2003, 03-13 Permit App: 03001604 Residence Project Number: 0300160.1 Inv: 1 Application Date: 3/13/2003 Page 1 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RESIDENCE W/GARAGE-NATURAL GAS Contact: LINDSEY CONSTRUCTION
Address: PO BOX 30792
C - S -Z: SPOKANE,WA 99223
Setbacks: Front 25 Left: 6 Right: 6 Rear: 50 Phone: (509)879-3420
Group Name:
Site Information: Project Name:
Plat Key: Name: \/Je -M "I n jt Te! t i .e District: D
Parcel Number: 35233.1401 Block: 14 ' Lot: 1112
SiteAddress: 4913 E 14TH AVE Owner: Name: LINDSEY CONSTRUCTION
SPOKANE,WA USA 00000 Address: PO BOX 30792
Location::SPO SPOKANE,WA 99223
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 54 Depth: 129 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: .
Review
r� Site Plan Review/ Released Released By: ^, _
��1.C�tL
,' t %S `'
Plan Review1,-----> ,..
.)
Released By: 1, ..._.
Il-en---1 — KIS t AS t (- - 60±,1(, 5
t
Special Inspections Released By: e (-- Z-1-01--) 3 13-02-
tto Nio u-n cys
Fi I 1 aiubilt ct.bu,/
( :
Special Reviews Released B� �7�
—
App : ■i ainage Released By:
,....
_.,2_2__FAiktia. . axilk._ _0/.4 I
Operator: CKF Printed By: CKF Print Date: 3/13/2003
'
Project Number: 03001604 Inv: 1 Application Date: 3/13/2003 Page 2 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Flood plain Released By:
N-1-1 Sewer Review Released By:
Stormwater Control Released By: .4.50
� —
5 Ct'ed Inspchjn or j 'nu r1- 1: arr-d cirri
R Lc i) drawls h ix &uhrniked Sto(mi,vc Cl>'�liii ✓ur 12)
A
Building Permit
Contractor: LINDSEY CONSTRUCTION INC Firm: LINDSEY CONSTRUCTION INC
Address: PO BOX 30792 Phone: (509)879-3420
SPOKANE,WA 99223
Building Characteristics
Const Category: New Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: ❑
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VN 1,060 $13,038.00 1,060 $13,038.00
COV DECK R-3 VN 240 $2,416.80 240 $2,416.80
GARAGE U-1 VN 480 $5,760.00 480 $5,760.00
RESIDENCE R-3 VN 1,120 $73,920.00 1,120 $73,920.00
Totals: 2,900 $95,134.80 2,900 $95,134.80
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $867.50
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $190.85
Permit Total Fees: $1,062.85
Operator: CKF Printed By: CKF Print Date: 3/13/2003
Project Number: 03001 604 Inv: 1 Application Date: 3/13/2003 Page 3 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Mechanical Permit
Contractor: R& R HEATING&AIR COND Firm: R& R HEATING &AIR COND IN
Address: 4019 E CENTRAL Phone: (509)484-1405
SPOKANE,WA 99207
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00
GAS PIPING 2 #OF UNITS $2.00
HEAT PUMP OR A/C 0-3 TONS 1 NUMBER OF $12.00
VENTILATING FANS 4 NUMBER OF $40.00
CLOTHES DRYER 1 NUMBER OF $10.00
HOOD -TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $96.00
Plumbing Permit
Contractor: DAVIS BROTHERS PLUMBING Firm: DAVIS BROTHERS PLUMBING IN
Address: P 0 BOX 931 Phone: (509)927-4186
VERADALE,WA 99037
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 3 NUMBER OF $18.00
SINKS 4 NUMBER OF $24.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
FLOOR DRAINS 1 NUMBER OF $6.00
WATER USING DEVICES 3 NUMBER OF $18.00
Permit Total Fees: $102.00
Operator: CKF Printed By: CKF Print Date: 3/13/2003
Project Number: 03001604 Inv: 1 Application Date: 3/13/2003 Page 4 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
CONTROL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS
Lots on the north side of 14th in the 4800 and 4900 block have fill. Soils investigation/foundation
engineering done by Strata(see plat file)requires: (1)footings=min. 24 inches wide(2)foundations
no closer than 12 ft from north edge of fill
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $1,062.85 $1,062.85 $0.00 $1,062.85
Mechanical Permit $96.00 $96.00 $0.00 $96.00
Plumbing Permit $102.00 $102.00 $0.00 $102.00
$1,260.85 $1,260.85 $0.00 $1,260.85
Disclaimer:
Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and finds the information
contained within to be true and correct,and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for,or an approval of,any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: CKF Printed By: CKF Print Date: 3/13/2003
�, -jnv
l PROJECT APPLICATION WORK SHEET '
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFOR*,�}\f>
1026 WEST BROADWAY AVENUE i. i t `;.,
/16,
VIII . SPOKANE,WA 99260 `
509-477-3675 (/
09-477-36754�v�
SPOKE COUNTY
SPECIFIC SITE INFORMATION
Street Address: �1 13 e- / v�' ,
Assessor's Tax Parcel Number(s): i ) 'l 3 `) ' / 1- j1
Legal Description.
