1992, 03-03 Permit App: 92001232 ResidenceSPOKANE COUNTV.DERARTMENT OF BUILDINGS
W. 1303 BROADWA+( 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. 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 APPLICATION
-
OWNER OR AGENT DATE
PROJECT NUMBER- 9200 232
APPLICATION DATE= E.... i.33r03 r2 r -AGF:.... 01
**1:1:1:34• THIS IS NOT A PERMIT ***3iii:
PENALTIES W1:l...i... BE: A; `;:•'E:: i SE:i) FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET=
ADDRESS -
PERMIT -USE= I)y) E:S:Pll:Fc1' IT USE::-::
r ,...t -`i1 n:::::
BLOCK-
•n•N.
OF r i.....) t:r E -
OWWli~TER-::
iT'REET-
AI)TDF:;1::: ,",;:::::
2013 S NEWER CT
1; E:Ft:AL A1...i:: WA 99037
RESIDENCE •••• NATURAL. GA;
005092
00015121
121
•e•
PARCEL:-- 26544-1220
PLAT NAME= AUTUMN (:RE::r'T 2ND AL'i)
LOT- 5 ZONE- UR -3,5 DIST4-
DEPTH-
DWELLINGS= i WATER DIET VERA
L.ANDRETHCONSTRUCTION
T:[oN
3124 i• REGAL a T 4100
SPOKANE WA 95
BUILDING
�
CONTACT NAME::- RON :o,ss
BU :I:L i)I. NG• SETBACKS: FRONT= 28
PHONE-- 509 535 7778
R/W: ,,0
PHONE NUMBER= 50 535 7778
i._EF:..r:::: .10 RIGHT- 15 REAR= 66
r r Mim Hi ! * * k e k'*i*nc ri Ni** riia3*iREVIEW CNFi Ft , T
1tN 3*r***w*3i ;* * * * ti 3 * 3 n 3 * m�
DEPARTMENT
BUILDING
BUILDING
ENGINEER
EF
FSE:v:CE::i4•(::(DM iEN1
PLAN REVIEW REQUIRED
SETBACK REVIEW REQUIRED
AF'l i',(: AC;Ffi,'E..I...(:ion PLAIN/DRAINAGE ry
APPROVAL C:OMrMENT;
/ir'w».. »...—C(-96-4?-.
»-. Y—Y
31: 3k •i4 ri• 1: 34• hi. 34• •r• 34.3h 34• • ii 3r 3k 3* 3i 3i * 34• a •i4• : * •it• 34.3k * :8 t,I 1: L.. I.'+ T (N G P E R I`'i I T• * ri 3i 3k * 3< 3t •Ni * * * 34•
CONTRACTOR-
STREET-
ADDRESS-
NEW=
Oid1 RACTOR.>TRE:.i::.T :-:
DW1:::LL. t,1N1.T
C:.1._ D G w X D
REQ PARKING-
L..ANDRE:'rH CONSTRUCTION INC
3124 .} REGAL S T 4100
;4F`1. AN1 14('i 99223
X
1
RE-MODE:L. -
OIC::CUP i...i;:::: q
4i:1•1AN::,is(:::r"11'' :
)4. 3t• •,i •Ni •k• r 1:• 3r Jk )l 3i 3!• x• 1: 3k i(• 3k 34. 3t 1: 3i 3G 3M 34. 33. 34• i+k s! rR. 3* 31 MECHANICAL
CONTRACTOR= BARTON HEATING & ('C INC
STREET= 11816 1. MANSFIELD AVE .11003
AriDRE:E ::- ;i::=(`II.:nrNE WA 99206
3e3k*34.3t'3G3{*• 3i3e3E
PHONE= 509 535 7778
ADDITION=
BLDG HG•T•::::
SPR1NKLER= N
CRITICAL MAT= N
CHANGE OF USE=
STORIES=
PERMIT
1:• a 3k 3* 3* 3* 3i 34.31 * * a 3':• 36 W h: 3r 34• •k:• •i+: •ir 3c 1.1.3E *
PHONE= 509 922 50l; 0
: H• 3t 1•- ii• * is •H 1i iK 3k 34.3b 1: 3i• 3{' 3r •ii• 34.34• i4 *34.1:• •»::a.• •ik 9* 3i t +1 , » ' `
L. I.I i"i :. i Y t�' .: Fk i�r .t: •T •r.• •x• vd• 1• ie 1:• 1i 1• •ii• 1: 3i• •ir 3i• •k! 3e ii * •M.• 34• ii•'H• 1: 3E 3r 31F 3E 3f •'r.• * 3r
CONTRACTOR= GATEHOUSE PLUMBING
