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2003, 05-16 Permit App: BD-03-453 Poolq71' t . iMR Sit I 1e • .0 .s Valley Mechanical Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone 509-688-0037 - Fax Spokane Valley, WA 99206 60 (D3 -k-153 PROJECT As( ) j JZ Y ,'Z ADDRESS: L/-12.,14 att, L W ;9 qct 0'37 PERMIT USE: OWNER: Ji �� 4'(�L.I�I,� J X COST PHONE (Daytime Contact): Q.- Z - (-IN CI / MAILING ADDRESS: 1 FUEL BURNING APPLIANCE (street) X (city/state) (ZIP) CONTRACTOR: 1` L up 0 0 , i „ " I LICENSE #: /Do _. OL - G`.i / - A42 r f C P MAILING ADDRESS: sl h t&.I Y- , (A 49- Q9 V:/ 519 PHONE #: ` -2 cam, l C - C �' - - I l . (� (street) UNLISTED APPLIANCE (ADDITIONAL FEE) = OR <400,000 (city/state) (ZIP) METHOD OF PA 0 CASH ❑ CHECK 0 DESCRIPTION OF WORK # OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE = OR < 100,000 X 515 = 2 FUEL BURNING APPLIANCE > 100,000 it 14575 /C X 519 I l . (� 3 UNLISTED APPLIANCE (ADDITIONAL FEE) = OR <400,000 X 550 = 4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 400,000 X 5100 - 5 USED APPLIANCE (WSEC min. AFUE rating) = or < 400,000 X 550 = 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X 5100 = 7 BOILER/REFRIGERATION 1-100M BTU X 515 = 8 BOILER/REFRIGERATION 101- 500M BTU X 828 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X 539 = 10 BOILER/REFRIGERATION 1001 - 1,750M BTU X 557 - 11 BOILER/REFRIGERATION +1750M BTU X 595 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE - X 510 = 13 RANGE - X 510 = 14 DRYER - X 510 = 15 FUEL BURNING WATER HEATER - X $10 = 16 MISC. FUEL BURNING APPL. - X 510 17 GAS PIPING (ea. Outlet) - ( X 51 = , 18 DUCT SYSTEMS - X $10 = 1 19 VENTILATING FANS - X $10 = 20 AIR HANDLER (DOES NOT include ducting) = OR < 10,000CFM X 512 = 21 AIR HANDLER (DOES NOT include ducting) > 10,000 CFM X 519 = 22 EVAPORATIVE COOLERS - X 510 = 23 TYPE I HOOD - X 550 = 24 TYPE II HOOD - X $10 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 = 26 AIR CONDITIONER 3-15 TON X 520 = 27 AIR CONDITIONER 15-30 TON X $25 = 28 AIR CONDITIONER 30-50 TON X 535 = 29 AIR CONDITIONER +50 TON X $60 = 30 LPG STORAGE TANK - X 810 - 31 WOOD OR PELLET STOVE/INSERT - X $10 = 32 WOOD STOVE - FREE STANDING - X 525 = MENT I y I�dSI SUBTOTAL: ) W PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: 5 5, QD 0 CASH ❑ CHECK 0 City of SPOKANE VALLEY BUILDING PERMIT APPLICATION PERMIT # A D BOX 1 OWNER iGL 14-1 #3_s JOB LOCATION /(0 1 /Z OWNER'S ADDRESS 5/ CITY V C-,2,sj'- c L.- STATE Lifts PHONE (22-fElr BRIEFLY DESCRIBE JOB / 14 X 3c,) .1mt'`' w POO L BOX 2 CONTRACTOR'S NAME pooc G.) 0 INC. PHONE -(Z E Cc CONTRACTOR'S ADDRESS � 5 �� 7a ° ITY SAA -4^11 STATE 1"/V1- CONTRACTORS REG. # PC) -N.-- 14) ,Y2-4-(1 L % EXPIRATION DATE I l 3/ OL/ (CARD MUST BE PRESENTED AND COPIED) BOX3 CONTACT PERSON OF PROJECT - IM \ ('%6k -OC -t4- PHONE ADDRESS CITY STATE BOX 4 SEWER AVAILABILITY WATER AVAILABILITY BOX 5 ESTIMATED PROJECT COST $ t` -)IL- EXISTING BLDG. VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBR LOT NUMBER BOX7 BUILDING SQUARE FOOTAGE (EXISTING/ PROPOSED) 1ST FLOOR / SECOND FLOOR BASEMENT / CARPORT THIRD FLOOR / GARAGE TOTAL BOX 8 ( ( ( ( BOX 9 / DECK / SINGLE FAMILY MULTIFAMILY (NO. OF UNITS) COMMERCIAL / INDUSTRIAL