HomeMy WebLinkAboutPermit M05-049 - LU RESIDENCELU RESIDENCE
14114 55 AV S
M05-049
Parcel No.: 3365900143
Address: 14114 55 AV S TUKW
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
Contractor
doc: IMC- Permit
City Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
LU RESIDENCE
1411455 AV S, TUKWILA WA
LU 3ASON DUNG M
14114 55TH AVE S, TUKWILA WA
ANDY TRAN
8136 5 AV SW, SEATTLE WA
TRANSON'S HOME
151 SW 100 ST, SEATTLE WA
License No: TRANSH *960M3
MECHANICAL PERMIT
DESCRIPTION OF WORK:
NEW GAS FURNACE AND ASSOCIATED DUCTWORK FOR NEW ADDITION.
Value of Mechanical: $3,500.00
Type of Fire Protection: SMOKE ALARMS
Furnace: <100K BTU 1
>100K BTU 0
Floor Furnace 0
Suspended /Wall /Floor Mounted Heater 0
Appliance Vent 0
Repair or Addition to Heat/Refrig /Cooling System.... 0
Air Handling Unit <10,000 CFM 0
>10,000 CFM 0
Evaporator Cooler 0
Ventilation Fan connected to single duct 2
Ventilation System 0
Hood and Duct 0
Incinerator: Domestic 0
Commercial /Industrial 0
Fees Collected: $201.56
International Mechanical Code Edition: 2003
EQUIPMENT TYPE AND QUANTITY
* *continued on next page **
M05 -049
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 206 229 -8898
Phone: 206 - 355 -8793
Expiration Date: 07/23/2006
Steven M. Mullet, Mayor
Steve Lancaster, Director
M05 -049
05/13/2005
11/09/2005
Boiler Compressor:
0 -3 HP /100,000 BTU 0
3 -15 HP /500,000 BTU 0
15 -30 HP /1,000,000 BTU.. 0
30 -50 HP /1,750,000 BTU.. 0
50+ HP /1,750,000 BTU 0
Fire Damper 0
Diffuser 0
Thermostat 1
Wood /Gas Stove 0
Water Heater 0
Emergency Generator 0
Other Mechanical Equipment 0
Printed: 05 -13 -2005
Permit Center Authorized Signature:
I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws
regulating construction or the oLwork. I am authorized to-sign and obtain this mechanical permit.
Signature:
doc: IMC- Permit
City Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
7
Print Name: \ G�
A)(ZD
. V
This permit shall become null and void if the work is not commenced. within 180 days from the date of issuance, or if the work is
suspended or abandoned for a period of 180 days from the last inspection.
M05 -049
Steven M Mullet, Mayor
Steve Lancaster, Director
Permit Number: M05 -049 z.
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Issue Date: 05/13/2005
Permit Expires On 11/09/2005
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Printed: 05 -13 -2005
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the 2
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3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to in_ d
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
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4: All construction shall be done in conformance with the approved plans and the requirements of the International W
Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. o
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5: Manufacturers installation instructions shall be available on the job site at the time of inspection. o f-
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6: Ventilation is required for all new rooms and spaces of new or existing buildings and shall be in conformance with the ♦-
International Building Code and the Washington State Ventilation and Indoor Air Quality Code. g_ z
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Parcel No.: 3365900143
Address: 14114 55 AV S TUKW
Suite No:
Tenant: LU RESIDENCE
1: ** *BUILDING DEPARTMENT CONDITIONS * **
Building Official.
PERMIT CONDITIONS
Permit Number: M05 -049
Status: ISSUED
Applied Date: 04/08/2005
Issue Date: 05/13/2005
7: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms,
bathrooms, toilet rooms, storage closets, surgical rooms.
8: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE
GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that
the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests.
9: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum
distance of 4- inches shall be maintained above the controls with the strapping.
10: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Department of
Public Health - Seattle and King County (206/296- 4932).
11: All electrical work shall be inspected and approved under a separate permit issued by the Washington State Department
of Labor and Industries (206/248- 6630).
