amend, modify, amplify or terminate any of the conditions nerein enumerated so as to
conform to any state statute or county regulation pertaining to the public welfare, safety. health or highway regulations as are or may hereinafter be
enacted, adopted or amended, etc. The Board may terminate this permit if grantee fails to comply with any such changes
14. Petitioner by accepting this permit agrees to notify and check with all utilities regarding their installations hetore commencing work, together with
private property owners when such property is liable to injury or damage through the performance of such work, and the applicant shah make ail
necessary arrangements relative to the protection of such property andlor
15. In accepting this permit the petitioner. his successors and assigns agree to protect and save harmless the County from al! cia,ms. actions or damages
of any kind, and description which may accrue to or be suffered by any person or persons, corporation or property by reason of the pEr fornia,iGe of any
such work, character of materials used or manner of installation, maintenance and operation or by the improper occupancy of right of way or public
place or public structure, and in case any such suit or action is brought against said County for damages arising out ot or by reason ot any of the above
causes. the petitioner, his successors or assigns will upon notice to him or them or commencement of such action defend Inc same 01 110 or her sole
cost and expense and will fully satisfy any judgment after the said suit or action shall have finally been determined it adversely to tne County
* INFORMATION WORKSHEET
*
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• PARCEL NUMBER: - de,3
*
* STREET ADDRESS: / L �G� .: i T ' ' c/
*
* CITY/STATE/ZIP�p�; Lc,lx7
* SUBDIVISION: ii4
rte;/r 1.7
*
* BLOCK: LOT: ZONE: DISTRICT:
*
* LOT AREA: F/A: WIDTH: DEPTH: R/W:
*
* # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
*
OWNER:47-17 PHONE: - 9? - ori' % E
* MAILING ADDRESS : d; &( /4/12-% 5-
• CITY/STATE/ZIP:
CITY/STATE/ZIP: �j,p6iE.s,
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CONTACT: / -�
PHONE:
C-0 7c
_
SETBACKS: - FRONT: 3-1SLEFT: /- RIGHT: / 2 REAR: 6
PERMIT USE:
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* BUILDING INFORMATION
*
* CONTRACTOR LICENSE NUMBER: i/ o Z %' J /H 2/3 D e.
*
* CONTRACTOR : C ✓ ; /4 ot,+G+ /J PHONE: -ye F - c
* MAILING ADDRESS:,.C, ,,j< /4/2e;_f=-,-- 0/
* ARCHITECT/ENGINEER: PHONE:
*
* MAILING ADDRESS:
*
* NEW:t2Y REMODEL: ADDITION: CHANGE OF USE:
*
* DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
*
* BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.:
*
* REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT:
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NGI?ItE t -CNE INPCRNATICA
* CCNTR LIC+i:
*
* CONTRACTOR: PHCNE —
* MAIL inG ACCRESS:_
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* PREVICLS ADDRESS:
*
*
LOCATION:______ PARCEL NLNeER:_—__`
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STREET:
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* CITY/STATE/ZIP:_
*
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* RELCCATICN INFCRPATICr
• CONTR LIC#:
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* PREVIOUS AGGRESS:
• LCCAT ICN: PARCEL NUMBER:
* STREET:
* CITY/STATE/ZIP:_
*
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CCNTR LIC*:
CONTRACTOR:
MAILING ADDRESS:
SCUARE FOOTAGE:
SIGN INFCFNATICN
FI -CNE:____
POLE F -E I GH 1:___
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* OEN.CL I T ICN INFCRFAT IC f 4
* CONTR LICH: i
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* CONTRACTOR: , FF4CNE: — — *
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* MAILING ADDRESS: _
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BUILCING SCI,ARE FOCTAGE:
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NUMBER CF BUILCINGS: *
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* MAILING ACCFESS:
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MECHANICAL INFCRMATIGN
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MECHANICAL FEES
ITEM OESCRIPT[CN
PROCESSING FEE
DUCTWORK SYSTEM
aOCCSTCVE/INSERT
GAS WATER HEATER
GAS HTG EOUIP<10C.000>3Tu
GAS hTG EQUIP'100.000 BTU
GAS PIPING — # OF UNITS
NEATPUNP 1-10t1H eTu
HEATPUMP 101-500e BTU
HE ATPUMP 501-1. COON BTU
HEATPUmP 1,001-17508 BTU
HEATPJMP +1,750H BTU
REFRIG 1-100M BTU
REFRIG 101-5008 BTU
REFRIG 501-1,000M BTU
REFRIG 1.001-1,750M BTU
REI -RIG +1,750M BTU
AIR CONDITIONER 0-3 HP
AIR CONCITICNER 3-15 hP
AIR CCNDITICNER 15-3C HP
AIR CCNC.IT ICNER 30-50 HP
AIR CONDI TI•GNER +50 HP
VENTILATING FANS
EVAPORATIVE CCOLERS
HOODS
CLOTt-ES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER 1-10GOC CFH
AIR HANOLER 10000+ CFM
NLKBER CF
YES OR NG
PLUMBING FEES
ITEM DESCRIPTION
PROCESSING FEE
TOILETS
SINKS
SHOWERS.
OATH TUBS
KITCHEN SINKS
DISH WASHERS
GARBAGE OISPCSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR GRAINS
FLOCP SINKS
BAR -SINKS
ROOF CRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URNAL
DRINKING FOUNTIAN
NUt4BER 0t=
YES OR NC
ZZ E L. IL 2,
1
S5`
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