2005, 02-10 Permit App: 05000427 PoolS`''pokane
_#Valley
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address:
ilon
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
[1 Building Permit
Relocation
I la t "32'
Change in Use [1 Grading n Manufactured Home
Tenant Improvement I Fire Safety 1g—Other
OWNER/APPLICANT INFORMATION
Owner: (d0 ) gr 514:411----j ❑ Applicant:
Phone: Gg25•q<5-i Fax: Phone:
Address: JIOq id ( Ssi 6_ Address:
'PJ/Liv-'c trott..€€4l 1, 1,1 412.rZ
State Zip Code City
Fax:
City
•
2' Contractor: PO% LJ6y-LO l✓ -1C_ ❑ Architect:
Phone: QZ1-‘s-i —Fax: Phone: Fax:
Address: /-35 ' / . 512th✓,. Address:
SPOILy1rt v' -'1 1/in q f'a
State Zip Code
City
State Zip Code
WA State Contractor License #:
City
OL - (A/ Zy/Ceontact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS.
# OF STORIES.
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SO FTG
UNFIN BASEMENT SQ FTG
FINISHED BASEMENT SQ FTG.
GARAGE SQ. FTG.
DECK/COV. PATIO SO FTG
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY.
SEWER OR ON-SITE SEPTIC
SYSTEM?
Slifka" De
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address: /109" j5 5
Owner: A/OQ 01 SfS-y
Mail ng Address-
�� jmg r/ /1,,65/
/¢
Con rector: VEL 0A92 -i4)
Mail ng Address: ) 3s zV G, s;e6i►t:v4_
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use: '.6.4:-/t01/(1/44
Phone (Daytime Contact)' 'yzt
SiStp.p Zip Code
#: 2.2: 0-66- Y
SpedZAAr4- thk,i+
City
License #: P3 -,CIL -L' ( a qI CP Phone
S6e,4714i. yfl o .ria7
w'r9- 9,zt-
State Zm Coae
AUTHORIZED SIGNATURE-
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
512 00
=
2
FUEL BURNING APPLIANCE
More than 100.000
/
/
X
515 00
=
/5--
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550 00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100 00
=
5
USED APPLIANCE (WSEC min- AFUE rating)
Equal to or less than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
5100 00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
512 00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520 00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
525 00
10
BOILER/REFRIGERATION
1,001- 1,750M BTU
X
S3500
=
'
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560 00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510 00
=
13
RANGE
X
51000
14
DRYER
X
51000
=
15
FUEL BURNING WATER HEATER
X
51000
=
16
MISC FUEL BURNING APPLIANCE
X
510.00
=
17
GAS PIPING (each outlet)
/
X
51.00
=
/
18
DUCT SYSTEMS
X
510 00
=
19
VENTILATING FANS
X
510 00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
512.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
515 00
=
22
EVAPORATIVE COOLERS
X
51000
23
TYPE I HOOD
X
550 00
=
24
TYPE II HOOD
X
510 00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
=
26
AIR CONDITIONER
3-15 TON
X
520 00
=
27
AIR CONDITIONER
15-30 TON
X
525 00
=
28
AIR CONDITIONER
30-50 TON
X
535 00
=
29
AIR CONDITIONER
More than 50 TON
X
560 00
=
30
LPG STORAGE TANK
X
51000
=
31
WOOD OR PELLET STOVE/INSERT
X
510 00
32
WOOD STOVE - FREE STANDING
X
525 00
=
33
REPAIR S ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS
X
512.00
35
VENTILATION MECHANICAL EXHAUST
-
X
$12.00
=
36
INCINERATOR—RESIDENCE
X
$19.00
=
37
INCINERATOR — COMMERCIAL
-
X
522.00
=
METHOD OF PAYMENT:
IDCASH 0 CHECK 0 VISA 0 MC
CARD #
DATE,
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE-
Project Number: 05000427 Inv: 1
Application
THIS IS NOT A PERMIT
• Penalties will be assessed for commencing work without a permit
Date: 02/10/2005 Page 1 of 2
Project Information:
Permit Use: 16 X 32 SWIMMING POOL W/GAS POOL Contact: POOL WORLD INC.
HEATER & PIPING Address: 13524 E SPRAGUE AVE
C - S - Z: SPOKANE, WA. 99216
Setbacks: Front EXI Left: 16+ Right: 11 Rear: 38 Phone: (509) 928-6585
Group Name:
Site Information: Project Name:
Plat Key: 001288 Name: HUTCHINSONS ADD District: Nort
Parcel Number: 45181.0920 Block:
SiteAddress: 1109 N BESSIE RD
Location:: CSV
Zoning: UR 3.5
Water District.
Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Lot:
Owner: Name: SEARS, NORM & VIRGINIA
Address: 1109 N BESSIE RD
SPOKANE VALLEY, WA 99212
Hold: ❑
Review Information:
Review
Site Plan Review
Permits•
Contractor: POOL WORLD INC
Address: PO BOX 14927 Phone: (509) 928-6585
SPOKANE, WA 99214
Mechanical Permit
Firm: POOL WORLD INC
Item Description
GAS APPLIANCE >100,000BTU
GAS PIPING
Units Unit Desc
1 NUMBER OF
1 # OF UNITS
Operator: K_C Printed By: K_C
Fee Amount
$15.00
$1.00
Permit Total Fees: $16.00
Print Date: 02/10/2005
Project Number: 05000427 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 02/10/2005 Page 2 of 2
Swimming Pool
Contractor: POOL WORLD INC Firm: POOL WORLD INC
Address: PO BOX 14927 Phone: (509) 928-6585
SPOKANE, WA 99214
Item Description
PRIVATE POOL
STATE SURCHARGE
Units Unit Desc Fee Amount
1 SELECT $50.00
I SELECT $4.50
Permit Total Fees: $54.50
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Mechanical Permit $16.00 $16.00 $0.00 $16.00
Swmuning Pool $54.50 $54.50 $0.00 $54.50
$70.50 $70.50
Disclaimer:
$0.00 $70.50
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: K_C Printed By: K_C
Print Date: 02/10/2005
This site plan Isbeinga-"--'-d-lor:the purpose o1
• obtaining a bundg p rmll and is a We and sonact
1 epi •septation of llita-propwal.TAb-known-prepeny
--- - 11 ,es/dimer tab fbre9.ebu6ureSand easements
_haverbaen-ice`-Abo; kMkated-anrantlands.
• bodies
-- - --- Signed'-- ' �-'-'- ---
10+C7
Date' ��
I ! I I
it't r'-,LcC
and Accessories
) Public Works Conhazlor s #13648-A4(47)
ive
SCALE POOL DRAWING FOR:
Name /hoar•. 9 3t-.,. S s#ea
Job Address 110E /4 eeMi4
SPECIFICATIONS:
City SpoI&tni 0/ L t Zip q`iLl L
Dhnnc_rinu 1 nig 1 c7 A iS1
Make Model
Pump Coping
Filter Facia
Hnatnr Plaster
It is understood and agreed
that this drawing and its
specifications are a part of
,the Construction Agreement.
Buyer -
Seller
poi. ;'
1 '-1
II -I
' \ 1 --!--r -
-
This site plan Isbeinga-"--'-d-lor:the purpose o1
• obtaining a bundg p rmll and is a We and sonact
1 epi •septation of llita-propwal.TAb-known-prepeny
--- - 11 ,es/dimer tab fbre9.ebu6ureSand easements
_haverbaen-ice`-Abo; kMkated-anrantlands.
• bodies
-- - --- Signed'-- ' �-'-'- ---
10+C7
Date' ��
I ! I I
it't r'-,LcC
and Accessories
) Public Works Conhazlor s #13648-A4(47)
ive
SCALE POOL DRAWING FOR:
Name /hoar•. 9 3t-.,. S s#ea
Job Address 110E /4 eeMi4
SPECIFICATIONS:
City SpoI&tni 0/ L t Zip q`iLl L
Dhnnc_rinu 1 nig 1 c7 A iS1
Make Model
Pump Coping
Filter Facia
Hnatnr Plaster
It is understood and agreed
that this drawing and its
specifications are a part of
,the Construction Agreement.
Buyer -
Seller