12: VALIDITY OF PERMIT: The issuance or granting 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 building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
doc: Conditions
* *continued on next page **
M05 -049
Printed: 05 -13 -2005
The granting of this permit does not presume to give authority to violate or cancel the provision of any
regulating construction or the performance of work.
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions
governing this work will be complied with, whether specified herein or not.
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431-3670
doc: Conditions M05-049
of law and ordinances
other work or local laws
Printed: 05-13-2005
CITY OF TUKWILA
Community Development , ?artment
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
King Co Assessor's Tax No.: ' . fir. • j c: % CL
Site Address: k/. / / el S C /4 P "',- . c /,-ti t Suite Number:
Tenant Name: L(! • "•l iDEA1Cf New Tenant: ❑ .... Yes
Property Owners Name :..> f1S• , in _ !) i. h c') / -t 2 . . . t._ — e l 7 ' A / AriA 1) i ) & (-
Mailing Address: /./.:t // ['l (,• >4 t - . c / E / -._ (. -,a
City State
Name: A 11 d. 1 r ri i
Mailing Address: , .� . . :, ` /4 /277.
E -Mail Address:
Mailing Address: 2.s /.Z ' (-) 2 /? c•,
`.J
Contact Person: riS 1:j':' /' i2 CD Li r. .
E -Mail Address:
Company Name: i
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
* *Please Print **
e-ORD -:All Oa
Mailing Address: 2 2 2 C 1 h
Contact Person: ' % ,'--/
%permits plualicc chengea'permit application (7.2004)
Page I
Building Perm' 'o. 1)0 5 13
Mechanical Permit No. (V? (95 ¥�
Public Works Permit No.
Project No.
(For office use only)
Floor:
❑ ..No
Zip
Day Telephone( ..G 2 2- c 7
City State Zip
Fax Number:
GENERAL CONTRACTOR INFORMATION - (Mechanical Contractor information on back page)
Company Name:
Mailing Address:'
Zip
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
AREHITEO';
Company Name:
t be wet stamped by Architect of Record
;47/ 2= e- l4. '/
City
State
Day Telephone.6 ;7 )
Fax Numbe(t7 s> 70. 7
State
Zip
ENGINEER OF RECORD — All plans must be wet stamped by Engineer of Record
City
Day Telephone:
E -Mail Address: Fax Number:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
Air Handling Unit >10,000
CFM
Fire Damper
0 -3 HP /100,000 BTU
Furnace >100K BTU
Evaporator Cooler
Diffuser
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan Connected
to Single Duct
Thermostat
15 -30 HP /1,000,000 BTU
Suspended/Wall/Floor
Mounted Heater
Ventilation System
Wood/Gas Stove
30 -50 HP /1,750,000 BTU
Appliance Vent
Hood and Duct
Water Heater
50+ HP/I,750,000 BTU
Repair or Addition to
Heat/Refrig/Cooling
System
Incinerator - Domestic
Emergency
Generator
Air Handling Unit
<10,006 CFM
Incinerator — Comm/Ind
Other Mechanical
Equipment
Y
tic - /..-., c vlc
MECHANICAL PERMIT INFORMATION - 206- 431 -3670
MECHANICAL CONTRACTOR INFORMATION
Company Name: t c'r --:•‘ ,. i • cy ' /I e L' /3/ !' / e - s.'/
Mailing Address: /CHIC "s' 2. /G• ' / ' r Ac .',.- •S /__, S , 7 " L�� (L., , '2' / - 1 Ci G_
City State Zip
Contact Person: :S"4 -r,. - ) • Day Telephone: .%:". _.s' .-- '.2 c':
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Valuation of Project (contractor's bid price): $ .> G
Scope of Work (please provide detailed information):
^,, r 7 L /
/ " -- r') fi:. /..54.) - ;)�, CS C
!!i i7
Use: Residential: New .... ff Replacement ❑
Commercial: New .... ❑ Replacement ❑
Fuel Tvpe: Electric ❑ Gas ....0 Other:
Indicate type of mechanical work being installed and the quantity below:
[ APPLICATION NOTES - Applicable to all permits in this application
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as
defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR AU RIZED AGENT:
Signature: c , ti 4�.
