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1993, 08-17 Permit App: 93007124 Residence qavyt,:6 16.$6 -� PROJECT NUMBER= 93007124 APPLICATI NDATE= 08/17/93 PAGE= 01 ****** THIS IS NOT A PERMIT ** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 14112 E WABASH AVE PARCEL#= 46353. 0716PTN ADDRESS= SPOKANE WA 99206 PERMIT USE= RESIDENCE W/GARAGE - GAS PLAT#= 005335 PLAT NAME= PACE 1ST ADD BLOCK= 3 LOT= 3 ZONE= UR 3.5 DIST#= H AREA= 00000000 F/A= F WIDTH= 80 DEPTH= 193 R/W= 50 # OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = TRENTWOOD OWNER= HOMESTEAD CONSTRUCTION PHONE= 509 926 0755 STREET= 312 S FARR RD ADDRESS= SPOKANE WA 99206 CONTACT NAME= CHRIS SWANSON PHONE NUMBER= 509 926 0755 BUILDING SETBACKS: FRONT= 30 LEFT= 7 RIGHT= 8 REAR= 133 ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT ' BUILDING PLAN REVIEW REQUIRED 1) L3 ^ Lam ` COMMENTS: BUILDING SETBACK REVIEW REQUIRED COMMENTS: ENGINEERAPPROACH/FLOOD PLAIN/DRAINAGE ,G'f' '. �'yJr COMMENTS: cci r., 44. _,�", HEALTHDIST NEW OR ADDITIONAL WASTE WATER COMMENTS: ******************************* BUILDING PERMIT ******************************* CONTRACTOR= HOMESTEAD CONSTRUCTION PHONE= 509 926 0755 STREET= 312 S FARR RD ADDRESS= SPOKANE WA 99206 NEW= X REMODEL= ADDITION= CHANGE OF USE= DWELL UNITS= 1 OCCUP. LD= BLDG HGT= 8 STORIES= 1 BLDG W X D = X SQ FT= 1992 SPRINKLER= N REQ PARKING= #HANDICAP= CRITICAL MAT= N PROJECT NUMBER= 93007124 APPLICATION DATE= 08/17/93 PAGE= 02 ******************************* MECHANICAL PERMIT ***************************** CONTRACTOR= MARTIN SHEET METAL INC PHONE= 509 924 8088 STREET= 3808 N SULLIVAN RD 103 ADDRESS= SPOKANE WA 99216 ***************************** PLUMBING PERMIT ****************************** CONTRACTOR= GOLD SEAL MECHANICAL INC PHONE= 509 535 5944 STREET= 5524 E BOONE AVE ADDRESS= SPOKANE WA 99212 PROCESSED BY: JULIE SHATTO PRINTED BY: JULIE SHATTO ******************************** THANK YOU ************************************ _...._ V"Ai:,?:'5; IN, : ,,;ri;, .: • , 'I t' :: tw;:vii',,,:rog kir \-• 474Z1 .., • : yx•-.4:m.gli4lko. ,,t, .• I:• ::41.,i4;i:Z1414:" 6,7:t?. ,.::;' Spokane County • i .; 1.149:Mt. ,tr jaal,n,': ' 1 4 Ilift*tik,,Vi;af k,• .1• •!id ' • DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 4'fr4'4*v 4 i INFORMATION WORKSHEET . , PCEL NUMBER: yitzfircer;144•7:!•-•• ' • 4 1„4•470:11,e ' :il•-;:::::' AR IA*t d v.-4••••‘•....