STREET= PO BOX' 4:'01
ADDRESS= . (:::l•1fyt.1...T•riFtiJY WA 990 03
F'ROC:E:,`..`E D BY: WENDEL.. , C;t...C.)F1T.r^,
PRINTED I;: Y : WI::i•1L'1EL , GLORIA
PHONE= r09 238 9132
34 r•: 3t i4.1: •is• •N: •i4- 3r iu: 1: •iE 3i 3F rk 3{ 34 34.1: i4 34• r: N 34.1: * 3+: 3+: 1:• 3k 34. *
THANK 1,• , i *******************************x*
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
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. 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 APPLICATION
ibWNER OR AGENT DATE
PROJECT NUr BE:F: : 92001234
APPLICATION DATE= 03/03/92 PAGE= 01
*;i•*•**•*• THIS IS NOT A PERMIT sI;* *•**•
PENALTIES W:I:I...L BE:: ASSESSED ES. ED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 2013 S NEWER C:.. F•:'ARf::.E::t..:A::::: 26544-1220
ADDRESS= VEF (LDAI...E WA 99037
PERMIT USE= SEWER CONNECTION •_' AUTUMN C::FE:tiT• 2ND _ T'i D (92S-152)
:ri** SEE NOTE: • • •
F•`L..riT1; :' 005092
BLOCK=
AREA= 000151—
OF
,0 15'I ..
i:lF BLDGE= y:
F:'I...AT NAME= AUTUMN CREST 2ND ADD
LOT= 5 ZONE= E::: UIY.....,. D:I: .T :::: F
DWELLINGS= I1 CY .1 WATER DIET = aI.Rr",
Ft'/W= ,a,r
OWNE::F:;:::: i...r-`INDRF T H CONSTRUCTION PHONE= 509 535 7778
STREET= z,1:.'-4 S REGAL t. 1.. 4100
ADDRESS= ) i , 9.223
CONTACT P1 E:::N ;~SrPHONE NUMBER= 519 535 77 t
BUILDING SETBACKS: FRONT= = NA LEFT= INA RIGHT= rN,• REAR= Nr
:'!• :il• 'H: -1C :p'.:p..M: » i?. ;i4 .i,...)': '3 'ji,• .i,; *. •it ' * 'ft' 'b: 'fY />.• : •}I: * •iC ;EWER PERMIT **.k; 9•i '}i .x..ii..h. *.:ri• ii •'r.• •r•: •k• * •ic * •k * * it * •ri it u.• •p: f« *• * n•
CONTRACTOR= I...ANDRETIH CONSTRUCTION INC PHONE= 509 .w 5 7778
STREET= 3124 REGAL ;> T 4.100
ADDRESS= 99223
ITEM DESCRIPTION QUANTITY FEE AMOUNT
--
PROCESSING E:•E:E:, r` 10.00
SEWER CONNECTION 'r 40,00
PERMIT TYPE FEE F' AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT i`i T T . 50.00 ,0 :i 50„00
50,00 ..::0 50.00
E'Ri7C;i:::,`.>SED BY: WIE NDEL. , GLORIA
PRINTED D BY : WI: NDI:::I..., GLORIA
SEWER ;>1I..l:f't AS....r::tU:i:I...T INFORMATION 1:,: AVAILABLE AT. THE COUNTY
UTILITIES 1)E:1 FiR:T11I:::N'T (456-3604)
CONTRACTOR AC::TOF OR APPLICANT :C;:i 10 FIELD LOCATE AND CONFIRM THE::
ELEVATION AND POSITION ON OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO ] I...OCA1E:: BURIED i:;F`iI•:{L..E::t', i:; i=r ;s" PIPING, WATER LINES, ECT,
CAI...I... FEfl:iRE YOU DIG t'456••• -81:)00i
SEWER
STUBS ARE tCBE CHECKED
HCKFr FICR TO CONNECTION NECTION TOI
N
SURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED rr T11 SEWER MAIN
nkxcxn.isCALL FOR 1N`FEfTICN PRIOR "LCOVER•t,i****;x
