1989, 12-06 Permit App: 89005094 Blasting Foundation 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 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 N{ MBE {: 09005094 , # "
• '
:{ / PAGE=
-
APPLICATION
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SITE S # RL#::. ! :::: 1926 S ROCKY RIDGE DR ''ii#'i!..!"±_..n•=" 26543-1413
ADDRESS= SPOKANE WA 99212
PERMIT
EMIT t ; .= BLASTING •R FOUNDATION
NTaT. fNFROM
. RO M . . ar : . 9 Tn
12/15/89
rLATo- 001170 PLAT NAME= HEATHER PARK 1ST ADD
BLOCK= LOT= 13 ZONE= SFR DIET4= 1:7
±:• 1.± i F•I:::: : 68 DEPTH= 303 #:?,•'
.". .i:: DWELLINGS=
OWNER= SHOREWOOD HOME ' INC PHONE= ? ' 885
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STREET=E"i'= 1zy •)•",,:... J E 40TH
ADDRESS= REDMOND WA 90052
CONTACT NAME= MIKE SCHIMMELS GENERAL f Oi,'! 1.,: PHONE NUMBER= ':%?:i`} 926 78.38
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BUILDING SETBACKS : FRONT= NA LEFT=._ fir` RIGHT= Nf'•'! REAR= NA
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: 9 :: ! }i3iFIRE :f " : _ 7 "Mt, t { p } 1*i ii 13n i 1i' : n
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CONTRACTOR= GENERAL CONTRACTORS, INC PHONE= .>,. . 926 7838
STREET= 3722 N FLORA
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE E AM#:iUN #
EXPLOSIVES 20,00
PERMIT TYPE EF" AMOUNT T• !tl'O #fit! I PAID AMOUNT OWING
FIRE SAFETY{•Y F`?"! f 20.00 l ii 20 ,00
20, 00 ,00 20 , 00
PROCESSED BY : jULTE .,'.;HATTO
PRINTED BY : Jill._IF ;'i..#A_#...l.C:.
aaa :i {N . .}{ i :d.: aa .s :iiL ..r ;.. t. { 1i THANK
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I�rS
DEC 86 '89 10: 12 GENERAL CONTRACTORS 509 926 0104 P.1/2
GENERAL CONTRACTORS, INC.
N.3722 FLORA RD.
SPOKANE,WA 99216-1711
DIRECT DIAL FAX NO. (509) 926-0104
FACSIMILE TRANSMITTAL
DATE - G - ? ?
TO: SPoieictrio egew..A.)741 FAX NO. 47c`- -J/7'7-1
oz-.66
17 A): r
FROM:
eS
REF: /62.-ns.77,0r t7— -- ,111e
TOTAL NUMBER OF PAGES , INCLUDING COVER SHEET: - '
COMMENTS:_ C2L4ILF1 Ari .S r
2-40
IF YOU HAVE PR I BLEMS REGARDING THIS TRANSMITTAL,
CONTACT / 4 AT (509)-926-7838
DEC 86 '89 10: 12 GENERAL CONTRACTORS 509 926 0104 4 . . P.2/2
•
. r, D.partn►Mmt of Labor'sod Industries
USERS (BLASTER'S) LICENSE) f
'Fhlr aotJt[n t1,st
MARK A, J0HNS0N' _
• A N 570 „E« Street
Spokane WA 99205
_ ar«1,..xa
une , �?g90
• 'rw. "•1<1121e1"°Constru •
s~tion
JO—HN—$M_A15N 4 - -
•
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Dapartnient at tabor and induabiSs
; DIVISION OF INDUSTRIAL
SAFETY d; HEALTH
• USER'S (BLASTER'S) LICENSE
as prescribed_ (Possession,Use,and Handling of�
'Ives,70.74 n State Ezplosiva Act)and under the condi.
tic=stated,in the application.This license limit'the user to operations
' • •. listed on mine side. . : ..
.' Atw t or tar ` sty th.