%• • •I . , ,,,..,ihirtie. V•Vc:, c.... ' 'co„Re.e.clit t,), STREET ADDRESS: \ , VN\\,-)_ \,...) .:?.., ...., ;I ,F4en, ITY/STATE/ZIP. r-p.,\JN.c.c.--L 1 s .1.,_13111r'. 4:> ,, •, •‘, . •• 1 lie'''IZ,i;Z° ' SUBDIVISION: 1 .1 :.. 04,%..,, • ;,‘,. it-, , • is. „.'t,• 1„e ...,;. % .,•:'!•:!•••'„ ' ... 1 l' &or-4'; •' ' BLOCK: i. LOT: ZONE: DISTRICT: :•*; t.I.t- fkit_ot;,:',.... to, • ' LOT AREA: F/A: w I 111.It: ' (Th DEPTH: \?\,... R/W: I A'.., ....'4-..1.j.' ' '• k`• '''') ,'s, . , . . _ 1 pi''' `i•i'c'4,,,--.,, •,'••: t l. - ' -,-• yA,vi,:•,: OF BUILDINGS: # Or DWELLINGS \ WATER DISTRICT: \c - OWNER; ''4 tili'14:,:v:':' ,,:,•:• 1, ''' ,i; .1/4,:'-, • '.' 1 ,,Or ••••••4"...;::, OWNER: - , PHONE: -__---- t , ; ,.,044,.-.m i .•'VI e'.. -":. '. MAILING ADDRESS: S _ ` \•-•%.., Sc:).,.,c. %.... „, .. _ ' '4,1"- , ' • CITY/STATE/ZIP: ,_. c.?‘ •\),„ .c.. ,,.._,, \ $Q„ ' 0\‘'`‘:•"•\• '1..1/4. ,)*ilit,.77:‘ -:,:::',•. . _ .cONTACT: ,.: ..4-..(z=*c--,...,. c. PHONE: - - ' Atli 4 .4'4• ';:•iib'•••• SETBACKS: - FRONT: Th-4Th LEFT: -` RIGHT: REAR: V', ,•:&*••5/..71,'" ' ,,,,..s , pERmtT USE: P Ot1.4 Vg:i'e' .4:;4•:. ‘. i• 0,......4,,,‘.. ••• • BUILDING INFORMATION e ',...,t'ir:i•..i - ' vZiP.:':•"..:'4,.. • • ee, _.. CONTRACTOR LICENSE NUMBER: N-•••&_ )\-N--\ ,.. ,_„.. S__Cs e"t\ \c„, C.." 3rt,!., . '. . • i ej;/,' ' • ' . CONTRACTOR: PHONE: ___-- - - It -:r,..s.:: • :,,,,i'.1•,*Is4dit 6,„,,•, .. MAILING ADDRESS. ''• 'IV4.&:;0 '!":: :;...,•„:,..V.,..7),,'••1--..;•".*:::;:: ,:1•,;-,z,f,F,::,,-..!, .„ .' • ARCHITECT/ENGINEER: PHONE: - - •te.:::,N::-.: * '7,,, ;-•-• MAILING ADDRESS , v., .....,:,,,...,,,• . h 1 NEW.I____ UD :RLMODLL: AJ TiONCHANGE OF USE: _ DWELL UNITS._____ OCCUPANT LOAD: .- -.-- -. BUILDING HGT: STORIES: i •.`k,ciiv'''''• : _ ____ ' , BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. PT. : sg; —____ REQUIRED PARKING: # HANDICAP: SPRINKLERED: 1.4•.,,.,, -_, --- CRITICAL MATERIAL 0: "• - . . •°:•••••••••••• •:.....:.*. '.:.,..-‘• •" ' - .•-•.,;•.4.!•-.A.2:1-.'•:',4-;,:•'1••• ,,,•,,,.•.,• • -•:::44.,,.'...z.v:.•ei,: '''. •'' . :11.,1o.43,,...,.%•;•,.,41,•;4;,'••-,••' '' . , . .• • .• . PleaseprOvIde the following information for Energy Code compile I I G 0: • '',%; ...,*;..1' ' i•14j;.ife.t.iii. ,V,‘ • f'. • 11,1;:k......''' • ... —.i. • '' '"i "% ..".. :,.7,. • : : . * .•.,:. 44,**.'11'• ',A • 0 .., type(check one) . . . '%•trA • 'f ,•trid :electric 114, EloctrIc basoboard or wall mount Propano ..;•.--.5.;,;!;),, '..,e :•„,<‘,t ,,•„„FA.•, ,••irt, e .N.4 .... .0 thor: ,. . •r••-, • ,gits „i% float pump . ' •I''• :.:. •,,, • .