HomeMy WebLinkAbout1989, 04-11 Permit App: 89000817 AdditionSPOKANE 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
OWNER OR AGENT
APPLICATION
DATE
ADDRESS= E:_
BUILDING j.. k ::'•.t_,. FRONT= 50. LEFT= E : •r RIGHT= 11 REAR= ...
jfi{:i i # * # i * i * !#is#** :jy*:: r.i. YINFORMATION
. r O A_?_****1******************** .iF:
DATE
DEPARTMENT Ni••1M::. REVIEW COMMENTS !,:: i.t ? INITIALS
BUILDING
!:,!!' is -.
! f:
ENVIRONMENTAL HEALTH .t. .'_: !'': L:. 1"! r.i L':. �..+..i``'. �� LOT c.: '..i �'. :.... . i"! S.f i::.
INo
_. _CoJ ....... .....Cbti...
.10(0)..t1
P
8904.1
1.1.1..l:.t . ✓ 14
4.-
yf ILII /041 -
****************.**************
lam
:Et' :El• iC'S?: ii: :.r..j:: jt• * i!: :.}!.• #: :ii.: r.:g::;;:.if.:d.::i.:: S -::=r. B i .
.. ,..: (. ;!?; :?r• ;k!; %i ai ;Fi ?:? .. �: t.l .i. i ...... ...:...: `}::` t.... '. t`�i ?. ****************:****:k
CONTRACTOR= 1::::'•. ± i A.4 .. :. t.., ..r...: E... R ( 3 t r, �, {,
i' r
STREET= 317 N FARR RD
ADDRESS= f..l;.•'ANr" WA 99206
PHONE,: 'S.09 726 7727
NEW= REMODEL= ; ADDITION=
DWELL UNITE= t ;..
t .
CHANGE
RFQ PARKING=
'i?' ? ! 3^E ° :_r .L C.r ! .. SEWER= :..`: HYDRANT=
PROCESSED 'BY: STEVE. HOLYK
PRINTED Y• STEVE !iOI._•FlI'
.,t....: a::': rk• #.' ;k #: ''-+: iii :iE! i$• #i #i •i?: '!$ ;r:.Jr. * 7¢ •tii :i?: iiii i'r: •iii iiii : }:*...;. x. "J - : r.:!!: �E::;?: s::�r. a...-;{.::-:: a .•c +: ::
.}:
THANK .. .: ! :. .{ :i :}} ;}!, :: .:!: :ii, .u: :L. gip..; ..iY •i•
PARCEL NUMBER:
INFORMATION WORKSHEET
5-41? 1� �
STREET ADDRESS:
�J�
CITY/STATE/ZIP: i i �j , /()=
SUBDIVISION: 9t ----
BLOCK: LOT: Z2 ZONE : DISTRICT:
LOT AREA: F/A: T WIDTH: % 5 DEPTH: / R/W:
# OF BUILDINGS:
OWNER:
# OF DWELLINGS: WATER DISTRICT:
PHONE:
MAILING ADDRESS:
CITY/STATE/ZIP: 'a'?.i .
