1990, 05-15 Permit App: 90002073 Residence13
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
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 l 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 APPLICATION
OWNER OR AGENT DATE
12'I OJECT NUMBER= 90002073
DATE= 05 /15/90 19 /9t0 E AGE= Ai
ISSUED) PERMIT
"*M************************** APPLICATION ;(..li..iE:q..y(.ii..h.+p.u..k..)girt.ii..yp.yEu(..yp.y(..)v)4****ir ***9i iF.g..yi.:t(.
SITE STREET= 17501 Ei: MONTGOMERY DR PARCEL..R'= 07552--0405
ADDRESS= GREENACRES WA 99016
PERMIT USE=
PLATO==
BLOCK
AREA=
ti.: OF BLDc.;5::=
OWNER=
STREET=
ADDRESS=
RESIDENCE
004437 PLAT NAME: SP -969
LOT= A ZONE= AGRI DISH=
FSA:= F WIDTH= DEPTH=
: DWELLINGS=
1
ftLUM, JELMER E
105 << NE:YL..AND RD 4
LIBERTY L_AKF. WA 99019
CONTACTNAME-:: JERRY f'PL..LIM L
BUILDING SETBACKS: FRONT
.31..11.)4341*34****34***31*131**1*34**1*3434313':*
DEPARTMENT
BUILDING
BUILDING
BUILDING
Q EN(:;s.NEEE?
C HEALTHDIST
PLANNING
PLANNING
CD PLANNING
REVIEW COMMENTS
PHONE= 5199 255 6322
R'W==
PHONE: NUMBER=:: 509 924 23+y1
LEFT= 2170+ RIGHT= 20 REAR::=— REVIEW INFORMATION *******:***.33**********34
PLAN REVIEW REQUIRED
SETBACK REVIEW REQUIRED
ENERGY PI. -AN REVIEW REQUIRED
APPROACH/FLOOD PLAIN/DRAINAGE
NEW OR ADDITIONAL WASTE WATER
INADEQUATE FRONT YARD SETBACK
INADEQUATE REAR YARD SETBACK
REGULATED SHORELINE:
****************************X**
CONTRACTOR= OWNER
APPROVAL_ COMMENTS
4/La. s -/h 66
6
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bit .-( 5--._._Cf`r
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EIIt:LI...T;:I:NG 3t..
NEW= X REMODEL=
DWIEL.L. UNITS== 1 OCCUR. LD=
BLDG W X D == X SQ FT= 2430
RE_2. PARKING= :":HANDICAP=
***4343( 34'34****13134*3434*34*34*
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PHONE
ADDITION=
BLDG HGT=
SPRINKLER= N
CRITICAL MAT-= N
CHANGE OF USE=
STORIES=
4****x..14.*. MECHANICAL PERMIT RMIT 31343434*34*3434.3.**1*•*•
CONTRACTOR=: OWNER PHONE==
a4**4*1**3434.*.y4.*.343i3i .*.*3434*.*.*1;e.**.;4.*.*.a4 PLUMBING PERMIT 3434 a4;@.p..*33434443(**34.*133..1(.
CONTRACTOR= OWNER PHONE=
343434343434343111
.**..x..*..x..*.* iE +:.y(..)(..*.
PROCESSED BY: WENTiEL.., GLORIA
PRINTED BY: WENDEI_, GLORIA
********:*****.***'4***3333*•*****4(**•*• THANK you **34*34349434*3434*..*..*..**ft .*..********343(33:33:**
NOTICE •
It is the responsibility of the permittee, not Spokane County, to see to itithat the use described on the front of this permit
complies with applicable codes and requirements and that required inspections are requested. Failureto request required
inspections and obtain the necessary approvals prior to progressing beyond the point where inspections are required may
necessitate removal of certain parts of the construction at the owner's/permittee's expense. At a minimum, the following
inspections are required by County Code:
