1989, 08-10 Permit App: 89002727 PoolHUG -le -189 07!23 ID:ELD5 AHD SAFET '3(-1.1 FEL NO:509-456-4703 #883 Pe11
PROACT NUMDERn 0Y0027.17
E. 00/i0/09 PAGE 01
APPLITON
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GONTACT NAMF
S MARMLD ST
VCRADALL. WA 9M67
!NIMMING POOL
PARLH 23544-'2604
iT NAME- LLOURA ADP
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DWELLINGS
(MALTZ, POKR'f
i306 S MARIGOLD
VERADALE WA 99o.
RON SW1'.:ASEN
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PHONE 50T '04 Yk:j6
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DEPARTMENT Nr. REVTCW COMMLNIS
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ENVIRONMENTAL HEALTH rin PLA PrV FW
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ADDRES= i(:OKANL WA 99206
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POOCLAD 1(04) WENDEL, GLORIA
PRINTED Wtr. WENDLLI GLORIA
Ha tritA.441.
AtiOUNI PAID AMOUN1 'OWING
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PARCEL NUMBER:
STREET ADDRESS:
CITY/STATE/ZIP:
INFORMATION WORKSHEET
Ste , 13r6 Al /441/ LA
SUBDIVISION:
IAA g -t z-7,27
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
# OF DWELLINGS: WATER DISTRICT:
OWNER : Je — * V�•
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT:
PHONE :
so, / 4 fly/ La
1/- -/7671-a__ - r 51o37
PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
L4-/ L,46 A)c_.-uu sith74A-1,10— ao-L.
*****************************************************************************A
CONTRACTOR LICENSE NUMBER:
BUILDING INFORMATION
e_cc S r n Q
CONTRACTOR: OLISrbri /bL S PHONE : - V - i i- 7 q
9 A/es f SA i R. 912/04
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS:
REQUIRED PARKING:
X (WIDTH X DEPTH) SQ. FT.:
# HANDICAP: SEWER (Y/N): HYDRANT:
PLUMBING INFORMATION
CONTRACTOR LIC#:
CONTRACTOR:
MAILING ADDRESS:
***************************************************************************
CONTRACTOR LIC#:
CONTRACTOR:
MECHANICAL INFORMATION
MAILING ADDRESS:
ELECTRIC: GAS: OIL:
ENERGY CODE: WSEC:
CCAL: WOOD: SOLAR: HEAT PUMP
NWEC:
UTILITY:
SGC:
APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS:
***************************************************************************
MECHANICAL FEES
ITEM DESCRIPTION
PROCESSING FEE
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
GAS HTG EQUIP(100,000)BTU
GAS HTG EQUIP +100,000
GAS PIPING — # OF UNITS
HEATPUMP 1-100 BTU
HEATPUMP 101-500 BTU
HEATPUMP 501-1000 BTU
HEATPUMP 1001-1750 BTU
HEATPUMP +1751 BTU
REFRIG 1-100 BTU
REFRIG 101-500 BTU
REFRIG 501-100 BTU
REFRIG 101-1750 BTU
REFRIG +1750 BTU
AIR CONDITIONER 0-3 HP
AIR CONDITIONER 3-15 HP
AIR CONDITIONER 15-30 HP
AIR CONDITIONER 30-50 HP
AIR CONDITIONER +50 HP
VENTILATING FANS
EVAPORATIVE COOLERS
HOODS
CLOTHES DRYER
NUMBER OF
YES OR NO
RANGE
GAS LOG
TDJT_Tc'PT?r !'_AC ADDT_TT*Tr't
PLUMBING FEES
ITEM DESCRIPTION
PROCESSING FEE
TOILETS
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISHWASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOOR SINKS
BAR SINKS
ROOF DRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URINAL
DRINKING FOUNTAIN
NUMBER OF
YES OR NO
SPOKANE COUNTY HEALTH DISTRICT
r
E. O. PLOEGER, M. D., M.P.H., HEALTH OFFICER
N. 819 Jefferson Street
Spokane, Washington 99201
PERMIT NO / / 7 ' 5 7
DATE c=>//7/T4.`
No. A 15254
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Ocl
Name
� '� — �� �—� �'G& Address `2/90VPhone No 7
Address of Proposed Site / �d-
Type of Use
Number of Bedrooms
Water Supply
Septic tank capacity
Length of disposal field
Yom/
Is basement for building planned?
Building Capacity Camp Capacity
(City, Well, Spring). Drywell�
(1) Show relative location of: Proposed house, se
disposal field, well, garage and other out bu
lc tank,
dings.
(2) Make note of any heavy slope or swampy are
other Important topographic details. <T::17
Other
gals. Style of tank
Absorption Pits
Leach Bed
Final Inspection Date
Remarks•
5/A/ 7.4"
�itc.tC Q E a .. J 1l 7
CONTRACTOR
7
FORM 346 REV. AXLTH
For Spokane County Health District