••• , . ^; ,. ...4o•••• , - , 4e..At'4`..itzik,'-':1.:,, .•,:.''..•.* t•,:i••„ . ., ,,,iriit#4,f !;;;‘,, • . t.. .eTA-(,,14660A r•;., . 0: *Slings R '1% Doors U___ _`"\ a, ted1011Ings R `1,, Windows ,.. •• - •yi,...r,,..:34S,...... ,...__•. $1 ,..4..,:.•10. R ••,,,,,,ITy•-..,, ..pstn ge.w is \cz,.. Glazing area -1.. )._ OA:\: - ,.,20;,,,. ..,,e......:141 •• . agf 4! C:•BO 9Vrade.Wane R, \I\ Total floor area ' it of heated space \c"\c'\->-- . . . . . . •••••:. •:;• ':•).'.. ltFq„04irt OlaliOnggrade-0 :•,..• -e,..,•,tt .4„. - FFurnace efficiency rating 9 ,(' - rniii;.•foi:,.-:1.....:;iq? . • -..••••• .•'...1•'.'re. ,,.!& , •,,..4)0.4.iviltyt.m . 11,4..e..,........:.•.: _. „ .1 ;;.::ese: ,•,,,..•:t 't.e.• ...‘ ''." ..,,•• .,•••,,,. •,,,g,t..!..,. .... PIciltSe cgottte on your plans: The location of the radon ventand the location of the vent fan area. . . , ,• • :.. , .• ' 4, . .., .::.,':1.;.'• "5Sy.',;.*•;, , • .. .•.. .....•• . t•' 1.1;1110drt• -.1(.%,i '4k; •• ',•f.,.''::. I tg:,:. , .. . ' .'••-,y•i'll,• - • ,1143 ::.; ..03:w.•••4,:fe.,..,,v,,tr.rr ,..••• ' • ' •,,,,,-,4 ,2/.,.,.," • .- I,- 't irt.,;.;•41:•- •i='4,.. .•••• ' :;,, ,1‘,!•,,,r;•.4',..,:te •• •„ ,,•44SegOnd flOdn. - ; t. •t ' , 0.:4:7k.,..,„fi.A.......,..,..,,,,,. ,,• : • ., • • • '....'., .. '7 Basement.7.Finished: . - • .:.;::.; .;;..?F:o .:,:.•;... '.•'•, ‘,.. .',*4{0,%.....A,.,4.,to•I'444,7•, ' .0:144‘..t,',,.:.'.. .!.. .-..,ri. •.. ;'.;.Unfinished: ' \ 117. .,)-;-r...,.44 ...i. • ':1411f,,3:7,0 , .,„ . • p.•.,..7.:_• • • ;:c':.'-1.: • .;;;I.,• . d . .•- •• • . arae: • .m.,::,,,. c'cl .. .:I,' ,', ...,-,:•.:4;,,.114-,•??', • . P, Wirt24;740',?-i;37.tov..r.,'• -- ,r:4';44P 0;..Carport; ' ' . •.,' cSixetik:•4••,....-•••-•—vt*.,-..r.: .. . or•- 44.:..i,,,...4,..,At,:....,::..k,).,•si, .. p.„ . .. 1' ..'Pee,k3.;a0 d•- ,• . tlittftt;)rteret'i',...''.. I P''• .. k Th ,,.....Additional'Areas:.:.1-.,tf. • e_f_N • • ,. • '• -'talaiOr-''•i-;it . , • ''- ''' ' . .). .4.....'!‘•:f,',:: •-- s ',',-:•?'::M'5L.1 ‘. ': , , '.,),0%:';'!•':' ',1'...'';'::.:,*-'141,`-:i!.. 'A•„..:*!:.,,,X.1:".:4•4•;•1•...••;,*140igliir.t4' .: • Ir;!.W:,',',:.'.'.'‘,'• .. ''..--,,-,':"^T,1-..' ,:•i'•••) •—_____._._ _. , • ctryg.re, . • . ) :' 4 • • ' 1 • ' •' •'••4••• PI'''..•r • :'1',./:; ' ' .e."• ‘.' , zt.57g,...??.s* . • I' '.',le 1,A•14'.dt.1—'.'' • •.,' '' • •t • '''4V11,*iiyi'k.it 1,:,•. . ... e;* , * * - ,;,.:'!.,.N: •. . • , • •*. ' i. ' '' ..1.1.,*.. .. . • c`'k :i;.... *•"?'