r:*•*.,')ty**-. 24 I•If:llli, NOTICE REQUIRED II:I:I_;I::r) *)i•*•*••ii•*•**••r.•*
„; •i; .i:* •h: * H •)i• * * * ::g: ii k• *• * is ri: * * k• * r: * •k:• ii •iii ,i ii * ii• THANK 'p' CJ I• i * •ie ri ***************:*****4********
Spokane, County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: S . 4013 AJ t -w CT •
CITY/STATE/ZIP: V E �r� 1,3g .. 95027
SUBDIVISION: A LA:rc&JWU Cp. s- S Ccv b
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: /‹021 F/A:� WIDTH:A DEPTH: R/W:
# OF BUILDINGS: 1 # OF DWELLINGS: WATER DISTRICT: OE -PA
OWNER: L 0RG CO. T-LGTa�J.� PHONE: 6<:),-4 —S 3.— '17'%c�'
MAILING ADDRESS:. S. 21.24 jc_, S 100
CITY/STATE/ZIP: S _‘
CONTACT:
qI��-3
PHONE: / —
SETBACKS: — FRONT: S / LEFT: /Of RIGHT: /S f REAR: (,6,f'3 "
PERMIT USE:
k***********************************************************************###
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
L1VivdJP—- 11'32/►tk
CONTRACTOR: LA-NOp•Ev - S s -c -c -T A -J
PHONE: 9 -X35--7 i78
MAILING ADDRESS :.6 - 3 1.2_4 2.12 ,StAc DO 4cv_ii.ioE, - 6A.m-•3
ARCHITECT/ENGINEER: DES176,..1 PHONE: ( — I/4,3
MAILING ADDRESS: .5. ,3(..1 � r13-(_1 .3 pkDY:A
NEW: % REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
/1/7_
i
BUILDING DIMENSIONS: P. 66, i X i(" (WIDTH X DEPTH) SQ. FT.: t���
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
Please provide the following information for Energy Code compliance:
Space heating type (check one)
Forced air electric
gForced air gas
Flat ceilings R
Vaulted ceilings R cO
Above grade walls R f 9
Below grade walls R t9
Floor R 30
Electric baseboard or wall mount
Heat pump
Doors U .410145
Windows U • '-i<q
Glazing area '901
Total floor area
of heated space =
Slab on grade R 10 Furnace efficiency rating
Propane
Other:
iyo
Please indicate on your plans: The location of the radon vent, and the location of the vent fan area.
Square footage
Main floor:
-�ksa a cCurrA_ ‘32.45-
Second-fleor:
Basement - Finished: W
Unfinished:
Garage:
Carport:
Decks:
Additional Areas:
OWNER: Le3, �:bzi7:- CGN5T2 ���-T: LOQ PHONE NUMBER: (s4-57-3-C:"777E
JOB STREET ADDRES S :
CITY/STATE/ZIP: USS 01V---,13/04 .99037 PARCEL NUMBER:
MAILING ADDRESS:
(Street)
PLUMBING PERMIT APPLICATION FORM
Infortatioh Worksheet
5 ,3� Z� ! Sia ii �q^'E, Cjici . q522_3
3
(City/State) (Zip)
CONTRACTOR:
*CokAiDAA-ly
LICENSE NUMBER: T t) C- 1 O SP J
21
\PHONE NUMBER: 13SO4 Z 3S - L 3 Z
MAILING ADDRESS: ' ::: D . 80 a•7 A. i}1 h -2Q rr 4 Q,003
Street : wr.1. •.(City/St�te). . (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE.