TENANT. IMPROVEMENT ( ) NEW CONSTRUCTION ( ) EXISTING STRUCTURE TOTAL AREA OF PROPERTY SQ. FT. IMPERVIOUS SURFACE SQ. FT. PLUMBING FIXTURES (INCLUDING ROUGH INS) NO. _ WATER CLOSETS _ GARBAGE DISPOSAL BATHTUBS SHOWERS _ LAVATORIES SINKS DISHWASHERS _ ELETRIC HOT WATER HEATER _ LAUNDRY WASHER OUTLET URINALS _ DRINKING FOUNTAINS _ SUMPS, SPRINKLER VACUUM BREAKERS _ FLOOR DRAINS BACKFLOW PREVENTOR _ WATER SOFTNER (BUILT IN) _ GREASE TRAP HOT TUBS TOTAL FIXTURES S -V APPBP MECHANICAL FIXTURES GAS PIPING: OUTLETS NO. _ GAS LOG FURNACE, ELECTRIC _ GAS_ GAS HOT WATER HEATER _ CONVERSION BURNER _ BOILER: SIZE _ AIR HANDLING UNITS _ HEAT PUMPS: SJZE _ UNIT HEATERS _ AIR COOLING UNITS: SIZE _ COMMERCIAL HOOD _ EARTHQUAKE VALVE _ VENTILATING FAN _ WOOD STOVE _ INCENERATORS _ SUSPENDED HEATER OTHER OVER 0 ZONE _ BACKFLOW PREVENTOR _ WATER SOFTNER (BUILT IN) GREASE TRAP T HOT TUBS OTHER TOTAL FIXTURES WOOD STOVE INCENERATORS SUSPENDED HEATER OTkIER I VERIFY UNDER THE PENALTY OF OR PERJURY, THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURI•HER THAT I AM AUTHORIZED BY THE OWNER OF DIE ABOVE PREMISES (OR SITE) TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER / AGENT DATE OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT REMARKS SEPA; EXEMPT NOT EXEMPT PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE FIRE SPRINKLERS FIRE ALARM ACCESS ROADS WATER FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE STREET USE STORM DRAINAGE OTHER (CASH OR CERTIFIED CHECK MAY BE REQURED FOR STREET CLEAN UP) PUBLIC WORKS APPROVAL DISAPPROVAL DATE TYPE OF JOB: NEW RESIDENCE RES. ADD / ALT NEW INDUSTRIAL IND. ADD / ALT NEW COMMERCIAL COM ALT / ADD NEW MULTIFAMILY NO. UNITS MULTIFAMILY ADD / ALT TENANT IMPROVEMENT ROOF. OTHER OCCUPANCY TYPE OF CONSTRUCTION STORIES BUILDING SQ. FT. @ $ = SQ. FT. BUILDING SQ. FT. @ $ _ • SQ. FT. BUILDING SQ. FT. @ $ = SQ. FT. BUILDING SQ. FT. @ $ = SQ, FT. TOTAL SQUARE FEET TOTAL VALUATION $ BUILDING PERMIT NO. PLANS CHECK FEE $ RECEIPT NO. PERMIT FEE $ PLUMBING FEE $ MECH. FEE $ WSBCC $ ENERGY FEE $ DECK / CARPORT FEE $ OTHER FEES $ TOTAL FEES $ AMOUNT DUE $ BUILDING DEPARTMENT APPROVAL BY ASSIGNED ADDRESS RECEIVED STAMP ACCEPTED FOR FILING S -V APPBP �5�2 W Q_/_ -------------- t t ca o CL-.. qCi, w� f j" ,]�i.` ..� r. .-.._._ 'f'I• T. J t 1' xk­ Client I kws Pool K Spa ❑ Deluxe model Return Appointment WA Contractor POOL WORLD Coping 6 gy Facia Decking _ Registration 13524 E Sprague Ave 1DPublic Works Contractor Registration #13698-A4(47) Water Feature ❑ Bar •Stools •Table ❑ Fire Pit •BBQ ❑ Spokane, Washington 99216 (509) 928-6585 • Fax (509) 928-9469 ©2003 All rights reserved. Poor World • Spokane, WA • 99216 www.poolworld.biz• e-mail: ted@poolworld.biz i -------------- t t ca o CL-.. qCi, w� f j" ,]�i.` ..� r. .-.._._ 'f'I• T. J t 1' xk­ Client I kws Pool K Spa ❑ Deluxe model Return Appointment WA Contractor POOL WORLD Coping 6 gy Facia Decking _ Registration 13524 E Sprague Ave 1DPublic Works Contractor Registration #13698-A4(47) Water Feature ❑ Bar •Stools •Table ❑ Fire Pit •BBQ ❑ Spokane, Washington 99216 (509) 928-6585 • Fax (509) 928-9469 ©2003 All rights reserved. Poor World • Spokane, WA • 99216 www.poolworld.biz• e-mail: ted@poolworld.biz