..i .'. •.. * . . • • • ,''7”r'rt",? . . . .... .. . '4V. -0.1A-A-Ork-4-.1•A-kAlckirA•A A-A•A./.A.A/-A.A•A•A lekirA-A-kkol-irirkinfnificktirlairlridekirkiffkk.frift ,,i4.4'•••":,•'•.. • • -.;•.'-44-.•••••• • .• .. .. .,• , Ve:LENDER/LIOND HOLDER: __. 4!„.."0„„„„.,„„,„, „ _ — .• ..•'i!ADDRESS:;'',':!..4: ,,,, • ,..,• , , .,.•,'.7 p . . , .' • :,:! ! ..:..`.,-'.'-'.V..;"'•''' . •••.1%.,:i.:•t•. •••', K),:s.s.‘i i;•?:. fr&v,,';'.;4V••,:',.. . . _____.— Z••41:'dONTAcT:' ' ' aPs.•,,.. . . . PHONE: .. .,7f•t•I''''”' • . "V , " , . r.: :' ...7‘..iriVC ...., ,. , , , .,... ,r,.-,•.;7•V , '..::1,4.tarp.p, .i. , .•. , . • ,,, •, 1.7,7'!".LT, •, 'f...1 , , •:. e:;..",t`•:', ev.r`,:!-, . . . ,•. . ',: .'....:•.'":i!f,..ia "4,, • 't 'Wit.,•;',2-0)ii.t4'. ,4,;.,,...,., . tl, i • . : , •i , lifl4r,Vr:** \ ". MECHANICAL PERMIT APPLICATION PROJECT ADDRESS: \tl' \\� _ ,.1 S= C -s OWNER: IPHONE: MAILING ADDRESS: (street) (city/state) (Zip) CONTRACTOR: LICENSE: PHONE: MAILING ADDRESS: _ (street) (city/state) (zip) # MULTI- COST l DESCRIPTION OF WORK OF UNITS rumor- /UNIT Lsou za AMOUNT ..•.:FUEL BURNING APPLIANCE =or<lOo.oOo ‘ • $12 - s FUEL BURNING APPLIANCE >t00000 $15 - 1 ::UNLISTED FUEL BURNING APPLIANCE =or<400,000 $50 - '1305.UNLISTED FUEL BURNING APPLIANCE >400,000 $100 - USED APPLIANCE(Must meet WSEC's min.AFUE rating) =or<400,000 . $50 - ti Tie USED APPLIANCE(Must meet WSEC's min.AFUE rating) >400.000 . $100 - B08 BOILER/REFRIGERATION 1-1ooM BTU $12 - :BOILER/REFRIGERATION tot—SOOM BTU , , . $20 - BltT`BOILER/REFRIGERATION 501-1,000M BTU $25 - Bit BOILER/REFRIGERATION Lan—1.750M BTU —. s 3 - • B12 BOILER/REFRIGERATION +1.750M BTU $60 - 1313:::GAS LOG,GAS INSERT,AND/OR GAS FIREPLACE - $10 - B14>RANGE - . $10 - 8.15€DRYER - . $10 . Of FUEL BURNING WATER HEATER - \ . $10 - . 17 MISCELLANEOUS FUEL BURNING APPLIANCE - . $10 - r ' 1$`GAS PIPING(ea.outlet) - ` $1 - 119:'DUCT SYSTEMS - . $10 - $ B20 VENTILATING FANS - . $10 - r :B21'AIR HANDLER(DOES NOT include duct systems) =or<10,000 CFM . $12 - tiii,AIR HANDLER(DOES NOT include duct systems) >10,000 CFM . $15 - . 