1st E 12406 Inland Machine & Mfg Add to Machine Shop Coci't-ac[ Pereon Na;me Buet�ess Nacne .�AI/,q /j1,���1�
g
`�::dreee� �13 Z�� ta. Addr�s�� 4f�
r''� �Phone 'T Z�' Ptione
(:oun�ty Contact Person• ��ksrg Phone No�. 456-3600 Date
�COriMERCIAL HUILDING PE�RMI�T�REV�IEW j
This �buil'ding pe'rmi[ re.view 18 i�nCe�ded Co app�.a�ise y:ou of the �imn.�ovemen�te (r�c�,a w 'side-
wal�k, cu�rb, stor•mwa[er, etc.) which must he cons�[r�uc�Cec� i�n association wi�tii ,.your bui_ldin�g
permit. This checklist will be filled out by [he En�;;inee'r's sta.ff and� a co.py..will be �re-
tur,ned Co you at .�the` time tha�t the. permlt is i�n�iti�Aled b.y the Cng-ineecing De'part�m�nG,. All
requirements ahall �be complet�ed prior [o �issuance of the building perm�it. All unchecked
boxes �require addit�iooal research ;or tnf.brmat�iaQ ta� make a de'[erminatlon.
I�. S�toi�mwater D,rai�a e Consideretions
�A. Per gu�deTine�o,r '�[ocmwater Management 1�9.81" bo�th on and off ei.ce,
1�: 208 Cons�i�derations* Yes a No
2. �Flaod hazard zone �conai.derations** p Yes� Nu
3., Storm :Drainage �Plan Yes q �No
�II. Plann�in� Action
1. Pl�at, sho'rt plat., ,rezone, �Cond�i�ional Us,e ar Vari�ance a� Ye9 No
on piope"rty. Pla�nning Number
2.o Are requiremente of planni�g ecC-�,on i�corporated Yes No
into eite plan�
III. R��ht of �'Wa-y i
1.. �Does permi-� ne�cessi [ate R:O:W. dedicati�on (��y�1� Yes No
2�. �Di�d� zone� change requ�ire R.:O.W. dedica[l�o�n a Ye�§ i�'o
3. Radius at ��cornec Yes No
IV. County Road �Improvements
1. Roada need to be improved. Hvw wide p �Yes No
2. Curb a Yes No
3. CR�P/:�R-xD agreemen[ (Copy of deed, contract,, �or Yes No
G��tle report required.)
4. f or improveraen,ta provided Yes No
5. Sidet�►a�lk Y�s No
V._ Pa�r-kin� P�lan; b Approach �LocaCion�
1. ReviPw and �sign off by Tr.effic Yes No�
2�. Ap�Tn�ch Permit from Engineer'�s Office �Yes No
3�. 5cat or Ci ty� ai�gn off Yes Nc,
4. I�s �t t�� s road on- 6� �Yea'r Plan Yes No
�VI. .ULID Ag w Yes� �No�
VII. �Field �Revi:ec,•: Pc.el�iminary Comments
All Iend��withi�y t-lii� Aqui�fer Se�sitive Atea, whe"r� deemed Feasible by� the County Cr�g'i�-
neer, shall i����o�r.pura[e s[o,cmwat'er trea�[crient �.to mit�lga�te� th�e po'tenC•ial for ,g�roundwater
degradation. See Guide_lines for SGormwat,er Management 1981, Spokane Board` of Coun�ty.
Commiseioner�'s F.esoluCion �No. 8�0-1592� as amended.
�The purpoae �o�f f loud haza�rd zone r-eview is 'to �iiiimize losses �due to f loodi�ng in sp.e--
ctfic areas cie�,-tgna[ed, 'b.y F1'ood Haza�rd Iiou,n�ci'ary inap's on �fil�e at Che County Engicieer's
Off�i.ce. (�See "�po-k.ane .Board of County Commissioner'',s Resol'ution No. 81-0;72b�� as
amended•.�)
9 2 2��/,8 5
(,THIS f� N'�OT A�PYRMIT)
�UILDING PERIViIT APPLICATION 1NORK�1-iEET
PLEASE-PRINT AND COMPLETE ONLY THOSE PARTS 4F THE FORM YOD UNDERSTAND
COMPIETE IN INK
(Pleaso �etcirn this o�iginal and your buildinp plan§ to the Department,ot 8ullding and-Safety)
SHADED AREAS-AAE FOR OEPAfi7MENTAL USE �"s°�-�
=�ro�ec� N�mb�����������
��s t
'Owner'e N�me LAgT FIRST MI
�C- E R W�4-�.t Q
Project Addrese,lSlrcet NamB 8. NumOer) Zip
�i�ST z �-o� t i ,¢�E S �o �.�.��a ur �9 Z �6
AOP�ipnt ��3T 3 Z3 Z3
t�►��.� �G
���y s���� Sta,� 2ip9g�Z�,& �'a
'��09
f
Business P1�one
�50� Z.8 S'?
'Contractor/qperit Addres's�
c z/�t.� ��P c.1
��y State Zip Prone
.f
Contaci License NumDer (Rsquired) 8usiness Phone
I 1'
Architeot/Engineer Addre.9s
�J. t 31 Z� 2�
,�ly, Stete ZiP Pt�nE
l.v� Lt �Saq� g► L8 "?-L
SI�O�%�'�-?�
ca���� e���� P i��g L 1�
Z�' 7
-lender Addiess
Ct1y S1ate Z1D Phone
'1 1
Oescsibe r Q Ra. �m-
-p i t o 1�..� a 1 w E �Z�
S�bdlvlsfon%Piet N8m9f Sfiort Pta! Numbe► I a •b= `,�r y-: i}�;i:7
r i
�a�w �6���Num� 0, I B�wl�' ���VmYW r ��_r�
2�5r-f 2 a y� o.
