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HomeMy WebLinkAbout2003, 04-29 Permit App: BD03-201 Pool . • " City of SPOKANE VALLEY BUILDING PERMIT APPLICATION PERMIT # B poi -- .7f)( BOX 1 /+ L / 3. 7' OWNER Gal &lir JOB LOCATION //3, 7 OWNER'S ADDRESS 1/3,29 35CITY STATE lc4g- PHONE Lz ' V)S BRIEFLY DESCRIBE JOB 141,(4) 1. ,14g1A, "4 / -( (G,X3 • BOX 2 DCONTRACTOR'S NAME AV, tj()�'•-41 /z-G PHONE 2i 1 55 CONTRACTOR'S ADDRESS&-/3 5) Y CITY §00kotedi'STATE 7J/i CONTRACTORS REG. # OL �tl.� '; �/ o EXPIRATION DATE 1 3 760(74 (CARD MUST BE PRESENTED AND COPIED) BOX 3 I'7G%G1 7 5- CONTACT PERSON OF PROJECT PHONE �" ADDRESS e-13 5 .y lier CITY a6�rj C � V � J��v'' "_ STATE W4,4 BOX4 SEWER AVAILABILITY WATER AVAILABILITY "Y BOX 5 ESTIMATED PROJECT COST $(S/d1/0 EXISTING BLDG.VALUATION$ BOX6 PROPERTY TAX ACCOUNT NUMBER 1 LEGAL DESCRIPTION (IF NECESSARY,PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBR LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE(EXISTING/PROPOSED) 1ST FLOOR / SECOND FLOOR / BASEMENT / CARPORT THIRD FLOOR / GARAGE / DECK / TOTAL / BOX 8 ( ) SINGLE FAMILY . ( )NEW CONSTRUCTION ( )MULTIFAMILY(NO. OF UNITS) ( )EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT. ( ) TENANT,IMPROVEMENT IMPERVIOUS SURFACE SQ.FT. BOX 9 • PLUMBING FIXTURES (INCLUDING ROUGH INS) MECHANICAL FIXTURES NO._WATER CLOSETS GAS PIPING: OUTLETS _GARBAGE DISPOSAL NO._GAS LOG _BATHTUBS _FURNACE,ELECTRIC_GAS_ _SHOWERS _GAS HOT WATER HEATER _LAVATORIES _CONVERSION BURNER _SINKS _BOILER: SIZE _DISHWASHERS _AIR HANDLING UNITS _ELETRIC HOT WATER HEATER _HEAT PUMPS: SIZE LAUNDRY WASHER OUTLET _UNIT HEATERS _URINALS _AIR COOLING UNITS: SIZE _DRINKING FOUNTAINS _COMMERCIAL HOOD SUMPS, SPRINKLER VACUUM BREAKERS _EARTHQUAKE VALVE CD � FLOOR DRAINS _VENTILATING FAN L- _BACKFLOW PREVENTOR WOOD STOVE . _WATER SOFTNER(BUILT IN) _INCENERATORS _GREASE TRAP _SUSPENDED HEATER HOT TUBS _OTHER — TOTAL FIXTURES OVER S-V APPBP BACKFLOW PREVENTOR _WOOD STOVE WATER SOFTNER(BUILT IN) INCENERATORS GREASE TRAP -SUSPENDED HEATER T_HOT TUBS _OTHER OTHER TOTAL'FIXTURES 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 FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES(OR SITE)TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER/AGENT • / e$ DATE 5 OFFIC 1 SE ONLY-PLEASE DO NOT WRITE BE OW THI. LINE ZONE 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 "0 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 crrt � ilk 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone NpOtiile Spokane Valley,WA 99206 509-688-0037-Fax •Mechanical Permit Application ti) 0 3 ".20) ADPERMIT DR ES: // 3z L, £ 3 S`A USE: /d /4.4.. ,(__> OWNER 77-412P�7 f Q ' PHONE(Daytime Contact): MAILING ADDRES /' 1132c/ E -5 S` 5-,e ' U' 9 9Z®� (street) (city/state) (ZIP) 111 CONTRACTOR:,a7y? W 2, TiG , LICENSE$: pg..... L 10-4- 9// G p MAILING ADDRESS: PHONE A..' J..1-"f ` re....,rtr,?.,,,, . „ ,i, 6 (street) (city/state) (ZIP) DESCRIPTION OF WORK x OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE -OR<1C0,000 X $15 - 2 FUEL BURNING APPLIANCE ;S'4 PW >100,000 / X $19 - !fr m0 3 UNLISTED APPLIANCE(ADDITIONAL FEE) -OR<400,000 X $50 - 4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 - 5 USED APPLIANCE(WSEC min.AFUE rating) -or<400,000 X $50 - 6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X $100 - 7 BOILER/REFRIGERATION 1-100M BTU X $15 - 8 BOILER/REFRIGERATION 101-500M BTU X 528 - 9 BOILER/REFRIGERATION 501-1,000M BTU X $39 - 10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 - 11 BOILER/REFRIGERATION +1750M BTU X $95 - 12 GAS LOG,GAS INSERT,GAS FIREPLACE - X $10 - 13 RANGE - X $10 - 14 DRYER - X $10 - 15 FUEL BURNING WATER HEATER - X $10 - 16 MISC.FUEL BURNING APPL. - X $10 - 17 GAS PIPING(ea.Outlet) - 7 X $1 - 7 61 G 18 DUCT SYSTEMS - X $10 - 19 VENTILATING FANS - X $10 - 20 AIR HANDLER(DOES NOT include ducting) -OR<10,000CFM X $12 21 AIR HANDLER(DOES NOT Include ducting) >10,000 CFM X $19 - 22 EVAPORATIVE COOLERS - X $10 - 23 TYPE I HOOD - X $50 - 24 TYPE II HOOD - X $10 - 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 - 26 AIR CONDITIONER 3-15 TON X $20 - 27 AIR CONDITIONER 15-30 TON X $25 - 28 AIR CONDITIONER 30-50 TON X $35 29 AIR CONDITIONER +50 TON X $60 30 LPG STORAGE TANK - X $10 - 31 WOOD OR PELLET STOVE/INSERT - X $10 - 32 WOOD STOVE-FREE STANDING - X $25 SUBTOTAL: Zp,II J PLUS PROCESSING FEE: $35.00 METHOD OF PAYMENT iiilliiiy, I TOTAL PERMIT FEE DUE S c, VI/ 0 CASH 0 CHECK ® MOM 0 L__.." -_-.1 `:.' DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Q4.; o 2 o 11 > z •�' 0 m rn a -moo w e m 1 WOOD WAR© I 1� C m r 1 culla t� t7 I til i3 I r c a 7 ___ L• ..11 ZP7, T -4)- ° A in 6„ 1 • N __________ / V ' $ y i w w 73 . N a` z . 1 z 1 zz / il . m ❑g 0 m 1 `irrr �m iiia •W„.." G Z C k' I.k1 RI r- 1 ?._ .. 1 4 m 1 w 6i i '°(/'. W f p z LO 04 It" .... ---1.--0 1%T tot - z m I n �. , m coLA e, m ..1 3 t 03 Cn S..I X i \ /1- O to o ' P (14 6I 0me n .. I 0 i CP // • ; r E Z 0 0 1 cnX 0 In \ .. o m m p t a0> r X i z , • • � ooZ y z O me^ • mmw .. >o srm \---..re,- i��- iii -iii = .� ti o ("inc,.! mm m `� N ❑ ❑ 0 z . • 0 o •N z, o 4 ; p w ❑ N G '9 gal 0 0 N .5 O Q W o �❑m Z 0 azc�ao 4' ❑❑❑ �l � 0 0 a w �0 \ 0,�, pi� � D Z z ❑ FZ a -4 n n n ❑ _ Z � v_ c r > o 8 8 8 m 0 D p M i c A 4 ; p n D m §.G 0 -4 z 7 .� Az o p c m al -< -< zz � gag.. ZmZEo � ? m mo o> No �ZED < 4 o z 03 2 9 - lit a A -4 3,3 ,0 F., m..., A r73-a Z 401, m x) 0 1 z y m z rn rn mD 13 9 z m2Ioo ' m - O o 0m (1) 1 N F' APPROVED BY ` S Client GAS Pool Spa ❑ Deluxe model Return Appointment -Coping - Water -Coping Water Feature ❑ acia Decking Bar • Stools • Table ❑ Fire Pit * BBQ ❑ O 2003 All rights reserved. Pool World • Spokane, WA • 99216 WA Contractor POOL WORLD Registration #P0-OL-W]*241CP 13524 E Sprague Ave Re Pubiic Works Contractor Registration #13698-A-4(47) Spokane, Washington 99216 (509) 928-6585 • Fax (509) 928-9469 www.poolworld.biz• e-mail: ted@poolworld.biz