1. FOOTING — when forms and reinforcement are in place and prior to placement of concrete.
NOTE: This inspection includes review of the structure's setbacks from property Ilnes. Minimum setbacks
are established by County zoning regulations. Typically, side and rear yard setbacks are measured from
property lines, while setbacks for yards abutting streets are measured from the property line or the center
line of the roadway right-of-way, whichever provides the greater setback from the center line of the roadway
right-of-way. Curb lines and fence lines are not necessarily indicative of property lines. In some residential
areas, the County can own as much as 20 feet of right-of-way between your property and the actual im-
proved street/ curb. The responsibility to comply with applicable setback provisions lies solely with the
permittee — neither Spokane County nor its authorized representatives assume any responsibility for the
verification or location of your property lines. Please verify their location prior to locating your structure.
Failure to properly locate the structure may require its relocation at the owner's/permittee's expense.
2. FOUNDATION — when forms and reinforcement are in place and prior to placement of concrete. (Block-
ing for a manufactured home is required to be inspected prior to the installation of skirting.)
3. FRAMING — after all framing, bracing and blocking is in place, and prior to concealing.
4. INSULATION — prior to the installation of drywall.
5. PLUMBING — after rough -in, before cove.ring, and final.
6. MECHANICAL — rough -in of piping, before covering, metal chimneys before concealment, and final.
7. FINAL — when complete and prior to occupancy and/or use.
In addition to the above inspections, any plumbing or mechanical systems or materials which would be concealed by
framing, drywall, concrete, etc., must be inspected prior to cover. Check with the department for "special inspections"
in conjunction with commercial projects. .
v
CALL 456-3675 FOR INSPECTIONS.
TO INSURE PROMPT SERVICE, PLEASE GIVE 24 HOUR NOTICE.
`' YOUR INSPECTOR IS
UNDER CERTAIN CIRCUMSTANCES, PARTS OF YOUR PROJECT MAY REQUIRE INSPECTIONS FROM OTHER
AGENCIES:
u road cuts for utilities or drives, State or County Engineer's Office
456-3600
o on-site waste disposal system, Environmental Health District
456-6040
• construction in a flood plain, County Engineer's Office
456-3600
a electrical wiring, State Department of Labor and Industries
456-2792
O sewer connection, County or City Utilities Department
456-3604
EXPIRATION
Unless otherwise noted, this permit will be considered null and void by limitation if the work authorized by the permit is
not commenced or is stopped for a period of 180 days, unless a written request for an extension of the permit is received
and approved by the Building Official prior to expiration. At a minimum an inspection should be requested at least once
every 180 days to assure the validity of the permit. A permit may be renewed within one year of the date of expiration for
one-half the original fee, subject to certain limitations — please call us if you have any questions.
MISTAKES?
If you think we've made an error in processing this permit or in conducting inspections pertaining to it, or find erroneous
information in the permit, please bring it to our attention immediately by filing a written request for correction within 10
working days of discovery. All such requests should be directed to the Department of Building and Safety at the address
found on the face of this permit.
0
Spokane County 37D
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
0-7552-- D//b.
STREET ADDRESS: )15o1 X71(MIT Go IN>?'/ JR
CITY/STATE/ZIP: CiVc-w-T/ ,e Rs WAS NtNTan/ /,
SUBDIVISION: s e- g% S-" 5/ `'4 37
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS:
WATER DISTRICT:
OWNER: 'Batt/ v EL )ICC C PHONE: So j - 2S$ - G3 2 2
)
MAILING ADDRESS: $ /OS A/eYL.O'-//o ,OPT
2g a / /
CITY/STATE/ZIP: 2 / S li'/
L / 1C L� 14/4.S// /A/c To iv
/
CONTACT: C2M al E, 5Lr/r/ PHONE: svy -zsj - 432 2 N
5z4' Z3o
SETBACKS: - FRONT: Z LEFT: ' RIGHT: 2 O REAR:
PERMIT USE:
CONTRACTOR LICENSE NUMBER:
BUILDING INFORMATION
I
CONTRACTOR: 0 lA/A/aDt PHONE: Soy - 255 - /r 5 2
MAILING ADDRESS: 5 %OS A/SW/4W Aar 7'
ARCHITECT/ENGINEER: N49 Env o,wr /ir-,/cn/
D/LAFri Art
MAILING ADDRESS:
PHONE:,
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS:
X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
JOB STREET ADDRESS:
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: PHONE NUMBER:
MAILING ADDRESS:
CONTRACTOR:
(Street)
MAILING ADDRESS:
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER OF
FIXTURES
X EACH
FIXTURE
= AMOUNT
TOILETS
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISH WASHERS
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
x $6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
MECHANICAL .PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
PARCEL NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
CONTRACTOR: LICENSE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip) _
(Street)
(City/State)
(Zip)
PHONE NUMBER:
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER
OF UNITS
X EACH
UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M,BTU (NOT A/C OR HEAT PUMP).