G
2-
Ick 1/ 4-ie_ %I k ; arc/Qrzd 7 race & lit
Project Description: 6s0STg-vc-T 5 106/.1, Ffi-m 1l:Y s 1 12Enc�
*Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign ❑ Tenant(New/Change) ❑ Other
Department Use Only
Water District/Purveyor. Sewer District/Purveyor ' Road width Setbacks
Front)) Rear:
School District: Fire District: Zoning `
Left: Right:
OWNER/APPLICANT INFORMATION
y� ❑ Indhule who should be conlarled n'urdin'Ihisjonyerl S761--- ‘100
❑ (hirer �i'`v S& 6//��/7 )- Phunc' ❑ Applicant:( (/��//t (��//y /Phone:
'.'STnll JON, L l•as: 1-I rel S `�6'gSI�fVC�I f d�/t a.: q y —lb f
Mailing.\Jdrr�.s: $�., �;..-r,2 Mailing Address:__ 111(11
N� . •;v,A Box 3e)79 Z
(:.r,,stmt.,/.ip City,State,Zip 9
Spe 1cane 1. a c1
Phone
Phnnc71 tuniractn ❑ Architect
2ae Pas I as
Maiing address Mailing address
(.itr,>iate tip City,State Zip
\\ \Slate Contractor license P Contact name:
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main Floor sq.ft. Unfinished basement sq.ft.
/2, 1 // 2-0 / 66
I)nnemams Total habitable 2'd floor sq.ft. Finished basement sq. ft.
()ccupancc group Construction type Garage sq.ft. Deck sq. ft.
(.,,t „i protect I Isar source(electric,gas,etc.)
q
Manufactured Home Sign
Width: Length: What is the square footage of the sign I low high is the sign?
face?
Year Make: #of signs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler Tent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
ISrm Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete O Welding O Bolting 0 Reinforcement Address
DITIONAL SITE INFORMATION
\rc there structures on the property? 0 YesNo What is the current property size? 6 `7^I(04
If yes,identify on site plan (square feet or acres)
Is any part of the property within 250 feet of a shorcli ? What is the current use of this property?
1/yes,identity on site p/an 0 Yes No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes ( No
0 Don't know 0 Yes ,J'No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
I/yet,idenli('on site plan Ifyes,ident61 on the site plan 0 Yes 116No
0 MaybeN6on't know 0 Yes f�J No
\re there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the r perm?
I/yes,identify on site plan 0 Yes 0 No Yes 0 No
Are there slopes greater than 30°'0 on the property?(30 ft rise in 100 ft) Arc critical or hazardous materials used or stored on site?
( °0) 0 Yes No 0 Yes `K No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? 0 Yes 0 No
OYes ONo
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
O Yes 0 No
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area?
O Yes O No
1).rti tece,eJ. Staff Representative:
METHOD OF PAYMENT
1�I�®V�': SUBTOTAL
VISA
❑ C vSII ❑ (:I II:CK 0 ❑ -� 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
I)\I l:: I(SI'IRNS: TOTAL FEE
h VNK;(._AI(D Nle\lhI](: MINIMUM PERMIT FEE IS$35.o0PI.I:A5I
MAKE CI LICKS PA%met:"FU SPOK.\NE
Vl I'I IOIZI%I:I)slGN VI FEE: couNTy PERMIT CENTER
I /3 ,6. /4/&
€, 3„�,g,53. No/
After recording,mail original to Owner: 4568873
Monogram Homes y P10NFFA. MIP�h1PANY N 03/23/2001 O11�09A
PO Box 602 4R m Snnkana en WA
Post Falls, ID 83877
-:TITLE NOTICE
Description of property:
--
Legal description:A11 1 ots i n Woodland Terrace according to the plat filed r in
Vol I of plats, page 16 in Spokane County, Washington
Parcel number(s);35o?33—•-7?/pJ Address ofro e
P P rly:
I hereby certify that I am the OWNER of the above-described property.
following notice be placed on the Title of the above-describedproperty,�' As owner, I herebyerequest that the
land: and that said notice shall run with the
(1) This property is located in a potential high-groundwater area,and
(2) Measures have been taken to prevent water from entering this basement. Copies of said easures
have been provided for Spokane County Public Works Department file number
ermit Center file )
I hereby execute a release of liability running to Spokane County in conjunction with its(
issuance of a buiildng
permit on the property, to include a basement, as designed under Section 5.1)3 (a) and (b) of the Stormwater
Control Ordinance. This release of liability shall constitute a covenant running with the land, and shall bind my
heirs, assigns, and successors ip i e
Property Owner Name r eg- F . P'�
Co-0Owner Name
(Pleas- P.: t
Property Owner's Signature �_ �..,« - L L . Co-Owner's Signature a Pnnt)
NotaryPublic: . . /Date
3/zZ/o/ Date
is
IctI certify t ilkilbW pq ve satisfactory evidence thateb iroIda
N(O(�{-
y. •��i ned this instrument and acknowged it to be(his/her)hfree e end voluntarson who ry act before ses a and said person
`% S purposes
tee&
= • •� Signature �, ! C: A1j,
Title
a6ea1 er Stand �, : .: N • �' u ter.{ ' q
S ;• eUO•� .4444 My appointment expires ►�j I /t �
g::nf•�' pokane
I cei-CI�J � vi�►�satisfactory evidence that
acknow Efd[)i�pt� he)signed this instrument and acknowled a is the person who appeared before me
mentioned in the instrument. 9 d itto be(his/her)free and voluntary act for the uses and puarpoid es person
Dated: Signature
(Seal or Stamp) Title
My appointment expires
Page 1 of 1
i
SPECIAL AG EEI IEfS ` ,
I
FOR BASEMENT INSPECTION
Project Address gni( 3 C_; /Lid- A-uS T R
Property Owner 1` %' �X
ulldin. Permit Pro ec>t,Number
= . . a _ur. � _ � 3a. � �® d 1 �O O
e pirp•Se o - • 1. 'i •- • s e '-
,
-, constructed in substantial conformance with accepted plans, and that the measures wi • <<
function as intended
Pursuant to Resolutions 0-0610 and 0-0558, as amended, the owners'engineer 0.,
architect has submitted design measures that prevent the entry of surface and/o
subsurface waters (into a below grade basement, useable or habitable space). The
above-referenced project requires special inspection of those design measures, as
described below:
{Insert a brief description of the design and/or measures that will be utilized to prevent the entry
of water, i.e. construction technique, specified materials, etc., or attach a copy of the
5 geotechnical investigation and design measures. Describe when these measures are to be
implemented in the building process.)
PART 1 - PROPERTY OWNER
REQUIREMENTS
1. Prior to construction of basement(s), the owner agrees to employ an arch!'- • - =x
engineer, currently licensed in the State of Washington, for the purpose of being a
special inspector of the construction activities for the design measures accepted fof
'or coorsina'ion purposes, t e owners a--prove e�contractor and specie,
inspector with names and phone numbers for all parties involved in the basemen
•
inspection process
3. The owner shall aid the special inspector by being present on the site when
required. The owner shall also aid the special inspector in submitting final re•• .
}
testing data, and record drawin•s to.the S•oka Cou •• •a. -t-r,
4. The owner shall help to facilita -. i- -d • - • • - _ _ _
measures.
