1985, 07-10 Permit App: 00006307 Residence.del'/ °
-6
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this original and your building plans to the Department of Building and Safety)
1 Owner's Name (last) (first) (m)
rpartmeny3Only
C>(/� /� 1 s. Comm
2 Project Address (not Mailing Address) cr Road ame Space Zip
, 3 gQ. 6( 29z/ 2-
r/
3 City/Community,State
(:)/.?C MO G d ,
144/44.
Subdivision/Plat Name
004W40 or. . >V
4 Assessor Parcel No.
0 i 'f' 3 -z 2
Lot
10-q
Block
15
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. #
Zone
Project No.
6 Dwell #
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Back -Front
45t
(L S-1
1C.O'
(R)S-2
/)'
j Rear
IF
Oansus Tract
Module No.
Initials
i,la m.
16 Architect Firm Name
I Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Contractor Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
License No.
Phone If different than above
( )
8 Owner/Agent (if different than #1 above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
Plan Check (Y/N)
Other (Y/N)
I SEPA Exempt (YIN)
Date
15 Type Work 74. Bldg
❑ Fire
❑ MH
❑ Demo
E}' New
!❑� Add/Alter
❑ Replace
❑ Move
❑ Other
14 Describe Work
S l 0 CE PPTA 61,+F/D GAtiurc,
10 Applicant Name
Street Address��
i
'/E�C�Y
11 Zip
/ )/
ity
State
4‘1'411/\ -*-4
Phone
( ) Y,,, 7;
Lender
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
1*
Additional Information
BLAILviNct -Pc,r2nAtr . 344.0
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6,7 aRToT - : 44a .06
*
*
1
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is nota Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
❑ Commercial;
D New Construction;
❑ Additional structure;
❑ Residential
❑ Bldg alteration/addition
APPLICATION #
Conditions/Comments-
Release
Release w/cond 1
Hold 2
it
Planning/Zoning: ❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage;
N. 721 Jefferson ❑ Setbacks; ❑ lot w/d; ❑ lot size; ❑ use/zone;
❑ CU, variance, zone change; shoreline; ❑ fence;
❑ Other
Conditions/Comments•
Engineers: ❑ Commercial; ❑ Residential; ❑ Flood Plain;
N. 811 Jefferson ❑ drainage ❑ new access/approach; ❑ fence;
❑/ road improvements /� / /�
�a .< !n.( --a-(‘ n vcd1 Klock,""f j /2c9 `? L 000) "7G 0:c
Conditions/Comments.
75,
/(.J c /�EX.G1 T �42c) t ie -t"--1
Utilities:
N. 811 Jefferson
Conditions/Comments.
Other:
Plan Exam
Fire Prev.
Conditions/Commen
s. ,4.itAtt
r J.
wt Y ►� wL t'
4%-ilVt y•le5/ GetZ p fit-r8LA
Project Representative
Agencies Performing Special Inspection:
1
Telephone
2
3
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
•
PLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last) (First) (M)
Department Use Only
Project No.
2 Project Address (Not Mailing Address) Space Zip
' 3 City/Community
I State
Subdivision/Plat Name
4 Assessor Parcel No.
I Lot
Block
16 Contractor Firm Name
Street Address
r 17 Zip
City
State
Phone
( )
18 Contact Person I
License No.
Phone if different than above
8 Owner/Agent (if different than 41 above)
Business Address
9 Zip
City
State
Phone
( )
15 Describe Work: New 0 ; Addition/Alteration ❑ ; Replace/Repair 0
Total Number
of Fixtures:
10 Applicant Name
Street Address
11 Zip
City
State
Phone
( )
9 Bar Sink(s):
Drinking Fountain(s):
Floor Drain (s):
Washing Machine(s): /
(
10 Doh Wshr(s): j
Garb Disp(s):
Kit Sink(s): /
Lndry Tray(s):
Sew Eject(s):
11 Urinal(s):
WtrCloset (s): 2._
Lav(s): 27_
I Shower(s): /
1 Tub(s):
Bidet(s):
Other:
/ Type;
12 Waste/Grease Interceptor(s):
13 Sewer Y N Septic/Health No.:
14 Electric Water Heater(s):
Drains -Roof:
15 REPAIR OR ALTERATION: Drainage, Vent, Water Piping /Treatment: Y N
16 Lawn Sprinkler System(s), including backflow device on any one meter:
17 Vacuum breakers or backflow devices in excess of line 16:1-5:
(Or) 5 +:
j-rp p
air
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state of local laws regulating construction or the performance of
construction.
SIGNATURE OF
APPLICATION
OWNER OR AGENT DATE
TO:
FROM:
SUBJECT:
UTILITIES:
RECEIVED
JUL 2 1985
SPOKANE COUNTY HEALTH DISTRICT
Inter -Office Communication
. DATE:
Spokane County Utilities and Spokane County Engineers
7/4(
Spokane County Health District - Environmental Health Divisio
Proposed Building Project at:
y..3fot v
Attached is the proposed plot plan denoting the location and in,tallation
specifications for the on-site sewage disposal system. The sewage
system installation permit is being withheld pending your comments and/or
esign for the double plumbing to facilitate connection to the future
pokane Valley sewer.