CONTACT:
141v /1/1C> lt-!27'NOE/2-
41110
PHONE : 9,(.0- 73
SETBACKS: - FRONT: .50 LEFT: jz)Q S RIGHT: /I REAR: EX? 5
PERMIT USE: 4f; d2~" a, R kw cscs) S
****************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: 614-M6
CONTRACTOR; .-� �� C-„,,C(i
MAILING ADDRESS:
PHONE: 9 79 aC 7
ARCHITECT/ENGINEER:
MAILING ADDRESS: V 3/ % d,(A)
NEW:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT:/2'
BUILDING DIMENSIONS: � X 2-4/C (WIDTH X DEPTH) SQ. FT.:
REMODEL:
PHONE:
ADDITION: V CHANGE OF USE:
STORIES: 1
REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT:N
}
F
PLUMBING'INFORMATION
CONTRACTOR LIC#:
CONTRACTOR:
MAILING ADDRESS:
***************************************************************************
MECHANICAL INFORMATION
CONTRACTOR LIC#:
CONTRACTOR:
MAILING ADDRESS:
ELECTRIC: GAB: OIL:
ENERGY CODE: WSEC:
CCAL: WOOD:
UTILITY:
NWEC:
APPROACH: PRESCRIPTIVE:
SOLAR: HEAT PUMP
SGC:
POINT: COMPONENT: SYSTEMS:
**************************************************************************
MECHANICAL FEES PLUMBING 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
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER 1-10000 CFM
AIR HANDLER 10000 CFM
NUMBER OF_
YES OR NO
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
SEWAGE SYSTEM VERIFICATION
The Spokane County Health District's Environmental Health Division
your project to insure compliance with the regulations for on-site
The sizing and workability of the sewage disposal
The Enviornmental Health Division office does not
showing where your system is located and the size
please fill out the following information.
PROJECT ADDRESS: (IF NO STREET ADDRESS IS AVAILABLE, GIVE THE PARCEL NUMBER,
ROAD, OR LEGAL DESCRIPTION, INCLUDING LOT AND BLOCK AND SUBDIVISION.)
will review
sewage
systems.
system will also be reviewed.
have any information on file
of the system, therefore,
NAME OF OWNER OF PROPERTY:
ADDRESS:
PHONE:
NAME OF TENANT/LEASEE/OCCUPANT (IF APPLICABLE): ADDRESS:
PHONE
EXISTING USE OF PROPERTY: (,RESIDENTIAL ❑ MULTI -FAMILY ❑ COMMERCIAL ❑OTHER
IF COMMERCIAL, WHAT IS THE NAME OF THE BUSINESS:
IF COMMERCIAL, APPROXIMATE METERED WATER CONSUMPTION PER DAY GALLONS
TYPE OF WASTEWATER FIXTURES CONNECTED TO SEWAGE SYSTEM (INDICATE NUMBER OF EACH):
/ TOILETS LAUNDRY SPRINKLER SYSTEM
SHOWERS CARWASH HOT TUB/WHIRLPOOL/JACUZZI
eR SINKS DISHWASHER SWIMMING POOL
AGE OF HOUSE/STRUCTURE /� r/(C AGE OF SYSTEM .25 ,F'S
TYPE OF WASTEWATER DISPOSALSYSTEM(S) SERVING THIS PROPERTY: (SEPTIC TANK, DRAIN -
FIELD, LEACHBED, CESSPOOL, DRY WELL, ETC.)
NUMBER OF BEDROOMS (IF RESIDENTIAL)
Se_ p7' n/r/E-
MULTI -FAMILY (DESCRIBE)
HAS EXISTING WASTEWATER SYSTEM BEEN RECONSTRUCTED OR REPAIRED?
❑ YES 5 -NO
WHEN REASON
HAS SEPTIC TANK BEEN PUMPED? R YES ❑ NO IF YES,
��WHENppr=REASON
LOCATION OF THE SYSTEM: (PLEASE MAKE A DRAWING SHOWINGGLOT, ATRUCTURES, TANK,
DRAINFIELD, DRY WELLS/OTHER, WELLS, WATERLINES, AND THE LOCATION/DIMENSIONS OF
EACH. INCLUDE DIRECTION NORTH AND ANY DRIVEWAYS OR PARKING AREAS. ATTACH THE
DRAWING TO THIS INFORMATION SHEET AND MAIL OR BRING TO ENVIRONMENTAL HEALTH,
WEST 1101 COLLEGE, SPOKANE, WASHINGTON 99201-2095. PHONE #(509) 456-6040.)
Rd ? 71//
THIS INFORMATION IS PROVIDED TO THE BEST OF MY KNOWLEDGE.
SIGNED
DATE �`' - f / - fy
1
/g F F cm goose_
j
V)
72t I LiL y