e r
Print Name: ."Th 5~ c , 11 / . - 7 - "A ,4 / 2 L`_
Mailing Address: / /
Date Application Accepted:
d' _c'-,
%permits plualice changestpermit application (7.2004)
Date Application Expires:
Page 4
Date: e,/ /4.,
Day Telephoned ?.- -, E:) : J— - • f F
L; . ��: es/ 9:)-7-6
- City State Zip
Staff initials:
'24u4.`y jn .:
il:a .Ki:ak:t;iit v idivsziii i.: iw.. i..rri:0J;. Fs3> 'ii'�teik,a
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3365900143
Address: 14114 55 AV S TUKW
Suite No:
Applicant: LU RESIDENCE
RECEIPT
Receipt No.: R05 -00686 Payment Amount: 167.25
Initials: BLH Payment Date: 05/13/2005 01:11 PM
User ID: ADMIN Balance: $0.00
Payee: JENNY THI DANG
TRANSACTION LIST:
Type Method Description
Amount
Payment Check 1359 167.25
ACCOUNT ITEM LIST:
Description
MECHANICAL - RES
Account Code Current Pmts
000/322.100 167.25
Permit Number: MO5 -049
Status: APPROVED
Applied Date: 04/08/2005
Issue Date:
Total: 167.25
3133 05/13 1 716 TOTAL 1694.55
Printed: 05 -13 -2005
Parcel No.:
Address:
Suite No:
Applicant:
Receipt No.:
Initials:
User ID:
Payee:
ACCOUNT ITEM LIST:
Description
3365900143
1411455 AV S TUKW
DUNG RESIDENCE
R05 -00495
SKS
1165
JASON DUNG M. LU
TRANSACTION LIST:
Type Method
Payment Check
PLAN CHECK - RES
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Description
1533
RECEIPT
Account Code
000/345.830
Permit Number:
Status:
Applied Date:
Issue Date:
Payment Amount: 34.31
Payment Date: 04/08/2005 09:26 AM
Balance: $167.25
Amount
34.31
Current Pmts
34.31
Total: 34.31
M05 -049
PENDING
04/08/2005
1914 04/11 9710 TOTAL 34.31
Printed: 04 -08 -2005
Project: . i
1...- 12e5 IC1 eoc,,e•
Type of Inpection:
1--- AJ m- /
Address: -
10/ 55 Au .
Date Call :
4-
Special Instructions:
Date Wpied:
_-- a.m.
p.m.
Requester:
Phone No:
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
•
•
1-1
INSPECTION RECORD
Retain a copy with permit
PER
(20
-3670
' proved per applicable codes.
EJ Corrections required prior to approval.
COMMENTS:
PC tc4e
(V.— TO 1--1 ki 4- (
Date:
2 0<
REINSPECTION FEE RQUIRED. Prioi to Inspection, fee must be
6300 Southcenter Blvd. Suite 100. 11 to sechedule reinspection.
'Date:
4
Pr ject t n ^ 'dp
Type of inspecri
Ad res
1
Date Called: - os
Special
ructiorls:
Date Wanted: 0/05 ,..-
m.
Requester: /
Ph "U') „ag
1
Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PER MR NO.
(206)431 -3670
C orrections required prior to approval.
COMMENTS:
Inspe tsr:
(A 4An f--.
. $ GC
i
.00 REINSPECTION FE REQUIRED. P$
d at 6300 Southcenter B vd., Suite 1
t No.:
Dat
or to inspection, fee must be
. Call to sechedule reinspection.
'Date:
Prte 2: A.e4 ••
s 1 i i t
Type pat n7 /
Address:
.),
Pate Called:L / ,.._.
v.. O..,
Sp cial I structiohs:
Date Wantedtp a:m.
Requester: i
INSPECTION RECORD
Retain a copy with permit (
INSPECTION NO. PER NO
"CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 _.(206)431-3670
pproved per applicable codes.
Corrections required prior to approval.
COMMENTS:
I spe Dat
r ec t No.: 'Date:
.00 REINSPECTION EE REQUIRED Prior to inspection, fee must be
at 6300 Southcenter Blvd., Suite 00. Call to sechedule reinspection.