• •
•
••((I• V .• WI . t Signature) •
This card with Identities ••. shell be shown on request to employer or
• !nekton of the Department or law enforcement Moan.•
• 1 1' difass.$ F447-001400 farar)QX A.73
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JAMES_GANG_SPO TEL : 15094553937 Dec 06 , 89 11 :48 No . 018 P .01
ISSUE DATE(MM/DD/YY)
Of . CERTIFICATE OF INSURAPCE _ -
PRODUCER THIS CERTIFICATE iS ISSUED AS A MATTER OF INFORMATION ONLY ANP CONFERS
ENO RIGHTS XTEND OR ALON THE CERTIFICATE HLDgR.THTER THE COVERAGE AFFORDED BY THE CERTIPOLIC PFICATE OLICIES NOTES AMEND,
FRED S. JAMES & CO OF WA.
P. 0. BOX 2151 COMPANIES AFFORDING COVERAGE
SPOKANE, WA. 99210
COMPANY A
LETTER Ata
509-455-3900
_ COMPANY s /��,.
INSURED - — — Aitnta 9 Ua 1 t u &
Qeneral Contractorsa Inc. COMPANY c
- N. 3722 Flora Rd. Aetna C .a
Spokane WA 99216 CETTER OMPANY D
- L
COMPANY E
LETTER
f-'COVERAGES
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING
ANY TIEACONDITION OF ANY CONTRACT OR OTHER RESPECT WHICH
BE SSUEOR MAYPERTAIREQUIREMENT,
, HENSURANCFFORDED BYHE POLCES DESCRIBDREN ISUBJECT TOALTHE TEMSEXCLUSIONS CERTIFICATE AND CONDI-
-
TIONS OF SUCH POLICIES.
LIABILITY LIMITS IN THOUSANDS
CO POLICY NUMBER POLICY EFFECTWE POLICY EXPIRATION EACH
TYPE OF INSURANCE DATE(MM/DDIYY) DATE NMIDOIW AGGREGATE
LTR OCCURRENCE
GENERAL LIABILITY 81C0163441 6/16/89 6/16/90 B°UAY $ $
MI COMPREHENSIVE FORM
PROPERTY
11 OF INSURANC
:�a EXPLOSION 3 COLLAPSE HAZARD XMONCXXXXMORNIKYLX
PRODUCTS/COMPLETED OPERATIONS BI a PD
COMBINED $ 500 $ 1000
X CONTRACTUAL
ECI INDEPENDENT CONTRACTORS
■ BROAD FORM PROPERTY DAMAGE PERSONAL INJURY $ 50 Q
® PERSONAL INJURY
- _____ . . .._
9 AUTOMOBILE LIABILITY 81FJ940169 6/16/89 6/16/90 ,wo
(PER PERSON $
X X ANY AUTO BDD1Lv
ALL OWNED AUTOS(PRIV PASS) 'NI PY
`
ln ALL OWNED AUTOS(PRIV pTHER PASS THAN (PER ACCIDENT( $
In HIRED AUTOS PROPERTY $
® NON-OWNED AUTOS DAMAGE
GARAGE LIABILITY BI&PD
COMBINED $ 500
C EXCESS LIABILITY 81 XS581629 6/16/89 6/16/90eI s PD ^�000 $ 3000
X X UMBRELLA FORM COMBINED
OTHER THAN UMBRELLA FORM
. STATUTORY [..
WORKER$' COMPENSATION (EACH ACCIDENT)
AND r $ (DISEASE-POLICY LIMIT)
EMPLOYERS LIABILITY $ (DISEASE EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPE:RATIONS(LOCATIONSNEHICLES(SP£CIAL ITEMS
AS RESPECTS : OPERATIONS PERFORMED BY THE NAMED INSURED.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
SPOKANE COUNTY PIRATO N DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 1 0 DAYS WRI N NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
BUILDING AND SAFETY LEFT,BUT FAILURE SUCH NOTICE SHALL IMPOSE NO 0 IGATION OR UABILITY
rt qnq T.7 RAf1AT1GTAY
OF ANY KIN UPO COMPANY, ITS AGEDI.TS OR REPR NTATIVES. '` - 4
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