P+ertlnent Ftle Numbera Zo�a Co�np. Plan �Census Tant
o
Numbe�of Dwelltng�Uriita Numberot Buildinpa Lot 5ize�(Sq. Fl./A�cr�e) Qepth F�antape ,s
�Front Setbac�t lefi Setbt�ck• ptght SetbaGi 1� Sal�aCk Al W.Width a
�'l4ddifiona! Inbrmatlon Square Footag6
.o
a
o�
z
O
2
C
m f�trr� 01 Bedrooms
Buliding Technkian Oate r GroUp' Type
e �r.- �ro
i
i� J
1
DEPe�1_FiTN�ENTAL �tEVIE�A/
A rav d Cond. Hold
pp q Approval,
E�vlronmenta! Hesllh Applicaflon
W. 1101 Cflllege
Room;200
P enning/ 9
I Ionln
N. 721 Jelterson
1 i e�:�,��-s 2s .S� �t
Engineers 7 7
N. 8t1 Jefie�son .i�!`(��
1 .'a.. �!lC...'. .1... C�tl.
Ut��itlas
Q N. 811 Jetterson
Plan Rsvtew/Fire P�eve�tion
N. 811 Jefierson
Other (SEPA/. Meteriel/etc:)
Foat Track�ISpeciet, inepecllon�inbrmetlon
e 5
Pro)ect Representative� Phone
Addtes's
I•,certify lh'at 1 have examined t�is� appticatiori` and state that the information contained tn it and submitted
by me or my agent to compile said application:is: true and cor�ect.
Signature� Dat+a,
�I
OF�, Q
r Yf l. V P1,�f �.595
��U�9�.�i),�(��►
N p' 6. s�ono,�E g Ko.
w�. Z25�? o �2'L
wOTICE TO THE PUgLIC''
RPOSE /�.!W�!
PU f
KNOW ALL MEN BY THESE PRESENTS, That W. R. Lemburg and Pauline M. Lemburg
�i
being the owners uf the following described lands in consideration of n�utual
benefits to be hereafter derived do for themselves, Ct�eir heirs, grant�es �nd
assigns, hereby agre� to the following:
The owner(s) or successoY(s) in interest agree to authoriZe the County to
place their n�me(s) on petition for the formati�i� nE a Ruad Improvement
Disttict (RID} by the petition method pursuant to ChapCer 36.88 KCW, which
pe[ition includes the owner(s) property, and furtE�er nvC tu object, by the
signing of a ballot, the formarion of a RID by the resolution method
pursuant to Chapter 36.88 RCW, whict� resolution �.n�lude� the owner(s)
property. If a RID is formed by either the petition �r resolution method,
as provided for in Chapter 36.88 RCW, che owner(s) or succeCsor(s) further
agree: (1) that the improvements or con�truction �ontemplated within the
proposed RID is feasible, (2) tt►at tt�e benefits tn be derived from Che
for.mation of the RID by [he proper[y included therein, together with the
8mount of a�y County participation, exceeds [he cost nnd expense of
formatio� of th� RID, and {3) that the property r��ithin the proposed RID
is sufficiently developed. Provicled, further, thp owner(s) or
su�cessor (s) shal]�, retain tfie right, as autiiorized under RCW 36.88.090, to
ob�ect to any assessment(s) on the property as a result of t1�e
improvements called for in con�u�ction wit�i the formation of a RID by
either petition or resolution method under Chapter 36.88 RCin'.
•,�,It is futther agreed that at such time as an RID is created or any•Road
Impravement Ptoject is sanctioned by Spokane County, the improvements
required (curb� sidewalk, drainage control and p�ving to existing
pavement) will be at the sole expense of the underslgned owner, their
heirs, grantees and assigns.
The conditions and statements apply to the following described property:
22542 0431
EaBt Half (E}) of Lot 19, in STEWART'S SUBDIVISION of Bleck 164, OPPORTIINITY,
in Spokane County, Washington. In Sec 22, 1�wp 25 North, Range 44 E.W.M.
These requirements are and shall run with the la�d and sha1Z be binding up�n the
owners, their heira, successors or assigns.
IN WITNESS WHEREOF, we have hereu to set our hand(s) and seal(s) this day
of'' (,L,G.,, 19
t/
�w, L G �J. U �i', R �'t��.�lI�1
R. Lemburg
r� C �l l+� aT°���;
�a�. Sw' i��frsA r
9 E�gl�ee� Pauline M. L mburg
S�P 9 4s PM 86
STATE �F ��'�'O
COUNTY OF ss W�����M L. �UNAHt�E
AU01`��R ��I�Lt4IV D�
,SP�KAN� COItNTY� WASN.
On thie day personally appeared b�� me W. R. Lemburg and Pauline M. Lemburg
personally known to r�e to be the individual(s) wt�o executed the Forgoing instrument
and acknowledged the said instrument to be the free and voluntary act and deed of
said individual(s), fox the uses and purposes therein mentioned.
Given u�der my hand and seal this ay of �t�q�� 19 g
�.....�f`�
T Q
Yr.
Notary Pub.lic:
y� r
j r� y
r: _ti ��d' In and for the State
'-�n� .,�;�p r�A'� �Cr re s i d i ng in h'�t,�41