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APPLICATION FOR RECREATIONAL HEALTH FACILITY PLAN REVIEW <br />AME OF COMPLEX: Maat-c., IA5 b / ,2 v.e-tk <br />ADDRESS OF FACILITY: / LY° Ti4 cdtAck s CITY: CA (ZIP): <br /> <br />OWNER/DEVELOPER: <br />POOL CONTRACTOR: ikkskliv% <br />ADDRESS: 7-47 ( 1.-oc <br />All Pool plans must be on at least 18" x 24" paper, drawn to scale (min. 'A" per foot) <br />All Spa and Wading pool plans must be on at least 18" x 24" paper, drawn to scale (min 1" per foot) <br />OFFICE USE ONLY — BELOW LINE <br />Major remodeling <br />Minor remodeling <br />Minor remodel <br />(Single Equipment) <br />Miscellaneous Plan <br />Review (Additional copies) <br />New Construction <br />CHECK ONE: POOL SPA WATER PARK ATTRACTION WADING POOL <br /> <br />DCATION ON PREMISES: <br /> <br />I 2-05 c Lo` i <br />DESIGN Shape Dimensions /') )4. V' 2- Area — sq. ft. <br />Depth-shallow .9,04r j 2'o" Depth-deep &21qm <br />CALC: <br />Grade Break Material Finish type & color <br /> <br /> PHONE: <br />PHONE: cv L.//7 - <br /> <br />CITY: 4.1 bor.,,/e., VteikA (ZIP): <br />CAPACITY — GAL. 7-i Si 5-7 GPM REQUIRED Aftw• appvMAX BATHING LOAD <br />FILTER Mfg. Type VkkL\- 6 ','"-- (-I ci'v'd \ Model No. <br />Quantity e _ Total Area — sq. ft. (00 Ye '-'2-'Turnover Capacity GPM itiigic <br />PUMP Mfg. WO Model No. <br />H.P. to ‘-`k - f • Capacity - GPM vay ,-,v, 6—:9 70 1-4. • lAcle,,t; <br />JET PUMP Mfg. Model No. °I H.P.: GPM: <br /> <br />SANITIZER Type Mfg. 6Q:6u4AA fC -(0(30 Model No. <br /> <br />FLOW METER Mfg. Model No. <br />-LAN APPROVED BY: <br /> <br />DATE: <br />