82;x':EVAPORATIVE COOLERS - . $10 - r iiik TYPE I HOOD - . $50 - : i2.5:::TYPE II HOOD - . $10 - ! S12 RA HEAT PUMP/AIR CONDITIONER o-S Tons i AIR CONDITIONER 6-15 TONS • $20 iii ``AIR CONDITIONER 16-3O TONS $25 - r LM:::AIR CONDITIONER 3t-50TONS . $35 - +. Baa:AIR CONDITIONER +So Torn $60 - 831`LPG STORAGE TANK - . $10 - i332>WOOD OR PELLET STOVE/INSERT - ` - $25 - Subtotal NOTE: MINIMUM PERMIT FEE IS$35.A0 PLUS: PROCESSING FEE $25.00 TOTAL PERMIT FEE DUE $ SIGNATURE: SPOKANE COUNTY DIVISION OF BUILDINGS WEST 1026 BROADWAY AVENUE•SPOKANE,WA 99260 • (509)456-3675 mMlct med$penn.hnd PLUMBING PERMIT APPLICATION PROJECT ADDRESS: \\\ ;_ \,.5 c�.je -t;, OWNER: PHONE: MAILING ADDRESS: (street) (city/state) (zip) CONTRACTOR: LICENSE: PHONE: MAILING ADDRESS: (street) (city/state) (zip) PLUMBING FIXTURES #OF Hum- COST DESCRIPTION I DETAIL. UNITS rumDKL' /UNIT mumu_AMOUNT BOA TOILETS WATER CLOSETS,BIDETS 1.., X $6 = $ 1303 URINALS - x $6 = $ _ 804 TUBS BATH,JACUZZI,SPA,GARDEN "').-- X $6 = $ B05 SHOWERS(per trap) BASE,STALL,ON—SITE BUILD x $6 = $ 806 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, X $6 = $ LAUNDRY,UTILITY,JANITOR,PHOTO, 3 X-RAY,FOOD(PREP/CULINARY/MEAD s tith.DISHWASHER - \ x $6 = $ B08 CLOTHES WASHER - \ x $6 = $ B09 GARBAGE DISPOSAL/GRINDER - x $6 = $ 1310 WATER SOFTENER - x $6 = $ B11 ELECTRIC HOT WATER TANKS (NOTE: if gas water tank see mechanical) X $6 = $ 414 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE x $6 = $ BI3 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $ B14 FOUNTAINS,DRINKING - x $6 = $ 815 WATER PIPING/DRAIN-WAKE-VENT INSTALLATION,ALTERATION OR REPAIR X $6 = $ B16SEWAGE EJECTORS GRINDER,SUMP PUMP x $6 = $ $1,,WATER USING DEVICES ICE AND/OR COFFEE MAKER, X $6 = $ HOSE BIB,STEAMER,PROOFER, CARBONATOR,SWAMP COOLERS B18 CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $ AND R.P.B.P.D.FOR:VATS,SUMPS, TANKS,BOILERS,&SPRINKLER SYSTEMS 1319 INTERCEPTORS GR EASE TRAP,SAND TRAP, X $6 = $ CHEMICAL HOLDING TANK B20 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN x $6 = $ 821 MISCELLANEOUS FDCTURES x $6 = $ Subtotal NOTE: MINIMUM PERMIT FEE IS $35.00 PLUS: PROCESSING FEE $25.00 TOTAL PERMIT FEE DUE $ SIGNATURE: SPOKANE COUNTY DIVISION OF BUILDINGS WEST 1026 BROADWAY AVENUE•SPOKANE,WA 99260•(509)456-3675 NIASTIR1PUJMPORMJMD `v- .4 . APPLICATION AND PERMIT FOR ON-SITE SEWAGE SYSTEM _ ENVIRONMENTAL HEALTH DIVISION SPOKANE COUNTY HEALTH DISTRICT rT \ � � � APPLICATION NO. C-i ---' /7 c7 --- �6 Ct,._ �, �.���; CENSUS TRACT WEST 1101 COLLf`GE AVENUE DATE OF APPLICATION h. 1") .-c-1-2'" _) "G1-2'" SPOKANE, WASHINGTON 99201-2095 (509)324-1560 INSPECTION RECORDING:324-1581__ SITE ADDRESS OR LEGAL DESCRIPTION OF PROPERLY: ' PROPERTY WITHIN: PSSA (OUT/INSIDE,A) L I^ ` ' ] GSSA (OUT/MI ASA) 1 L 1 i 2- L �(,, �1L;j \ LA V..l 3. L [] WWMA (OUTSIDE PSSA,ASA,GSSA) LEGAL OWNER OF-PROPERTY: ADDRESS: PRONE: /_[] OUTSIDE ALL OF ABOVE )- .i_, ,,r.4,11-Lv c., i 7 .:::-.3 . 