•
. DESCRIPTION" ....• '!' '
TOILETS .
SINKS j
SHOWERS ;: '.
BATH
KITCHEN
DISH WASHERS.'
GARBAGE DISPOSAL,''
CLOTHES WASHER•':`
UTILITY . SINKS
ELECTRIC: WATER HEATERS :
FLOOR DRAINS "
FLOOR SINKS •• •
BAR SINKS _ �...,.._.
ROOF DRAINS . ,z'
LAWN SPRINKLER • °'••.4
SEWAGE EJECTOR ,._ ::771 s:..
NUMBER OF
FIXTURES
X EACH
FIXTURE :
AMOUNT
•
'
WATER SOFTENER•..,
URINAL • = • •
DRINKING'FOUNTAIN
Y:
x 6.00.:= •i ;oo
•••':v2..•00 •
•
;'
x...6.•00=`'=
x ;6.00.,=
x'=6.00•=
X''6.00'=
x:t-6.00.=
x '6.00 =
X' -6.00 =
•
NOTE: MINIMUM PERMIT FE I•' $35.00
SIGNATURE
SUBTOTAL
$ (D(ot00
PLUS: PROCESSING FEE
1
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE • 1= $ 4(1'°C)
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spoke e, WA 99260 (509) 456-3675
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
J0$ STREET ADDRESS: 3 -,` leo l 3 JC- -- GT -
CITY/STATE/ZIP: JE.-ZA A u
, ^N ' C 037 PARCEL NUMBER:
PHONE NUMBER: (soy) 5 3��- -7713
(City/State) (Zip)
LICENSE NUMBER: f3Z
PHONE NUMBER: (-C-066
.�5's-�� \ : YA,QE , &1 • 619 zoo
•
vi�2rZ Lo -v5 -,fit -i-4- �.c»JJ
OWNER:
MAILING ADDRESS: •6 `"
CONTRACTOR:
MAILING ADDRESS:
(Street)
(Street)
(City/State).- (Zip) -
-MECHANICAL WORKSHEET/FEE. SCHEDULE
NUMBER
DESCRIPTION OF. UNITS
X EACH
UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT _ _
GAS WATER HEATER
HEATING : EQUIPMENT-: <100, 000 BTU -
HEATING. EQUIPMENT . +100, 000
GAS -.PIPING .. (EA ; OUTLET)
REFRIG 1-100M ,BTU.. (240T <,A/C OR HEAT';PUMP)
REFRIG `'1;'001-1 750M' BTU -"_ =
REFRIG +1,750M BTU ..•
;:. HEATPUMP. & AIR CONDITIONER 0-3 ;TONS._
HEAT; PUMP • & rAIR :''CONDITIONER.:3-15:TONS.
HEAT PUMP . & -AIR CONDITIONER. 15-3 0 :4TONS
HEAT PUMP . &.. AIR CONDITIONER 30750 .. ONS ._
HEAT. PUMP & AIR7•CONDITIONER +50
VENTILATINGFANS
EVAPORATIVE COOLERS' `: •
TYPE :I HOOD "(PER. 12'. OR .12.'. PTN.. OF: .HOOD)
TYPE II'`. HOOD °�=.._:•,.:
CLOTHES DRYER_ '� , ''' . x w" "'" ";-�•
RANGE - .
t.
GAS .LOG , j '- 'L ' f '"��`A= .`"'•
j•
'.:''•MISCELLANEOUS ;(NOT:COVERED. ELSEWHERE.
)_•._':.:
UNLISTED GAS APPLIANCE '<400,000BTU _'.'