No determinable location for future sewer lateral, therefore, double
plumbing is not required.
(signature)
(date)
2. Double plumbing required. Note location and specifications on
approved site plan.
(signature)
er comments and/ qX recommendations.
(d%te)
(signature)
(date)
(Please forward this response form to County Engineer if project is a
commercial proposal.)
ENGINEERS: The surface water grass percolation area is identified on the
attached plot plan.
ld
Other remarks:
(signature) (date)
Please forward this form back to the Spokane County Health District
the first working day after receipt of information.
Attachments
4/17/85
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Building Permit Fee agree
James L Mason, Spokane County Building & Safety Director
and
Daniel R Love & jane
RECEIVED FOR RECORD, this date, the above instrument,
numbered in order of reception.
WILLIAM E. DONAHUE
County Auditor
Spokane County, Washington
FORM 1 -AUDITOR
•
8508090202
viL'. 766 PAGE 1210
.1
BUILDING PERMIT FEE AGREEMENT
THIS AGREEMENT made and entered into this $T—`` day of
A u6.u5; , 1985, by and between James L. Manson, Spokane
County Building and Safety Director, on behalf of Spokane County, a
political subdivision of the State of Washington, having offices for
the transaction of business at West 1116 Broadway Avenue, Spokane,
Washington 99260, hereinafter referred to as the "County", and
Daniel R. Love and Jan Love, husband and wife, owners of that parcel
of property located at 3804 North Park Road, Spokane, Washington
99212-0000, hereinafter referred to as the "Owners", jointly,
hereinafter referred to as the "Parties".
WITNESSETH
WHEREAS, pursuant to the provisions of the Revised Code of
Washington, Section 36.32.120(6), the Board of County Commissioners
of Spokane County has the care of County property and the management
of County funds and business; and
WHEREAS, pursuant to the provisions of Chapter 19.27 RCW, the
Board of County Commissioners of Spokane County has created a
Building and Safety Department, which Department is responsible for
the administration and enforcement of the State Building Code within
any unincorporated area of Spokane County and in conjunction
therewith has adopted fees to be charged for the issuance of permits
thereunder; and
WHEREAS, Daniel R. Love and Jan Love, husband and wife, own that
parcel of property located at 3804 North Park Road, and as a result of
serious sickness and calamity, members of the public are desirous of
building for the Loves a residence and attached garage; and
WHEREAS, the applicants for the build '6-6 permit as well as the
owners do not presently have the fi ncial ability to pay for such
building permit, however, the owners are agreeable that if and when
such residence and garage built on such property are sold, that the
building permit fee will be paid; and
vc[.afr.766 PAGE1211
CI
WHEREAS, the Spokane County Prosecuting Attorneys Office has
advised the Board of County Commissioners in Spokane County that no
County may loan its credit to any person, except to the poor and
infirmed; and
WHEREAS, pursuant to the above provisions, the County is
desirous of deferring collection of the State building permit fees
collectable in conjunction with the construction of a residence and
attached garage at 3804 North Park Road, Spokane, Washington, until
such time as the property is sold or leased;
NOW, THEREFORE, for and in consideration of Spokane County,
through the Spokane County Building and Safety Department, issuing a
building permit on that parcel of property located at North 3804 Park
Road, Spokane, Washington 99212-0000, a photo copy of Permit being
attached hereto as Attachment "A" incorporated herein by reference,
and in conjunction with issuing such building permit deferring
collection of the fees in conjunction therewith, totalling $442.00,
the Owners, their heirs, successors and assigns agree that when that
parcel of property located at North 3804 Park Road is sold, or leased,
to person or persons other than the Owners herein, that at the time of
the closing of the transaction, in the case of a sale, or within
thirty (30) days of the lease of such property, an amount of $442.00
shall be paid to Spokane County, such amount representing the amount
owing and due under the building permit, attached hereto as
Attachment "A".
The Owners state that they have carefully read this document,
know the contents thereof, and that they have signed the same as thei r
own free act and deed.
The Owners further state that they have been advised to contact
legal counsel prior to executing this Agreement.
off. 766 PAGE 1212
Vel.
IN WITNESS WHEREOF, this Agreement has been executed on the day
and year set forth above.
STATE OF WASHINGTON )
) ss.
County of Spokane )
SPOKANE COUNTY BUILDING AND
SAFETY DIRECTOR
C2,-"rt.ed ae4f47440.0-kt...
MES L. MANSON
AMES L. MANSON
On this day personally appeared before me DANIEL R. LOVE AND JAN
LOVE, to me known to be the individual (s) described in and who
executed the within and foregoing instrument, and acknowledged that
they signed the same as their free and voluntary act and deed, for the
uses and purposes therein mentioned.
GIVEN under my hand and official seal this
w:\Lcs-r— , 1985.
$7H
day of
FILED 0 PEVORael
E a!W ::,f, (?V Spokane
County B1dg & Safely Div.