Proj ct:
.--t. I>
T of Inspection: -
r
',
�r .,
S
a °
D te C led
• a �� ^�
W
S cia I s uct
ns: -
Date Want a.m.
fo c .m.
Requester:
chq5eAo 2 4 ; . l i sf q, ,gs q w
INSPECTION RECORD
Retain a copy with permit I
INSPECTION NO. PERM
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Approved per applicable codes.
._J
COMMENTS:
Inspe tor: Date:
l e t e t n cA ,v � (n — 2 8 `o'
.00 REINSPECTIO FEE REQUIRED. P or to inspection, fee must be
I at 6300 Southcen er Blvd., Suite 1 Call to sechedule reinspection.
No.: JDate:
orrections required prior to approval.
Project Name:
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Site Address: ! 1)
RESIDENTIAL HEATING AND VENTILATION COMPLIANCE FORM
(Complete Sections I and II for Group R Occupancies 4 Stories or Less)
"G
MECHANICAL PERMIT APPLICATION NO.: / D-5
J 4Sa tJ $'
s S_41, 3{ 4,4
I. WASHINGTON STATE ENERGY CODE HEATING DESIGN METHOD (select A, B or C blow):
A. ❑ System Analysis — W.S.E.C. Chapter 4 (submit documentation)
B. ❑ Component Performance Approach — W.S.E.C. Chapter 5 (submit documentati n)
C. ❑ Prescriptive Option — W.S.E.C. Chapter 6 (for prescriptive, complete the following calculation):
House Square Footage (heated space): 1 } CS- City
FILE COPY
❑ Heating System Installed, (check system type below):
1. ❑ Electric Resistance
2. ❑ Electric (forced air)
3. Ei Other Fuels (gas, heat pump)
ftkifir
II. WASHINGTON STATE VENTILATION AND INDOOR AIR QUALITY CODE (select A or B below):
A. ❑ Ventilation by Performance or Design Method - W.S.V.I.A.Q. Section 302 (submit documentation).
B. ❑ Prescriptive Ventilation Options - W.S.V.I.A.Q. Section 303 (select one of the following):
1. ❑ Ventilation using Exhaust Fans (Section 303.4.1.)
❑ Exception for outdoor air inlets — Forced air heating system w /interior doors undercut'' Y2"
2. ❑ Ventilation integrated with Forced Air System (Section 303.4.2.)
3. ❑ Ventilation using Supply Fan (Section 303.4.3.)
4. ❑ Ventilation using Heat Recovery System (Section 303.4.4.)
❑ Prescriptive Minimum /Maximum Outdoor Air Calculation specified in Table 3 -2 (see reverse side of form).
1. House Square Footage: t C
2. House Number of Bedrooms: Z-
3. Required Outdoor Air Table 3 -2: Minimum - Go cfm
Effective: 7/1/02
tapplicalionslhealinp and ventilation system — form h.6 (7.2002)
Permit Center /Building Division:
206 - 431 -3670
Public Works Department:
206 - 433 -0179
Planning Division:
206 -431 -3670
BUILDING PERMIT APPLICATION NO.: Dd _Cr`/
Maximum -
qv
cfm
V.70-VIEWED FOR
I Cr n� f (ThiP'_l AiNCE
MAY 1 0 2005
X 20 BTU /h
= c23 , 3 6 0 Maximum BTU of Heating System Output
r; ru
APR 0 20Q5
MOSG-M
Floor
Area, ft2
Bedrooms
Maximum Length
Feet
2 or less
3
4
5
6
7
8
70
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
<500
50
75
65
98
80
120
95
143
110
165
125
188
140
210
; 7,;,:50.1- 1000'..
s,55 •
4r:83:''l
t`: =70' »-
:'r1 s
i8,5;4
;`:128: -
:':;100.
:450:.
:c11'5_-
'1:73:
> :130'i:
, :119.5:i
<
''
1001 -1500
,.., 6
90
75
113
90
135
105
158
120
180
135
203
150
225
.' 150 :; `,
.: 65 ::'
' :'.98.,
_780.