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
•
= AMOUNT
x$10.00 =
x. 25.00.,=
x 10.00.=
x 12.00_
�•..•
•
x 15.00='_=
x . 1.00;
x 20.0,1;47
x 2500•
x-35:00:.=
x ,60.00=
x'' 12:0C.{=
x.'20.00.`=
x 2500
X 35:..00"'= . L... .
x 60.00,=
X 10:09,—
x .10:.00
0:00 _X.10:.00
x 50.00.,=
x10.00:4
x 10:00';
•'
X•10.1v 00
x'10.00:=
x'5000.=
x100.00.
x 50.00=
x100.00 =
x 12.00 =
x 15.00 =
10,00
/o, ao
• / 2.•.. ®o›....
•
..
NOTE:
SIGNATURE
•
IT
EE IS $35.00
SUBTOTAL
$ 32.0c
PLUS: PROCESSING FEEL+ $'" 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ 51.00 •
. M� 'i7%;_• iii Y:
Spokane County Department oBuilding
an Safe 09) 456-3675
West 1303 Broadway Avenue Spokane,
SCALE in 0A,,01
4-
46.3.3 '
.33./ 1
6E
z;
„
/04 441
SW c
LOT 5 BLOCK2
AUTUMN CREST SECOND A )D
THESE PLANS
S��a,�
R-kO v
BY
basement
S
S. 2413 Never Ct.
Autumn Crest, orf Sullivan
/.
NIL
Radon Vent
•
•
•
garage
nnutn Lorpnra1i.nn
E. 8620 44th Spokane,a. 99206
Phone 509 926-6217 Fax 509 928-8689
Legend For Radon mitigation system
— --perforated pipe beneath slab
Q solid 4'ABS stack vent pipe
RADON SYSTEM SPECIFICATIONS ATT.
*672- (2.3Z
RADON MITIGATION SYSTEM
This radon mitigation system is
designed only for the specific Job -
site address designated. The system
is not guaranteed unless installed
by Cavalier Corporation
Job vitt address S 2013 Never Ct
builder Landreth Const.
Sq Ft 1800
(})(1)1A9-4&gillt
Warr J ,.y dl , t
Environmental Protection Age' },' „ „�Ei'OZ?44
Qanxtir engineering
radon services
E. 8620 44th
Spokane, WA 99206
Phone (509) 9-6217 FAX (509) 928-8689
RADON SYSTEM SPECIFICATIMOS, SPOKANE COUNTY:
1. Perforated pipe shelf be installed within the native soil
or fill (sand, gravel or soil) at a minimum depth of 1"
below the intended sh.b.
2. The pipe shall be a Minimum diameter of 4". meet AASHTO
M252, have perforatiess no wider than 1/16" and have a
minimum of 2.5 square inches of total perforations per
linear foot of pipe.
3. There shall be a minm of 10 linear feet of perforated
pipe per hundred squall* feet of slab floor space.
4. The pipe shall be laid in a continuous loop. connected at
both ends to the solkl stack vent pipe.
5. Any slab area, which is larger than 10 square feet, which
is isolated from oth t slab areas by footings or other
barriers, shall have a perforated pipe installed to the
above specifications_ (The pipe can be a single length
rather than a conneci*d loop if the area is too small or
narrow to accomodate a connected loop.)
6. A stack vent of ABS, aehedule 40, minimum size 4", shall
be connected to the mab-slab piping and proceed upwards
to an exit location w the roof. and extending 14" above
the roof. The pipe shall be Labeled "radon vent" every
16" or less for its tell length. The pipe's attic
location shall allow a minimum of 4' of head room. When-
ever possible this exit location shall be on the backside
of the roof.
7. Any elbows in the st k vent piping shall have a
centerline radius mi mum of 1.5 by pipe width.
8. An inline centrifuge/ fan, minimum 114 cfm @ 3/8" W.C.,
UL listed, manufactured specifically for radon mitigation,
maximum sone level 2.8, shall be installed in the exhaust
line, in the attic.
9. Couplings to connect the vent piping to the fan shall be
elastomeric PVC, Feraeo series 1056 or equal.
10. The fan shall be hard -wired and the breaker labeled "radon
fan".
11. All penetrations and joints in the concrete floor slab
below grade shall be sealed with caulk or grout.
