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1988, 05-12 Permit App: 88001150 Residence! 11, IF ' SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY NORTH 811 JEFFERSON SPOKANE, WASHINGTON 99260 (509) 456-3675 1 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. 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INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS : CITY/STATE/ZIP: SUBDIVISION-�%�2 BLOCK: LOT: ZONE: SJT:7f,� DISTRICT: LOT AREA: F/A: WIDTH:G'V DEPTH: I!I' R/W: 150 # OF BUILDINGS: / # OF DWELLINGS: WATER DISTRICT: N\/ ---17A OWNER: • ,(/I X • J qe oflssa C PHONE: MAILING ADDRESS: CITY/STATE/ZIP: /,vor9c/ CONTACT: 41 <<, ' n p -;v PHONE: -.L ZZ - SETBACKS: - FRONT: ZJ LEFT: /6 RIGHT: '15U REAR:;?.) PERMIT USE: BUILDING INFORMATION CONTRACTOR LICENSE NUMBER:_ Lli -, 'a�PHONE: MAILING ADDRESS: ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE: - - NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS::_ OCCUPANT LOAD: BUILDING HGT: STORIES:/ BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT /,2e 7 REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT: 12,F-7 PT:- 118V 0,4P 518 u Ft3 *73 -e CONTRACTOR LIC#: • zmw MAILING ADDRESS: CONTRACTOR LIC#: CONTRACTOR: MAILING ADDRESS - ELECTRIC: GAS - ENERGY CODE-.- WSEC: PulMBING INFORMATION i MECHANICAL INFORMATION OIL: CCAL: WOOD: SOLAR: HEAT PUMP NWEC: UTILITY: SGC:_ APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: MECHANICAL FEES PLUMBING FEES ITEM DESCRIPTION NUMBER OF ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO PROCESSING FEE YES OR NO DUCTWORK SYSTEM TOILETS WOODSTOVE/INSERT SINKS GAS WATER HEATER SHOWERS GAS HTG EQUIP(100,000)BTU BATH TUBS / GAS HTG EQUIP +100,000 KITCHEN SINKS GAS PIPING - # OF UNITS DISHWASHERS / HEATPUMP 1-100 BTU GARBAGE DISPOSAL HEATPUMP 101-500 BTU CLOTHES WASHER / HEATPUMP 501-1000 BTU UTILITY SINKS HEATPUMP 1001-1750 BTU _ ELECTRIC WATER HEATERS HEATPUMP +1751 BTU FLOOR DRAINS REFRIG 1-100 BTU FLOOR SINKS REFRIG 101-500 BTU BAR SINKS REFRIG 501-100 BTU ROOF DRAINS REFRIG 101-1750 BTU LAWN SPRINKLER REFRIG +1750 BTU SEWAGE EJECTOR AIR CONDITIONER 0-3 HP WATER SOFTENER AIR CONDITIONER 3-15 HP URINAL AIR CONDITIONER 15-30 HP DRINKING FOUNTAIN 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 ria`6-1 -'88 X :29 ID:HEHLLT,H '=P0 MF,111 HhHL. I K r PU ;• i 7$ viol - E_. a'10' r T rips i J- 4011 lop - TEL N5:509-456-4716 I I tN + lot i .a .* ----MMPW,bM R W .Sit LiutLIIW ,� ��p'y A�G�V,y�co,rs Pu IL 16WLO%S nv I�+G+vw�atre"l DOUBLE FLIJMBI 0 Y USE 4" PVC PIPE! M D•3034 SDR35 � OR ASTM F789 A� off, REFERENCE CAPPED ENDS CLEANOUT Cp , i��✓ 'P�0 a l��iN �e r- �� w►e�'�t - --- INFORMATION WORKSHEET L y Yl9C PARCEL NUMBER: 6 u ©l,<- STREET ADDRESS: l Ll g 2 / l.! ,;-- CITY/STATE/ZIP: CITY/STATE/ZIP: ��f.� /� if f e'6111 7 SUBDIVISION: BLOCK: LOT:_ ZONE: DISTRICT: LOT AREA: F/A: WIDTli:10d __ DEPTH: /V0 R/W: n OF BUILDINGS: ( # OF DWELLINGS: ( WATER DISTRICT: OW11£R: a2 IAStf(' �/, � PHONE: : - 11?- -c 7 � MAIL114G ):DDRL-'SS: CITY/STAJ'1: /:. . : _ 'c�i�s�1:�1, ---- 1��'1 i C/ SETBACKS: - FRONT:tri PE'Ri'iI'l' USE: LEFT: /-t,' R i G:i'�: �) REAR: XXX XX XXIt Xlt X X 1C r� ]t -l! r. }' x X XX XX7t X'X7t 7t��X'X'7tXX X X X ft X 1l It r r x r r r c r R XXX X X XX XXXX XX XX X'XXX r c c I BUILDING coca rR �c 1'ol: r,I c -IN NUMBER: z'o. 2 S_ l -I S -'-rj AriCli 1'ri;CT/ ENGINi:ER: MAILING ADDRESS: ,NEW: X, REMODEL: ADDITION: CHAINGE OF USE: DWELL UNITS:-_ / OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. : hV,,ILING A1)1)iZr'SS: AriCli 1'ri;CT/ ENGINi:ER: MAILING ADDRESS: ,NEW: X, REMODEL: ADDITION: CHAINGE OF USE: DWELL UNITS:-_ / OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. : PLUMBING INFORMATION: CONTRACTOR LICP: CONTRACTOR: MAILING ADDRESS- �t�tx,cx*�txx+r�r*x**x*�cxxx�t�tx**�t•�t**�t******�t�t�t�t*�t**it**:z:x�r*�:xxxxxx,rststx�t**�t�tst��r� MECHANICAL INFORMATION CONTRACTOR LIC$: CONTRACTOR: MAILING ADDRESS: ELECTRIC: GAS: ENERGY CODE: WSEC: OIL: CCAL: WOOD: SOLAR: HEAT PUMP NWEC: UTILITY: SGC: APPROACH: PRESCRIPTIVE: POINT: COfIPONENT: SYSTEMS: zzx*****zxx,r,rz*xrxrr,r,rxxxz�rxzzz�rzzzxzxrxs�zzzxxzxxzzxzzrzzzzxzzxzxxxzytyrzxxzr HECIiANICAl. i- i;ES ITEM DESCRIPTION MUMMER OF PLUt•-,3ING FEES ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO PROCESSING FE';-- YES OR NO �- t7UCTti•0:.;" SYS'I'EI•i 'TOILETS �3 tdO,ODSTOVE/ INSERT SINKS ;..`.S WATER HEATER SHOWERS / Gi�S HTG EQUIP(100,000)13.PU BATH T—BS / GAS HTG EQUIP +100,000 KITCHEi; SINKS Gt4S PIPING — = 01 ljNITS DISHW SHERS / HES=. T PU•iP 1-100 BTU GARBZi.G= DISPOSE -.L / HEATPUt.P 101-500 BTU CLOTitz.S WASHER HEATPLP.-Un 501-1000 BTU _ _ U1ILI i SINKS HEATPUi•11' 1001-1750 BTU ELECTR C WINE%' .. ATERS / HEATFUlt-1 1751 BTU FLOOR DRAINS i EFRIG 1-100 BTU FLOOR SINKS EZEFRIG 101-500 B170 Btgz SI'":.5 REFRIG 501-100 BTU _ ROOF D=.',INS REFRIG 101-1750 B1U LAWN S?RrNYLE.> EZEFRIG +1750 BTU SEWAGE EJECTOR / AIR CONDITIONER 0-3 UP WATER SOFTENER AIR CONDITIONER 3-15 ILP URINAL AIR CONDITIONER 1S-30 HP DRINKING FOUNTAIN AIR CONDITIONER 30—SO HP AIR CONDITIONER +50 IIP VENTILATING FANS EVAPORATIVE COOLERS — --- HOODS CLOTHES DRYFR � —� --- [ZANGE SKANE COUNTY HEALTH DISTRICT APPLICATION NO. _ ENVIRONMENTAL HEALTH DIVISION CENSUS TRACT WEST 1101 COLLEGE AVENUE DATE OF APPLICATION �- SPOKANE, WASHINGTON 99201-2095 (509)456-6040 SITE ADDRESS OR LEGAL DESCRIPTION OF PROP RTY: PROPERTY WITHIN: {j PSSA (BOUT/INSIDE ASA) GSSA (OUT/INSIDE ASA) / [] WWMA (OUTSIDE PSSA,ASA,GSSA) LEGAL OWNER OF OPERTY: A DR S• PHONE: [],OUTSIDE ALL OF ABOVE /� �` d �p�'"�`., 1­2�1 IN ASA ONLY CLUP: PROPOSED USE OF PROPERTY: \ SINGLE-FAMILY RESIDENCE - NUMBER OF BEDROOMS TYPE OF STRUCTURE: [] MOBILE HOME [] RANCHER [] SPLIT ENTRY { MULTI-LEVEL (] MULTI -FAMILY COMPLEX: NO. UNITS NO. BEDROOMS/UNIT (] COMMERCIAL/INDUSTRIAL (DESCRIBE): #EMPLOYEES/DAY: #SEATS/CHAIRS FOR CLIENTS/CUSTOMERS: IS THIS PROPERTY LOCATED WITHIN A COMMUNITY PUBLIC SEWER SERVICE AREA? �fj YES [] NO IF YES. NAME OF DISTRICT/SYSTEM: IS ULID AGREEMENT REQUIRED? ,Y( YES [1 NO SEWAGE SYSTEM PROPOSED SYSTEM BY APPLICANT:, ] SEPTIC TANK(S) NO. SIZE��C ? U [] OTHER PRETREATMENT FACILITY i (SPECIFY) /.] DRAINFIELD [] LEACHBED [] BUILDING SEWER [] OTHER DISPOSAL FACILITY (SPECIFY) WHAT IS THE SOURCE OF WATER FOR THIS PROPERTY COMPONENTS: 1 j REPLACEMENT/FAILURE: []YESfi]NO ALTERATION: []YES; REASON: [] SATURATION/SOG [] RELOCATE - CONFLICT [j OTHER [] C-HANGE OF USE [] ADO -ON WILL THIS RESULT IN AN INCREASED SEWAGE FLOW? []YES;'J4/N0 PUBLIC/SHARED WATER SYSTEM; NAME: ///! PRIVATE: [1 WELL [1 SPRING [1 LAKE PROPOSED PLOT PLAN IS TO ACCOMPANY THIS APPLICATION, ALONG WITH ANY OTHER PERTINENT INFORMATION, SUCH AS LEGA DESCRIPTION OF PROPERTY. THIS APPLICATION AND PERMIT APPROVAL IS CONTINGENT UPON MEETING REQUIREMENTS SET FORTH IN THE SPOKANE COUNTY HEALT DISTRICT RULES AND REGULATIONS FOR ON-SITE SEWAGE SYSTEMS. APPROVAL IS BASED ON THE ACCURACY OF THE INFORMATIO SUPPLIED BY THE APPLICANT. IF YOU ARE DISSATISFIED WITH THE DECISION OF THE HEALTH DISTRICT, YOU MAY APPEAL TO TH HEALTH OFFICER WITHIN TEN (10) DAYS,OF DENIAL OF THIS APPLICATION (SEE APPEAL PROCEDURE). CONTACT PERSON: f // - f' ( PHONF�-(,Sj_; SIGNATURE OF OWNER OR AUTHORIZED REPRESENTATIVE: �; � �.�r-liC-''>✓ is -y,� !�i> PHONE: i r,i'tj V sl (DATE: MAIL PERMIT> NO"-CORRE5 ONDENC�ITO l ✓ ` % J,INO SEG. DATE: 100 -FOOT SETBACK REQUIRED? �, INSPECTION CALL-IN DATES FEE PAYMENTS: AMT. PAIDI DATE -f REG.# PAID BY TEST HOLE INSP. TEST HOLE APPROVAL SIGNATURE AND DATE: APPLICATION 1: i -12— PARTIAL INSP. PERMIT SYSTEM SPECIFICATIONS BY DISTRICT: FINAL INSP. REINSPECTION REATMENT FACILITY: REINSPECTION [] DRAINFIELD SIZE: FLOW RATE [SOIL LOADING RATE, ['1 SEPTIC TANK SIZE: GALS. NO. € SCHEDULE OF APPROVALS RIIICAL MATERIAL USER: []YES T_]NO tv SEWAGE MAINTENANCE AGREEMENT REQUIRED? []YES J,INO SEG. DATE: 100 -FOOT SETBACK REQUIRED? [LYES N SAZSENU DENSITY REQUIREMENTS []YES ':f']NO EASEMENT REQUIRED? YES ,-N THER AGENCY_�i.e., DSHS, PLANNING, DOE) APPROVAL & DATE TEST HOLE APPROVAL SIGNATURE AND DATE: MINIMUM Ic SYSTEM SPECIFICATIONS BY DISTRICT: -LOW RATE GAL/DAY DISPOSAL FACILITY: REATMENT FACILITY: [] DRAINFIELD SIZE: FLOW RATE [SOIL LOADING RATE, ['1 SEPTIC TANK SIZE: GALS. NO. € GALS./FT2 x' - TRENCH WIDTH] i'`= 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 = 2 [] ALTERNATIVE: [] MOUND [] PRESSURE DIST. BED [j OTHER: [] OTHER (SPECIrY): SEE ALTERNATIVE SYSTEM SPECS. ATTACHED OTHER E.N. PROGRAM APPROVAL AND DATE APPLICAT,I(�.:APPROVAL SIGNATURE AND DATE: ;.' r _ i s DOUBLE PLUMBING REQUESTED - DATE: !!'i ("_ f /"i �' B1I1-0ING.0 PEAEL ASP D T r TIALS: REQUIRED RECOMMENDED N/A SEE PLOY PLAN J -/Y` - /� [] 206 REQUIREMENTS RCV'0 ULID TO APPL. DAT PERMIT` U_�PDATE: �> £XP��t S _ / 'ITIALS: fj N/A SEE PLOT PLAN ULID RCV'D DATE: ((�Srr // INSTALLER: (PHONE NUMBER) (INSTALLER SIGNATURE) FINAL INSPECTION SIGNATURE AND DATE: RLMARKS ANU AFFXUVAL UUNU111UNS: SCHD-EHO-0532 (REVISED 3/88) FOLLOWUP DATE: • OFFICE OF SPOKANE`C'OUNTY ENGINEER N. 811 JEFFERSON / SPOKANE, WASHINGTON 99260 (509) 456-3600 5/12/8,3 .PPLICATION TO PERFORM WORK ON COUNTY ROAD RIGHT-OF-WAY WRS & ASSOCIATES Permit # 88 - FNA161 PO BOX 14081 SPOKANE WA 99214 (509) 922-0782 The applicant hereby applies for permission to CONSTRUCT TWO RURAL APPROACHES TO TWO NEW RESIDENCES BOTH IN KARMA ADDN, E 14821 21ST CT, L9, B1 AND E 14804 21ST CT, L5, B1. CONCRETE APPROACHES CURBS TO BE CUT. Date work to start 05/12/88 The estimated time required for completion of the above work is 120 days hich the petitioner agrees to prosecute with all diligence and speed with due egard for the rights, interests and conveniences of the public. Petitioner further agrees to perform the work in strict compliance with the provisions enumerated below and states that he has read and will adhere to the general provisions applicable to permits contained on the reverse side of this form. The undersigned guarantees that if the backfill, street surfacing or improvement fails within two years from the date of final inspection by Spokane County, he shall pay the cost of the County for making repairs or restoration of the roadway and improvements. In consideration of the granting of this permit it is agreed by the applicant that the County of Spokane and any officer or employee thereof shall be saved harmless by the applicant from any liability of responsibility for any accident, loss or damage to persons or property, happening or occurring as the proximate result of any of the work undertaken under the terms of this application and the permit or permits which may be granted in response thereto, and that all of said liabilities are hereby assumed by the applicant. It is further agreed that if any part of this installation interferes with the future use of the highway by the general public, it must be removed or relocated as designated by the engineer at the expense of the permittee or his successor in interest. /1 SIGNED .PERMIT Subject to all the terms, conditions, and provisions written or printed below or on any part of this form. PERMISSION IS HEREBY GRANTED the above applicant to: PERFORM WORK TO COUNTY STANDARDS AND IN COMPLIANCE WITH APPROVED PLAN ON FILE IN THE COUNTY ENGINEERS OFFICE. TCO, TOP OF SLAB 1 FT. IN 30 FT. ON BOTH. INSPECTOR TO CHECK FORMS PRIOR TO POUR - 24 HOUR ADVANCE NOTICE REQUIRED. ALL CURB DROPS WITHOUT APRONS, UNUSED OR ABONDONED DRIVEWAYS - SHALL BE CLOSED WITH STANDARD CURB. ermit fee $ 10 Inspection fee $ 30 Total $ 40 Paid by CH # 2730 bond in the amount of $ 2000 issued to FISHER CONCRETE .s required to insure compliance with the above conditions, said bond to be kept n full force and effect for a period of 2 years following completion of work authorized by this permit. 'his permit shall be void unless the work herein contemplated shall have been ompleted before 09/13/88 INSPECTION REQ ED — 24 HOUR NOTICE REQUIRED Call Permit Office 456-3600 or 456 60 to notify when work begins and schedule inspection. COU�EER 01 c3, -./. -4,— DAT E " -- It is the respo ity of the appli to notify all utilities and private property owners when such pr ert liable to injury or damage thro the performance of t above work and the applicant shall make all necessary arrangements relative to the protection s- ch property and/or utilities. Traffic control signing and barricades shall be furnished by Permittee in strict conformanc ith "Manual on Uniform Traffic Control Devices This permit must be available on the work site and is valid only for the dates shown above. UTILITY DAMAGE IS COSTLY -- CALL BEFORE YOU DIG - 456-8000