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2005, 05-04 Permit App: 05001445 PoolProject Number: 05001445 Inv: 1 J Y Appi;ation' THIS ISNOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Date: 5/4/2005 Page 1 of 2 Permit Use: INGROUND SWIMMING POOL Contact: A-1 GENERAL CONTRACTORS Address: 6410 N MONROE C - S - Z: SPOKANE WA 99208 Setbacks: Front Left: Right: Rear: Phone: (509) 328-3054 Group Name:-- Site Information: Project Name: Plat Key: 002768 Name: VERADALE HEIGHTS, 06TH ADD TO District: F Parcel Number: 45142.1402 Block: Lot: SiteAddress: 13916 E CATALDO AVE Location:: CSV Zoning: AGSUB Water District: Area: .00 Acres Width: 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information Owner: Name: BLAIR, MIKE Address: 13916 E CATALDO AVE SPOKANE, WA 99216 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Septic System Review Released -By:c. 5J, / (! Permits: . Swimming Pool - Contractor: A-1 GENERAL CONTRACTORS Firm: A-1 GENERAL CONTRACTORS IN Address: 6410 N MONROE ST Phone: (509) 328-3054 SPOKANE, WA 99208 Item Description PRIVATE POOL STATE SURCHARGE Units Unit Desc Fee Amount 1 SELECT $50.00 $4.50 1 SELECT Permit Total Fees: Operator: JAG Printed By: DMD Print Date: $54.50 5/4/2005 05/05/2005 08:50 5093241567 SRHD EHS ruca 111/6zTO 3241567 P.01/03 MAY 04 2005 17:13 FR i Date: 5/4/2005 Page 1 of 2 ' Project Number; 05001445 Inv: 1 Application • I TICS IS NOT A PERMIT Penalties will be assessed for commencinrork without a permit pS111tgieinassinnamonsemenoseassissetspeseasseseean Pemit Use INGROUND gVpvL1VG POOL Contact: A-1GENERAL CONTRACTORS At: 6410 N E C - 51 - Z: SPOKANE WA 99208 Setbacks: Front Left: Right: Rear: Phone: (509) 328-3054 Group Name: ProjectNsme: Sire Iafr��sxs•� �tarkmo District: 1 Plat Key: 002768 Name: VERADALE HEIGHTS, 06TH ADD TO —. Parcel Number: 451423402 Block: Lot: SileAddress: 13916 E CATALDO AVE Owner: Name: BLAIR, MIKE Address: 13916 E CATALDO AVE SPOKANE, WA 99216 Location:: CSV Zoning; AGSUB Water District Area: .00 Acres Width 0 Depth: 0 Right Of Way (ft); 0 NM of Bldgs: 1 Nbr of Dwellings: 1 si•smss�ar�raes»� ReviewInformation* — .. -.. . ----_-- Bold: [] Septic System Review $)9;11101 Dig Pool Contractor: Al••GENERAL CONTRACTORS Firm: A-1 GENERAL CONTRACTORS IN Address: 6410 N MONROE ST Phone: (509) 328-3054 SPOKANE, WA 99208 )tem Description PRIVATE POOL STATE SURCHARGE units Unit De@E 1 SELECT 1 SELECT Permit Total Fees: tosaggat $50,00 S4.50 Operator: JAG MAY 05 2005 09:59 Printed By: DMD 554,50 Print Date: 5/4/2005 5093241567 PRGE.01 Project Number: 05001445 Inv: 1 AppCation ' THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/4/2005 Page 2 of 2 Notes: Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Swimming Pool $54.50 $54.50 $0.00 $54.50 $54.50 $54.50 $0.00 $54.50 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: JAG Printed By: DMD Print Date: 5/4/2005 Spokane 40,01alley 05 - 1445- . 445 . BUILDING PERMIT APPLICATION WORKSHEET ECIEtyN of.Stok Valley Community Development Department ��VVII C Building Division 11707 E. Sprague Avenue, Suite 106 MAY 0 4 2005 Spokane Valley, WA 99206 fone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: l3T/6 ,c, Gataldo Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: .1-n yro ✓n r S/✓i sin+rn a� foo ) ® Building Permit ❑ Relocation ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION C✓� Owner: -re 9 NMI /art Joh Phone: US -20/1 Fax: • Address: /39/g E. Cans/dg Spokane IVA 49114 City I State Zip Code ® Contractor: 4-/ Senn /'* / �p fr0etn :pc, Phone: 38l-3 ofy Fax: Slit- 9775. Address: ,449o /14 Nonroe- -Seek ant_ ---3eo/cnnt_ 1✓A 9920 State Zip Code City Applicant: (COAZICteilt Phone; Fax: Address: City State Zip Code ❑ Architect: Phone: Fax: Address: City WA State Contractor License #: 4/CENC,ZO9/t) / Contact: 4o 4 in State Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: # OF STORIES: MAIN FLOOR TO SQ, FTG: 2N0 FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. 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? MANUFACTURED HOME Width: Manufacturer: Length: i ; Year;i , ! Ci l Pit Set: RELOCATION Previous Address: Proposed Use: t.it • 1 l I. •: FIRE SAFETY Fire Sprinkler: Tent: # of Heads: Fire Alarm: Paint Booth: Fireworks Display: Blasting: Date/Time: Valuation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Phone: Fax: City Inspector: Phone: Address: State Fax: Zip City State Zip SPECIAL INSPECTIONS ❑ BOLTING ❑ CONCRETE Firm Name: ❑ REINFORCEMENT Phone: Inspector(s): ❑ WELDING Fax: DISCLAIMER The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Ownership of resulting development rights granted by any issued permit Print Name o the prop „6:wdm-. Signature m/yr Method of Payment: (Faxed permit applications will only be accepted with major bankcard) El Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other Bankcard #: Authorized Signature: Expires: VIN#: 16'X31' f .i c Laach j3ecr— >30 0 Woos t —fete v, koason /39/6 f Cata/do Spo kanc, 992/G Colt/do L