12. A notice shall be permanently attached to the electrical
panel advising the ower or occupant about the radon
system and that he/s111 shall test the home for radon
annually. The notice shall include Cavalier's name and,
phone number.
13. All craftsmanship shall be of high quality.
SCA -LE : / " 201
04.33
BUILDIN6 SFT8,4c-t
Qo
19114/N46e A"its eM'T
BUILD/NGS .SET5,$'A
.DRA/Ni46 E SW ,4L 4-
N.
N. S4'. f 1 470
(S - k)
/04. ‘41
4
i
-7.4, I
LOT 5 BLOCK2
AUTUMN CREST SECOND ADD
„Sr --“8„NO1103S
31VMS 30VNId8C1 1N3NVW83d
cx\t"
ti
IRRL`.'OC'ABLE LI�I�11:R Oi CII:
Ati1O1:N 1,: $ 1,1100.00
TO: SPOKANE CC)UN"IY ENGINEERS
811 NORTI1 JEFFERSON
SPOKANE, WA 99260-t)171)
SUBJECT: LOT BLOCK AUTUM CREST 2nd ADDITION
PLAT # P 1570A . (Development)
Gentlemen:
We hereby authorize our irrevocable Letter of Credit in your favor, and authorize you
to draw on the (bank).
a draft up to one thousand (Dollars) ($1,000.00), for the account of
(developer).
The draft, drawn under this Letter of Credit, covers the assurance of completion of
installation of storm drainage, drainage swales, sod and other work as is incidental and
related thereto in accordance with the drawings and specifications as submitted to and
approved by the Spokane County Engineer's Office on
(date), and is to be accompanied by the following documents: written request by
Spokane County Engineer's Office to (bank),
at the above address indicating non -completion of all or any of the above improvements and
that amount of money required to complete such improvements.
We hereby agree with the drawer, endorser and bona fide holder of this draft, negotiated
under and in compliance with the terms of this credit, that said draft shall be duly honored
upon presentation at the (bank),
at any time before completion of the above-described improvements or performance, in
which event written notice shall he given by Spokane County to the hank.
Drafts, drawn under this Letter of Credit, shall hear on their trice the words
Drawn under (hank)
Credit No. Dated
Bank Name:
!iv:
k\j\t\letter.cre
(authorized sik,nor)
For security purposes only,
ASSIGNMENT
hereby assigns to SPOKANE COUNTY, a political
subdivision of the State of Washington, the following:
Savings Certificate Number
in the face amount of $1,000.00
and held in and by
Bank of
Branch
]'his assignment is made as security for the full and faithful performance by of
certain drainage facilities and sod for LOT BLOCK , AUTUM CREST 2nd ADDITION (Plat)
Plat # P 1570A in accordance with the drawings: and specifications as submitted to and approved by the Spokane
County Engineers office on (date) 199
Any interest benefits accruing under said savings certificate shall remain the property of
Said savings certificate to be released to or any other party only with the prior written consent and
agreement of Spokane County.
PROVIDED, FURTHER, the undersigned does hereby authorize to
pay over to Spokane County all or a sufficient portion of the monies in the savings certificate referenced hereinabove upon
written documentation being received from the Spokane County Engineer indicating that the purposes for which the
savings certificate was assigned have not been fully and faithfully performed as required and a statement of that amount of
money which the County Engineer as required and a statement of that amount of money which the County Engineer deems
necessary to complete such obligation. Upon receipt of such written documentation,
hereby authorizes to release to Spokane County that amount of money requested up
to the maximum amount in the savings certificate.
DATED this _ day of , 199
DATL'I) this
STATE OF \VASI IINGTON
Uw111\ 01 ti1001\;utc
BANK OF
President
day of , 199
:ss
Secretary
DEVELOPER
on this day personally appeared before me
to me known to be the individual described in and who executed the within and foregoing instrument, and acknowledged
that signed the same as free and voluntary act ancl decd, for the uses and purposes therein mentioned.
I\ I ti' 11N1 tl :k MY I IANLD AND OFFICIAL, SIsAI. this
day of , 119
Notary Public in and for the State
of Washington, residing at Spokane