AUG 9 1199 MT
WILLIAM i:, f � HAHUf
SPOKANE COUNTY, WASH.
DEPUTY
Wi11 Pick Up xxx
ATTACHMENT "A"
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
NORTH 811 JEFFERSON
SPOKANE, WASHINGTON 99260
(509) 456-3675
P. 766 P11Gf 1213
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 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. The granting of a permit does not presume to give authority to violate
or cancel the provisions of any other state or local law regulating construction or the performance of construction.
SIGNATURE OF
JWNER OR AGENT DATE
APPLICATION
JOB ADDRESS:
(l4 N PARK RD
OWNER:
,JE, DANIEL R
ADDRE
;a04 N PARK RD
:ITP: AT: .. ,
i:IKANF: WA 99212-0000
APPLICANT:
..LY MAYS
CONTRACTOR:
ADDREI5:
Giro. 1T: 11►:
F. LICENSE•:
AHCH/ENGINEER:
ADDRESS:
CITY: ■T: 11P:
$36.00
PARCEL.:
1J5432204
CANAL'S TR:
0999
INSPECTOR:
PLATA,:
002544
LOT Q BLOCK
010 015
FINAL
PLAT NAME:
ORCHARD AVENUE ADD(TR.1-228)
ZDNlA,:
SONE
AGSUB
F.
045
1-1
016
1-1
030
RIE
000
MOO
USE OF PERMIT:
U1.+001 RESIDENCE W/DETACHED GAR
IDu ADDRESS:
3.::104 N PARK RD
STRUCTURE
Description
;Square feet
Description
Square feet
Description
Square feet
E:: s t Pin C h k
COMBO
.EO...
0006756
DATE,
07/10/85
PROIl:
00006307
Strurture Fee
119.f.3.9.(1/
Mechanical Fee
$12100
Plumbing Fee
$36.00
DIFF. FEES & AMT DUE -
$442.00
PEE.:
$,00
PAID BT:
CA
CN
CG
NC
X
COUNTER AP
PLANT EXAM:
0,0
DATA
07/10/85
PERMIT
N DWELL Group R-3 Type VN
001452 Occupancy Load 0000
N DWELLUB Group R-3 Type VN
001452 Occupancy Load 0000
N PRI GAR WF Group M-1 Type VN
000672 Occupancy Load 0000
$0,00 Actual Pin Chk
PLUMBING
fixtures: Bar sink 00 Drinking
Dish Washer 1 Gabage D,ppsai 0
Urinal 00 Wtr clset 02 Lava 02
TOTAL FEES $394.00
$0.00 V<:ar $0.00
TOTAL. FEES $36.00
Fnunt 00 Fir Drain 00 C/W Pipe 01
Ktchn snk 1 Lndry tray Sew e'ct 00
Shwr 01 Tub 00 Bidt 0 Oth 01 ee: $36,00
po CHANICAL TOTAL FEES $12I 00
rlppi: Dry 0 Range 0 Gaslog 0 Gas w/h 01 Solid Fuel 0 fee: $6,00
urlprsr/hp: to 3 01 3-15 0 15-30 0 30-50 0 50+ 0 fee: $6,00
OFFICE COPY
*
BUILDING PERMIT APPLICA
PLEASE PRINT AND COMPLETE ONLY THOSE PA
WORKSHEET i6&y1!'. P.",a 1214
OF THE FORM YOU UNDERSTAND
(Please return this original and your building plans to the Department of Building and Safety)
1 Owner's Name (last) (first) (m) Department Uee Only
0(1.‹.-.�A(61.41...,fss. Comm
Xl I
2 Project Address (not Mailing Address) or Road ame Space Zip•
//. 3?o y i>`. 292/ 2.
3 City/Community
2A'( '/eek Q
State
Lfia4).,
Subdivision/Plat Name
Q�G�, D or. Aiv
4 Assessor Parcel No.
0 (0” 1 3 - z 7 h/
J
Lot
(o -11
Block
15
* * + DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. 4
Zone ✓
Project No.
6 Dwell 9
No. of Buildings
i
Sq. Ft./Acre
Depth
14 i 1
Frontage
I cc '
7 Set Bads-Front(L
49'
S-1
ICO
(R)S-2
�''
Rear
Census Tract
Module No.
Initials
J0ti m .
* 16 Architect Firm Name
l Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Contractor Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
License No.
Phone If different than above
( )
8 Owner/Agent (if different than 81 above)
Business
Address
9 Zip
City
State
Phone
( )
12 Review Required
Plan Check (Y/N)
Other (Y/N) 1 SEPA Exempt (Y/N)
Date
15 Type Work. y.. Bldg
❑ Fire
7 MH
❑ Demo
EY New
/❑l Add/Alter
.. Replace
❑ Move
7. Other
14 Describe Work r� //��G �J/�
S l 0 � �] ''prAct-*� GA44.6'E
10 Applicant Name
Street Address \\CC •
11 Zlp
9e-
/ 22 /
Ity
State
IL" ""
Phone
( ) Y2,,,, !; '
Lender
Street Address 0
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
Additional Information
it
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ATTACHMENT "A"