5. The owner shall read{and understand the contractor and special inspector's portion,
of th' a•r-ei t
.r . ,...
or a certificate of occupancy (commercial) until deficient aspects of the constructio"
are corrected and the Stormwater Utility accepts the as-built record drawings
I
7. Prior to the issuance of a certificate of occupancy (commercial) or final inspection
11 (residential), the owner/applicant shall ensure that the special inspectors'inspe.L .•
reports, lab reports, and as-built record drawin•s have been submitted to th '
Stormwater Utility
OWNER: LIOds6t,t S
ADDRESS: & d?'(?`"( /�/l f/-/iiti t__ �(
PHONE NUMBER: DATE:
BY: BY: 4/..14P1/4
(Print Name) (Authorized §ig nature)
Please retain a copy for your records.
Original signatures are required to be on file
with Spokane County Stormwater Utility.
PART 2 - CONTRACTOR (BUILDER) REQUIREMENTS
•
1. The contractor shall provide the special inspector reasonable notice prior to
performing any construction activity that will require inspection by the special
inspector.
2. Activities that will require inspection include, but will not be limited to:
a) Inspection during excavation and construction of the foundation;
b) Placement of any waterproofing application;
c) Sub-surface drainage system (e.g. French Drains);
d) Placement of fill for drainage areas;
e) Finish grading, installation of sodding, seeding, landscaping, and
irrigation systems;
f) Other items, as listed under Part 3. special inspector requirements or in
"Exhibit A."
3. The contractor is responsible for reviewing the approved plans for additional
activities that require inspection by the special inspector.
4. The contractor shall correct any deficiencies in the work, as noted by the special
inspector, in a timely fashion.
5. The contractor shall immediately notify the owner, the special inspector and the
Stormwater Utility about any unexpected site conditions. Unexpected site
conditions are those that would prevent construction of the improvements as
designed, or which would adversely affect performance of the design measures.
(Spokane County Stormwater Utility can be reached at 477-3604.)
6. The contractor shall read and understand all requirements of the Special
Agreement for Basement Inspection.
CONTRACTOR: A\-40 5 5 nu �' l (---
ADDRESS: SI I --STP2-6-2- 42-0114-4-( f w6` 9
PHONE NUMBER: ,b� -3 D2_7 DATE: ala '/D
BY: /Yia:V 6. ..._WL) BY:
(Print Name) (Authorized ignature)
Please retain a copy for your records.
Original signatures are required to be on file
with Spokane County Stormwater Utility.
Xf 3 E. / '
3
PART 3 - SPECIAL INSPECTOR REQUIREMENTS
e specia inspe ors'a -9e orm •n si a mspe ons an• qua i con •
services to verify that construction meets the design criteria specified to p- i-
the entry of surface and/or subsurface waters (into a below grade basement,
useable or habitable space). The special inspector shall also verify that the
construction is:
a) In accordance with applicable Spokane County Codes and regulation ',-
b) As intended in the design; and
c) As shown on the accepted plans.
2. The special inspector must be an architect or civil engineer, currently licensed i•
the State of Washington, or the architect or engineers'authorized agent s ''
I3. The special inspector is responsible for being present on the site when no e.
by the contractor that work will be performed requiring inspection.- `�
I1 4. The special inspector shall initial and date the Inspection Record Card each tim
that inspection work is pe • 1H .• + ; ,
5. The special inspector shall Use-t e accep e•"p ans, as-9e me.` revious ,'"o,
overseeing the construction of the drainage facilities
6. Examples of inspection duties include, but are not limited to
a)
b)
Inspection during excavation and construction of the foundation
Inspection of the placement of any waterproofing application; :.i
c) Inspection of any sub-surface drainage system (e.g. French Drain ,
d) Inspection of placement of fill for drainage areas,;:
e) Inspection during installation of •• It,.. •- y‘, •• ' 1 1 •
away from the area of concern
f) Inspectio . • !- ::! . .•.--. !_, l .„,II I , _.• '":. A - •,111;; 4.., •
concern;
g) Observation of the placement of sod, seed, landscaping, and irrigation
systems to verify that these items meet specifications, and that they d•f.
not interfere with or harm the design measures or intended .rotection of ;
the below-grade basement from water impacts;
h) Other items of concern as listed in Exhibit'A', which is attached.
