2005, 06-09 Permit App: 05001977 Pool Project Number: 05001977 Inv: 1 Application Date: 6/9/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: INGROUND SWIMMING POOL Contact: WAYBRIGHT,JEFFREY
Address: 2809 S SKIPWORTH RD
C-S-Z: SPOKANE,WA 99206
Setbacks:Front 44 Left: 5 Right: NA Rear: 20 Phone: (509)000-0000
Group Name:
Site Information: Project Name:
Plat Key: 001393 Name: KOKOMO TOWNSITE(FEES) District: Sout
Parcel Number: 45283.4111 Block: Lot:
SiteAddress: 2809 S SKIPWORTH RD Owner:Name: WAYBRIGHT,JEFFREY
Address: 2809 S SKIPWORTH RD
Location::CSV SPOKANE,WA 99206
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .00 Acres Width: 130 Depth: 102 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review In ormation: :. r �
Review
Landuse/Zoning Released t
sga ' 1,r
Trver
— — Swimming Pool
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
PRIVATE POOL 1 SELECT $50.00
STATE SURCHARGE 1 SELECT $4.50
Permit Total Fees: $54.50
Operator: DMD Printed By: DMD Print Date: 6/9/2005
Project Number: 05001977 Inv: 1 Application Date: 6/9/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
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: DMD Printed By: DMD Print Date: 6/9/2005
_ 'BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
okalleSliBuilding Division
•
400,Valley 11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
N REQUIRED SITE INFORMATION ,6T -7.-• j4/ 7 7 1
•
Street Address: 4?,* r ei jja lir t LIT
Assessor's Tax Parcel Number(s): 9 0,1g.3. LI I I )
Legal Description: 1-'Tc i i ceKei t 21 h lcc.k 4 I , 4ke,.-1v Ta wvt 4:Tc
-Ra
PERMIT DESCRIPTION: Y,STes I( &r - Two e ns of.os g _ _=.___ , tidui
—ate__ c vi e
Building Permit ❑ Change in Use ❑ Grading ❑ Manu ac ' - : -ome
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
N OWNER/APPLICANT INFORMATION
Owner: Ni e-4rcLy W,t (er t of L F ❑ Applicant: ��04 .e
Phone: q�Fr73'7i Fax: Phone: Fax:
Address: 47, S. Ski Ip werT1� Address:
4 .
City State p Code City State Zip Code
❑ Contractor: ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
WA State Contractor License#: Contact:
Spokane Valley Bus. Liscense#: Contact:
I PERMIT/BUILDING INFORMATION I
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:a 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
P IApre) SYSTEM?
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE 0 REINFORCEMENT 0 WELDING
Firm Name: Phone: Fax:
Inspector(s):
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 Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
D 1E ( iE fl \\ •
11 I In)
April , 2006 APR 0 6 6 k-
i D.2 /Th,
Torn Scholtens O /1 L ID 1/ f�\ii ( j
Building Department �-
City of Spokane Valley
Dear Mr. Scholtens
Last summer I was issued a permit to install an in ground swimming pool and also a
permit to install two egress windows and a cover for the swimming pool equipment. As
often happens, I bit off a little more than I thought and I was unable to complete the
projects by the end of the summer. The pool is nearly finished; I just need to finish a
little wiring and finish installing the fence(the pool has a safety cover on it so that no one
can fall in)before I can have a final inspection. The egress windows are complete and I
have decided not to build a cover for the equipment as I found out that it can all be left
exposed to the elements and uncovered so the egress windows are ready for a final
inspection. Inadvertently, I have exceeded the 6 month time line to have inspections
performed and keep the permits open. I would like to request that I be granted an
extension on the permits at this time. I will call for an inspection on the egress windows
next week and I hope to have the pool completed by the end of June so that we can use it
this summer. Your consideration in this matter is greatly appreciated.
Jeffrey Waybright
Jeffrey Waybright
2809 S. Skipworth
Spokane Valley, Wa 99206
(509) 220-8045
S! -me
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Project#Search Grou. Name Search: Project Name Search: CSV
05001977
Site: 4 s Group: 1r6je8t Name:
Use: INGROUND SWIMMING POOL File Nbr: Dist: Si
Inspections
Date Type Occ Inits Status In Out Description Pmt Typ Final
06/21/2005 00920 0 MAH P 15:51 15:51 SVIIMMuMING POOL SP
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