2005, 05-25 Permit App: 05001800 PoolProject Number: 05001800 Inv: I Application Date: 05/25/2005 Pagel of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Fiat Key: Name: MORNINGSIDE PHASE I PUD District: Sout
Parcel Number: 55302.1513 Block: 4 Lot: 13
SiteAddress: 17116 E DAYBREAK LN Owner: Name: MCDONALD, GARY D & SANDRA
Address: 17116 E DAYBREAK LN
Review
Site Plan Review Released B
Permits:
Swimming Poo!
Contractor: IMPERIAL POOLS SERVICE Firm: BOB WALSH/IMPERIAL POOLS S
Address: 10718 E 25TH Phone: (509) 921-2251
SPOKANE WA 99206
Item Description
PRIVATE POOL
STATESURCHARGE
Units Unit Desc
1 SELECT
1 SELECT
Permit Total Fees:
Fee Amount
$50.00
$4.50
$54.50
Operator: K C Printed By: K_C Print Date: 05/25/2005
Protect Number: 05001800 Inv: 1 Application Date: 05/25/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
WATER APPROVED. FIRE DISTRICT 1 APPROVED FIRE DISTRICT 8 APPROVED OK TO
ISSUE SEWER PERMITS PR BILLY 1/1/9/95 CKF
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
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: 05/25/2005
AM
7
Spokan
;00Ualley
Street Address:
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
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:ro�4—
[] Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNERIAPPLICANT INFORMATION
Owner: `/fig Y' &'L AO
'\
Phoneso�> g� Fax:
Address: 7 iii c.
City state Zip Code
Contractor: �1i'C rc.c%cts
Phone,;, t ���,���� Fax:
Address: lo -)r X t )!�- -�
X26 cV41
City State Zip Code
■❑
Applicant:
Phone: _
Address:
city
❑ Architect:
Phone:
Address:
City
WA State Contractor License #:_ )J'Y't i_Contact:
Spokane Valley Bus. Liscense #: Contact,
IL-- PERMITIBUILDING INFORMATION
Fax:
State Zip Code
Fax:
State Zip Code
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2 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 N -SITE SEPTIC
TE ?
Width: Length:
Manufacturer:
Previous Address:
Proposed Use: _
Fire Sprinkler:
Tent:
Valuation:
MANUFACTURED HOME
Year:
RELOCATION
FIRE SAFETY
# of Heads: Fire Alarm:
Fireworks Display: Blasting:
Above/Underground Storage Tank Size:
Pit Set:
Paint Booth:
Date/Time:
II WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE N
Plans Examiner:
Address:
Inspector:
Address:
Phone:
Fax:
city State
Phone: Fax:
city
State
Zip
Zip
II SPECIAL INSPECTIONS N
❑ BOLTING
Firm Name:
Inspector(s):
❑ CONCRETE ❑ REINFORCEMENT
Phone:
Fax:
❑ WELDING
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 inure to the property owner.
Print Name C?fie i - f� , r''�.�j� Siy Signature2�2/��_�—
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard
Bankcard #:
Authorized Signature:
Expires:
❑ VISA ❑ Other
VIN#:
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