7 >t
:-7957,
`
,;1 :i
_;165::.'
::1'25':
;.188 : "'
;140 :,
;2710:.'
t;:155`T
:'%233;';
2001 -2500
70
105
85
128
100
150
115
173
130
195
145
218
160
240
':.4541; 30001° ''.
?.';75.; :
:::,1: S:
' x 90;•!
135 ,'
105 :,t
71.58;'
:`120':=
;'';180_
`135:::
';''203s`s
'c150?.
:225:y
71.165=:
! 248'
3001 -3500
80
120
95
143
110
165
125
188
140
210
155
233
170
255
zi,' i3501w4000 ,
:;; 85? .
s128"=
«
i ?,1.50:;''?
;1.1
`.1�7.3T
::1
0951
1451,
'2187;
}160.':
:175'
:2
4001 -5000
95
143
110
165
125
188
140
210
155
233
170
255
185
278
..:':5001.-6000 ` :.1105;`
"'15 ::.120.''
;:1.`80.1.
::%135 ° ^',';'203t;
' 150:
:.'
:465::
248
« .1'80`•
270'i
A 95
'7.293t:
6001 -7000
115
173
130
195
145 ''218
160
240
175
263
190
285
205
308
'..x:-7.001--8000` '
125'
:?i188:i
\14O
;521
:'455
,?
'1`7.01
.'255:
1.85;',::i:2'78}w
20011i
s 300x•
21'5'c'y3231.
8001 -9000
135
203
150
225
165
248
180
270
195
293
210
315
225
338
«`r 9000 f;
: 1'45 7
: 218;':
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` 24€i `
175s
e
':1:90. " `3'28
*205 ";•
x`3081^
,, *220`
;
. .
',. 53:
Fan Tested CFM
0 0.25" W.G.
Minimum Flex
Diameter
Maximum Length
Feet
Minimum Smooth
Diameter
Maximum Length
Feet
Maximum
Elbows'
50
4 inch
25
4 inch
70
3
'1,1" :?TiJt•t!;� I;f 71- 1
r .5 : T.4s !^
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50
6 inch
No Limit
6 inch
No Limit
3
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15
5 inch
100
3
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125
6 inch
15
6 inch
No Limit
3
s: .. a d s i .. ::
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, dam.
. <::3s;7 < <f. =�,��. :
TABLE 3 -2
VENTILATION RATES FOR ALL GROUP R OCCUPANCIES FOUR STORIES OR LESS
Minimum and Maximum Ventilation Rates: Cubic Feet Per Minute (CFM)
For residences that exceed 8 bedrooms, increase the minimum requirement listed for 8 bedrooms by an additional 15 CFM per
bedroom. The maximum CFM is equal to 1.5 times the minimum.
TABLE 3 -3
PRESCRIPTIVE EXHAUST DUCT SIZING
1. For each additional elbow subtract 10 feet from length.
2. Flex ducts of this diameter are not permitted with fans of this size.
w *y ,,
dbnsly p a d vei lil n s fn corm h-6 (7-2002)
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IMF• Y .1VS..•y,,,y/Inp K.rvn. - .r -. - -.. -. .. L..:.:i�..Isrc iy,�Ai
ACTIVITY NUMBER: M05 -049 DATE: 04 -08 -05
PROJECT NAME: LU RESIDENCE
SITE ADDRESS: 14114 55 AVENUE SOUTH
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # /before permit is issued
DEPA TMENTS: L��
Building ivision G ibk6
Fire Prevention
Public Works ❑
Documents /routing slip,doc
2-28-02
PERMIT COORD COP\
PLAN REVIEW /ROUTING SLIP
Structural
REVIEWER'S INITIALS:
PERMIT COORD COPY
Planning Division
❑ Permit Coordinator
DUE DATE: 05 -10 -05
0
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 04 -12 -05
Complete [ Incomplete ❑
Comments:
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS R9UTING:
Please Route ,L,Y�J( Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
Approved ❑ Approved with Conditions Not Approved (attach comments) ❑
Notation:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: