2005, 05-16 Permit App: 05001598 Pool, Heater, Piping Project Number: 05001598 Inv: 1 Application Date: 05/16/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 16 X 32 INGROUND SWIMMING POOL W/GAS Contact: POOL WORLD INC.
POOL HEATER&PIPING Address: 13524 E SPRAGUE AVE
C-S-Z: SPOKANE,WA.99216
Setbacks: Front 47+ Left: 42 Right: 16 Rear: 23 Phone: (509)928-6585
Group Name:
Site Information: Project Name:
Plat Key: 001418 Name: LAMOTTE SUB District: Sout
Parcel Number: 45214.0108 Block: Lot:
SiteAddress: 12119 E 9TH AVE Owner:Name: RAPP,DAVE&LINDA
Address: 12119 E 9TH AVE
Location::CSV SPOKANE VALLEY,WA 99206
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold:
Area: 13,140 Sq Ft Width: 0 Depth: 0 Right Of Way.(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review Released By: .. lltritt
nbt
Permits: s . .
Mechanical Permit
Contractor: POOL WORLD INC Firm: POOL WORLD INC
Address: PO BOX 14927 Phone: (509)928-6585
SPOKANE,WA 99214
Item Description Units Unit Desc Fee Amount
GAS APPLIANCE>100,000BTU 1 NUMBER OF $15.00
GAS PIPING 1 #OF UNITS $1.00
Permit Total Fees: $16.00
Operator: K_C Printed By: K_C Print Date: 05/16/2005
Project Number: 05001598 Inv: 1 Application Date: 05/16/2005 Page 2 of 2
•
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Swimming Pool
Contractor: POOL WORLD INC Firm: POOL WORLD INC
Address: PO BOX 14927 Phone: (509)928-6585
SPOKANE,WA 99214
Item Description Units Unit Desc Fee Amount
PRIVATE POOL 1 SELECT $50.00
STATE SURCHARGE 1 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
Swimming Pool $54.50 $54.50 $0.00 $54.50
$70.50 $70.50 $0.00 $70.50
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: K_C Printed By: K_C Print Date: 05/16/2005
_ ILDING PERMIT APPLICATION WORKSHEET
r one Valle Commun Develo ment De artmenf
Sjökane Building Division
ry 0 E. Sprague Avenue Suite 106
MAY40,00Valbv.
� � 20QJ 1977
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
UOLOUN
REQUIRED SITE INFORMATION
9 J
Street Address: P//�1 7-7; / � ‘ ,/,-, e .,--',..>'_--,-----,
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: 77;fy,ti-- % /w7
cBuilding Permit El Change in Use ❑ Grading El Manufactured Home
j
Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
I I OWNER/APPLICANT INFORMATION
` x:),,,,, jo Applicant: 0...C.)0-IMO—Cie
'�5 ❑ Owner: ���,:/.r�'> �
Phone: �t--Cs ; ; Fax: Phone: Fax:
^Ai A_ddrr/ess: la//9 ,< - - Address:
ct Ci y / State Zip Code City State Zip Code
0 Contractor: GJ Architect:
-, Phone: 9.,),-nr_> ` Fax: Phone: Fax:
Address: A? 5---Y ---. r_ Address:
,S -'//ter G.4,., - (i 0 7 _v`.-
�City State Zip Code City State Zip Code
• WA State Contractor License#: /"✓ ,7 we ontact: /12,_/ Gt/�
Spokane Valley Bus. Liscense #: Contact:
PERMIT/BUILDING INFORMATION I
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FTG: 2"u FLOOR SQ.FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ.FTG: GARAGE SQ. FTG: DECK/GOV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30%SLOPES ON PROPERTY: =00 WON-SITE SEPTIC
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
El BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ 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 inur to the property owner.
Print Name --t ., Signature c="---e,-
Method
= -Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ,49 0 Mastercard ti VISA El Other
- z
Bankcard v VIN#:
Authorized Signature: �-e ;, '� This document ;.,,►
B ly- contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.
Pool World OWNER SPECIFICATIONS
Pools,Spas,Service and Accessories
OWNER'S NAME: 6P'°
WIFE'S NAME: JJ/ui2,4
ADDRESS: - /)e---
CITY/STATE/ZIP: a9A-
HOME
PHONE: /" d
HIS WORK PHONE: 6::L.17--
HER WORK PHONE:
JOB ADDRESS: 1Z.// - 9/4
CITY/STATE/ZIP: .c2 ari/
DIRECTIONS: ' .� 0
1611-/ / 0,
NOTES: �e---#'7-*
Ticket No: 5145902 2 FULL BUSINESS
Send To: C_FAX Seq No: 60 Map Ref:
Transmit Date: 5/13/05 Time: 3:00 pm Op: jerit
Original Call Date: 5/13/05 Time: 2:57 pm Op: jerit
Work to Begin Date: 5/18/05 Time: 12:00 am
State: WA County: SPOKANE Place: SPOKANE VALLEY
Address : 12119 Street : E 9TH
Nearest Intersecting Street: ROBIE
Twp: 25N Rng: 44E Sect-Qtr: 21
Twp: 25N Rng: 44E Sect-Qtr: 22-SW-NW,21-SE-NE
Legal Given:
Type of Work: INGROUND POOL
Location of Work: ADD IS APX 1/2 BLK E OF ABV INTER LOC ENTIRE BACKAYRD AND
: E SIDE YARD
Remarks: CALLER GAVE TOWNSHIP, RANGE, SECTION INFO
OR: N
Company : POOL WORLD
Contact Name: KIM OLSEN Phone: (509) 928-6585
Alt. Contact: Phone:
Contact Fax : (509) 928-9469
Work Being Done For: POOL WORLD
Additional Members:
ATTCBL21 - COMCAST AVISTA09 - AVISTA CORP
AVISTAII - AVISTA LOCINC31 - LOCATING INC
MEWO1 - MODERN ELECTRIC H2O QLNWA32 - QLN-QWEST LOCAL NETW
SPENG01 - SPOKANE CTY ENG-RDS SPENG02 - SPOKANE COUNTY UTILI
SPKVLY01 - C OF SPOKANE VLY VERA01 - VERA H2O & POWER
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