7. The special inspector shall immediately notify the owner, contractor, and i.:.
Spokane County Stormwater Utility if unexpected conditions are encountered
that would prevent the proper construction of the improve to -t •....t,.,.A•, I•`
a negatively affect the operation of the drainage facilities.
t
l 8. Any field modifications to the accepted plans must be submitted to the :-
engineer for approval prior to construction of the modifications.
4
, 141
9. The special inspector shall submit copies of all inspection reports to the Spokan-
County Stormwater Utility after inspections are performed. Copies shall be
stamped and signed by the special inspector and may be mailed or delivered tai
Spokane County Public Works,
Utilities Division/Stormwater Se •
1116 W Broadway (4th Floor)
Spokane, WA 99260-0430
10. Prior to the issuance of a certificate of occupancy (commercial) or final inspects.,
(residential), the owner/applicant shall ensure that the special inspectors'
inspection reports, lab reports, and as-built record drawings (site plan and cross ..
section) have been submitted to the Stormwater Utility. The record drawings
shall be stamped and signed by the special inspector, with the following
statement placed adjacent or near the professionals stamp:
I of inspected the basemen
useable or habitable space, during its construction and find that the,:
construction conforms to the submitted design measures to preve .a
the entry of surface and/or subsurface waters. I further find tha
groundwater drains, if used, do not discharge to public road or rig'
of-way, to sanitary sewer, or to surrounding properties..,;
I swear under penalty of perjury that the above statement is tru
Signature
e p=cla I spe o s a rea. an. f. n• a'-requtremen o e •ecla
Agreement for Basement Inspectio x'
SPECIAL INSPECTION FIRM: CA.Jm m f 5Ne_ote_atod0--"Clin4.1--1v)
ADDRESS: -2- 1 61 (I tom- _ . !, 7 a
IPHONE NUMBER:LSA / ''k.Io > 4- 3CD DATE: 3 &// J °
SPECIAL INSPECTOR: _��-G( "vi vv
ISPECIAL INSPECTOR: • r
(Authorized Signature) -�
STATE OF WA. PROFESSIONAL ENGINEERS OR ARCHITECTS LICENSE NO. Oa?7I2
Please retain a copy for your records.
Original signatures are required to be on file
iith..S'okane Coun. rro -ter. tilh
... - --- -,---"- ..c1, UL VL 1D•U( r ...
'4719/3 L . /V-
35253 • /40/
Revised Fl ! ur• 2
•
Option 1 Option 2
Final Ground Surface
Sloping Away From Wall
7......cjZr....c........r. ft461111,
.4_,.._______--------Water-resistant,k,
Filter Coating .
0
Fabric, 461 a
0
o a
o Synthetic
Drainage Mat
o
Clean
0 0
► Drainage_ d
Gravel o
o Sand
1 o a Backfill .
Sand t. o
Backfill i o o -
o Overlap
•
o Fabric r
a Layer "
i \c 0 0 -
0
ipiv- ______
J
Minimum 4 inch Diameter -
Perforated PVC Pipe 14th.Ave. E. Lots(N. Side),Woodland Terrace
Subdivision,Spokane,Washington
WALL DRAINAGE DETAIL
Project No.00-117 November.2002
CUMMINGS GEOTECHNOLOGY
Not to Scale 3304 E. 16th Ave.,Spokane,Washington 99223
Phone 509-466-4350 Fax 509-466-4190
E-mail:grcummings@earthlinknet
ADDRESSq , / ' This site plan is being submitted for the purpose of
,1
ZONE_ (mak i • obtaining a building permit and is a true and correct
representation of the proposal.All known property
ROAD 'WIDTH lines/dimensions,curb lines,structures and easements
FR NT__._FLANKING
KING have been identified.Also indicated are wetlands,
COMMENTS bodies of w ter,steep slopes or other criticAl areas.
REQ' EWER ::`a" e,1 "'
Signed: 1-144-1-4- -f (e7 '4.',
i
Date: _ . --
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