REFRIG 101-500M BTU. F•
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0 -3 -TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12'
TYPE II HOOD.
OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
r
f
= AMOUNT
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x.35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10:00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9 260 (509) 456-3675
Spokane County
Department of Building & Safety
JAMES L MANSON, DIRECTOR
ON-SITE SEWAGE DISPOSAL SYSTEM INFORMATIONAL REVIEW FORM
For Single Family Residences
TO Spokane County Environmental Health Division
FROM: Spokane County Department of Building and Safety
DATE: 1 Z - -i — , 198 (7
RE : On Site Sewage Disposal System
REF : Describe Proposal:
Property Owner •
Road Name
Parcel Number •
Street Address
Legal Description:
SIGNED:
r
I �
posed Owner or Authorized Representative
%1 C "-C1- GOP ( t7Z i/ � ) (; I-7 g O A fj
FLAT "A" Cee-614A01.e-`5 klicDiSRtcr [_cT '',6°
t?,1-r ? r f'`l- •D�`�
Date: /2 --f -v%
/
:k. An initial review of the above -referenced property has been
conducted by the Spokane County Planning Department and the
following items are noted. An in-depth review of the property will
again be made at the time a building permit is applied for.
Requirements reviewed for property as of the date set forth
hereinabove.
Yes/No/N.A
Dedicatory Language within Plat
Subject Property is Legally Divided
Certificate of Exemption Required
Use Authorized Under Zoning Ordinance
Setbacks Met in Zoning Ordinance k)/4
Shorelines Permit Required
Variance Required for Following Purposes:
Other:
Planning Department: Date:
On -Site Sewage System Review Form
Page 2 of 2
2. An initial review of the subject property has been conducted by
the Spokane County Engineer's Office and the following items are
noted. An in-depth final review of the property will again be made
at the time the building permit is applied for.
SPECIAL REQUIREMENTS:
Maintained County Road Frontage
Approach Permit Required
Flood Zone
Variance Requirements
Other:
Engineer's Office:
3. The Spokane County' Department of Building and Safety has advised
the property owner/representative th at such time a structure or
building is to be placed/construction the ,ij operty, a building
permit will be required.
Building and Safety Department:
0ate:/2//�/
NOTE:, The review by the various departments as provided for herein
is solely for the purpose of advising the Spokane County Health
District of the subject property's compliance with various codes and
regulations. The issuance of a permit by the Spokane County Health
District for the installation of an on-site sewage disposal system is
not to be considered as a vesting of a right by the owner/rep-
resentative to obtain a building permit for the property. At the
time that a building permit is applied for, the subject property must
comply with all applicable federal, state or local laws, ordinances
or regulations with the exception of those relating to the issuance
of a permit for the septic tank/drain field on-site sewage disposal
system by the Spokane County Health District, pursuant to this form.
Accordingly, although as of the date of this document the subject
property may meet certain federal, state or local laws, ordinances or
regulations, in the event such items change between the date of this
document and the application for a building permit, the ow-
ner/representative will be responsible for meeting such regulations
on the date of the application for the building permit.
Roe-,
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