17-(,. (r i- \C �l qv() (z,t INSIDE ASA ONLY (-4-, PROPOSED USE OF PROPERLY: []'SINGLE-FAMILY RESIDENCE - NUMBER OF BEDROOMS 7...- / TYPE OF S1RUCTURE: (] MOBILE HOME [] RANCHER ['(SPLIT ENTRY [] MULTI-LEVEL [] MULTI-FAMILY COMPLEX: NO. UNITS NO. BEDROOMS/UNIT - II COMMERCIAL/INDUSTRIAL (DESCRIBE): #EMPLOYEES/DAY: #SEATS/CHAIRS FOR CLIENTS/CUSTOMERS: IS THIS PROPERTY LOCATED WITHIN A COMMUNI1Y PUBLIC SEWER SERVICE AREA? [] YES [] NO IF YES. NAME OF DISTRICT/SYSTEM: IS ULID AGREEMENT REQUIRED? 1] YES f1 NO SEWAGE SYSTEM COMPONENTS: ,. PROPOSED SYSTEM BY APPLICANT: ' REPLACEMENT/FAILURE: []YES WO ALTERATION: (]YES 'ARO (i SEPTIC TANK(S) ' NO. _ / SIZE I(cI--) REASON: [] RELOCATE - CONFLICT [] OTHER PRETREATMENT FACILITY [] SATURATION/SOG [] CHANGE OF USE u• (SPECIFY) [] OTHER [] ADD-ON '41 DRAINFIELD [] LEACHBED [] BUILDING SEWER [] OTHER DISPOSAL; SPECIFY: WILL THIS RESULT IN AN INCREASED SEWAGE FLOW?A -[]NYESW SY[]NO NOi WHAT IS THE SOURCE OF WATER FOR THIS PROPERTY: PUBLIC/SHARED WATER SYSTEM; NAME: "i e,P..�--.I L_0'1L_�_\ PRIVATE: fl WELL f1 SPRING fl LAKE [12929 APPLIES [1 2929 DOES NOT APPLY PROPOSED PLO! PLAN IS 10 ACCOMPANY 1HIS APPLICATION, ALONG WIIH ANY OTHER PERTINENT INFORMTION, SUCH AS LEGAL DESCRIPIION OF PROPERTY. 1HIS APPLICATION AND PERMI1 APPROVAL IS CONTINGENT UPON MEETING REQUIREMENTS SET FORTH IN THE SPOKANE COUNTY HEALTH DISTRICT RULES AND REGULATIONS FOR ON-SITE SEWAGE SYSTEMS. APPROVAL IS BASED ON THE ACCURACY OF 1HE INFORMATIONISURPLIED,BY(1HE APPLICANT. IF YOU ARE DISSATISFIED WITH THE DECISION OF 1HE HEALTH DISTRICT, YOU MAY APPEAL TO THE HEALTH,,OEELCER WITHIN TEN [10) DAYS OF DENIAL OF THIS APPLICATION (SEE APPEAL PROCEDURE OUTLINED�N THE REGULATIONS). CONTACT PER ON: 1 PHONE(�S): c SIGNATURE OF OWNER OR ^�TH IAZ REP s,EN AT VE• " T'L 1`f`# � m ,Ca -�G r, c.- („ . 1 _53-)C -) (/ 41 A. "'f,C.1.,. ,G,k -- 1 JOD MAIL FERMI I A U CORRESPONDENCE 10: o .t1-,1,-y r..,0 _ I ? c.f � �C( J ?C cam_ .i i2U(_ --` INSPECTION LL- 2ATES FEE PAYMENTS: AMT. AID DATE REG. PAID BY TEST HOLE INSP `•' a-H'"`'( / APPLICATION /Li t} ��/ � e m4',1.(/' PARTIAL INSP.._.---- PERMIT '' -''"' r//"J ? ,Y371 FINAL INSP. REINSPECTION REINSPECTION PLAN REVIEW EXPOSURE RENEWAL 29.29 REVIEW SCHEDULE OF APPROVALS CRITICAL MATERIAL USER: []YES t]NO SEWAGE MAINTENANCE AGREEMENT REQUIRED? []YES (%]N0 SEG. DATE: /Se 100-FOOT SETBACK REQUIRED? f1YES F NO ASA/SCHD DENSITY REQUIREMENTS:f1YES f'INO '-✓J- EASEMENT REQUIRED? f1YES TO OTHER AGENCY (i.e., Utif ties,Planning,00H) APPROVAL/DATE TEST HOLE APPROVAL SIGNATURE ANLL DATE r4 L ' MINIMUM SYSTEM SPECIFICATIONS BY1DISTRICT FLOW RATE 4/0 GAL/DAY DOSAGE VOL. GAL/CYCLE DISPOSAL FACILITY: TREATMENT FACILITY: ) 44 DRAINFIELD S15E: FLOW RATE [SOIL LOADI G RATE ('*V (, SEPTIC TANK SIZE: / f.'1i) GALS. NO. / GALS./FT2 x f L,'" TRENCH WIDTH] = /7# LINEAL FT. ` ,, [] GREASE TRAP SIZE: GALS. NO. [] LEACHBED: FLOW RATE : SOIL LOADING RATE [] PUMP CHAMBER SIZE: GALS. NO. GALS./FT2 = SQ. FT. [] SAND FILTER BED: FLOW RATE : 1.2 GALS= FT2 (]ALTERNATIVE: ()MOUND []PRESS.DIST.SSAS []SAND FILTER [] HOLDING TANK: GALS. NO. []O1I;ER (SPECIFY): 11 BUILDING SEWER 110THER: SEE ALTERNATIVE SYSTEM SPECS. ATTACHED OTHER E.H. PROGRAM APPROVALy DATE: APPLICAiION APPR9VAL S , NATURE A D.DA-TF�; 4 / /)-',w>4 L&L-t . -/ r 3 DOU,NLE PLUMBING REQUESTED - DATE:!` 7',' 'i_`_: BUILDINGeGODE R LEj E DATE: INITIALS: e [a]REQUIRED fl RECOMMENDED fl N/AEE PLOT PLAN • / �/T ,� '.1( ' 4 fie REQUIREMENTS RCV'D ULID TO APPL. DAT 7c PERMIJ •ISSUED DATE: EXPLR S• IOTIALS: fl SEE PLOT PLAN ULID RCV'D DATE:-//` l •l C % %�^ - / ''— r'(/ / <y' , INSTALLER: (PHONE NUMBER) (INSTALLER SIGNATURE) FINAL INSPECTION SIGNATURE AND DATE: REMARKS AND APPROVAL CONDITIONS: (see reverse side also) SCHD-EHD-0532P(REVISED 5/92) FUTURE SEWER SERVICE AREA FORM: FOLLOWUP DALE: tom: _..: REGISTERED AS PROVIDED BY LAW AS A: .§0t CONSTCONT GENE FZAVL-. REGISTRATIONNUMBEF1 EXP1 .DA `' k H0 MESTEA0: =CCDNSTRtiCTO W IIjt. ' - : .. 31.2 S F:A R F? �: . E." SPOKANE WA 99205 - SIGNATURE �.-)'^c 1�...� QC a.> - �.Icc�cu+zccr\ ISSUED BY DEPARTMENT OF LABOR AND INDUSTRIES ,' ' .� w:> N N • \h/ N Q N.S. ' _ .h.\! I ---ft_._- ----_-C --- - N co Do--de, N.'. ._. ,,, 4 4 ,'Zo V" 'SW.1. SSM`T 1111 moo' %•/f1120 SE?'?, ra L\c 1 . IN ..—'s M r J —_ — — — ..- _ — M . . �,�F rls SC S �" % -30' s JG�ov wAsN,4,c'' . 0 N o16 : rJo DQ.i�EvJP-( SNAU►... ti� ,' ' x 1 '• iSE P L (a GES is C 20 SS - G. r LOS" 5w c,LE ESN 'T d. i it.11 : :r.. ..0 A\c,\\-,_ ..\-_-_,,,,..,,,...„... .... 1":. qt,,, ats15- & 11=30610111111111 • • ADDRESS: E E. r 7 / r4 gletizt4)--;"?r.--9 1'1 ZONE: .,._.: '1 r'4111 --------•._._.._ ROAD WIDTH: I L.p a .2:) v�`C. •� FRONT: 50 FLANKING:_________ =Y _._ k . I-: t\. tc1 • EUGENE F. FISHER, P.E. • Civil Engineering (509)927-0120 Al 9,177 u..,,nnv nnnd Otis Orchards.WA 99027