HomeMy WebLinkAboutPermit M04-010 - CASCADE GLEN - LOT 16CASCADE GLEN —
LOT 16
3829 SOUTH 132 "0
PLACE
re 2,
00:
v) w;
u.
W O;
u..Q
lo
Oi
Z
2o
oN
o�.
= V
„F.;
ail Z`;
U =,
0F.". `
Z
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 1422600160
Address: 3829 S 132 PL TUKW
Suite No:
Tenant:
Name: CASCADE GLEN - LOT 16
Address: 3829 S 132 PL, TUKWILA WA
Owner:
Name: DREAMCATCHER HOMES LLC
Address: 13407 51 AV W, EDMONDS WA
Contact Person:
Name: JAY KEIROUZ
Address: 13407 51 AV W, EDMONDS WA
Contractor:
Name: 3 A K DEV & CONST CORP
Address: 13407 51ST AVE WEST, SEATTLE WA
Contractor License No: JAKDECCO23NS
doc: Mech
MECHANICAL PERMIT
DESCRIPTION OF WORK:
NEW HVAC SYSTEM WITH ASSOCIATED DUCT WORK FOR NEW 2430 SF SINGLE FAMILY
RESIDENCE
M04 -010
Permit Number: M04 -010
Issue Date: 02/27/2004
Permit Expires On: 08/25/2004
Phone:
Phone: 206 300 -6874
Phone: 206 - 300 -6874
Expiration Date:09 /04/2004
Value of Construction: $4,200.00 Fees Collected: $83.56
Type of Fire Protection: N/A Uniform Mechnical Code Edition: 1997
Permit Center Authorized Signature: e l (�- Date: a, /,a i/0 cj
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 constructi r -t - performance of wor am authorized to sign and obtain this mechanical permit.
�► = .( - '7 /6z
Signature: Date: )
Print Name: c, 1 4 4 �
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.
Printed: 02 -27 -2004
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 1422600160
Address: 3829 S 132 PL TUKW
Suite No:
Tenant: CASCADE GLEN - LOT 16
PERMIT CONDITIONS
Permit Number: M04 -010
Status: ISSUED
Applied Date: 01/21/2004
Issue Date: 02/27/2004
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: Plumbing permits shall be obtained through the Seattle -King County Department of Public Health. Plumbing will be
inspected by that agency, including all gas piping (296- 4722).
4: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical
work will be inspected by that agency (206- 835 - 1111).
5: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any
construction. These documents are to be maintained and available until final inspection approval is granted.
6: Any exposed insulations backing material shall have a Flame Spread Rating of 25 or less, and material shall bear
identification showing the fire performance rating thereof.
7: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition).
8: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations 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 ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
code shall be valid.
9: Manufacturers installation instructions required on site for the building inspectors review.
10: Ventilation is required for all new rooms and spaces of new or existing buildings in conformance with the Uniform
Building Code and the Washington State Ventilation and Indoor Quality Code, Chapter 51 -13 WAC.
11: Fuel burning appliances may not be installed in sleeping rooms, U.M.C. 304.5.
12: Appliances which generate flame, spark or glowing ignition, shall be elevated 18 inches above the floor (U.M.C.
303.1.3.).
13: Water heater shall be anchored to resist earthquake (U.P.C. 510.5).
I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local laws
doe: Conditions
M04 -010
Printed: 02 -27 -2004
r.
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
regulating construction or the performance of work.
Signature: Date: 0/Z 7/0 9
Print Name: (ilt 7'�� ��= ` e
doc: Conditions
M04 -010
Printed: 02 -27 -2004
Site Address:
Tenant Name: (. 0 t c _ .
Property Owners Name: r f><4� {� i C`ty��`r: (''f-6 c :>
Mailing Address: M ?> tn •'7 I ` A.;;..,=
City
Name:
Mailing Address: 1 t'••1. c=
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Et;CHIT.EGT1
Company Name:.
Mailing Address:
CITY OF TUKWIL4
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100.
Tukwila, WA 98188
F; RECQRDrAfls pe
. rl1 � it sl•u` r`
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
teooliultonitnermtt anniirnrinn 11.7M11
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 **
La:l ti :{t�'�..ii',t'k'1}twYi:• "!''�sr
siT r ,
re e c '.t`E; 1 . t}P , � > r' f � 1 ktx!S•xi: }: x a:t r v '�1 N 5" i
' fSii�a :.,a.,Cts,� :rer T�:t •,'eY;`. : ?:ti:�;<t' <�¢
King Co Assessor's Tax No.: 14 Z: v i
Y" L.IN C. t= Suite Number: Floor:
L.[
�'Arehit vf;i[tecor
New Tenant: D .... Yes [] ..No
L 0
State
C :1) t ei d p
Zip
Day Telephone: ( ) ; F, 6 .74
City State Zip
Fax Number: / '7. t -,) 71, '7 t'l L
;� r�'Fs ?�y K - 4 "3��i '�i ; i S;'f`�
:qtr d;lo� +�. °S.ai!�•... ..:Y'+,..�u � :�!':�:: »Y1'
vF�JOI . .
City State Zip
Day Telephone: C'Zz
Fax Number:
g 3 Expiration Date: ' /L / e.- C}r.:i-
Contractor Registration Number: .� A �. • liL - ` !`C.- c � � 3 : �:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
City
Day Telephone:
Fax Number:
Stale
Zip
=Nr1
City
Day Telephone:
Fax Number:
State
Zip
.Un%t'TYpe <_
Qh
;Unit.Type: ': . •,:;- ;
.Qty
':Unit.:Type :�< .
.Qty
'.Boiler /Compressor .-
Furnace <100K BTU
BTU
t
(
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Furnace>100K BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan
Ll
15 -30 HP /1,000,000 BTU
Suspended /Wall/Floor
Mounted Heater
Ventilation System
30 -50 HP /1,750,000 BTU
Appliance Vent
Hood
i
50+ HP/1,750,000 BTU
Heat/Refrig/Cooling
System
Incinerator - Domestic
Air Handling Unit
<= 10,000 CFM
Incinerator — Comm/Ind
MECHANICAL CONTRACTOR INFORMATION
Company Name: \) A le.. i 1 '-`1 L
Mailing Address: < 77; } tt-
Contact Person:
E -Mail Address:
City State Zip
Day Telephone: (^�.� %�) 3 Q_: r.': e,
Fax Number:
Contractor Registration Number: ,..57L\ t7 C- C L� Z /�_`� Expiration Date: e- Li /
* *An original or notarized copy of current Washington State Contractor License must be presented at t e time of permit issuance **
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information): A) E 1..v 1I \.) A e_
Use: Residential: New ....®' Replacement ....❑
Commercial: New .... ❑ Replacement .... ❑
Fuel Type: Electric ❑ Gas ....(' Other:
Indicate type of mechanical work being installed and the quantity below:
It - 4 MITAPP,Fil TI, NOT '=
4g-6.
ii S..a: , ::;N:: '• .a ` �. t��y:e�... r %. T.�.M
Mailing Address:
Date Applicat7o ccepted:
/ /-O
City
I Date Application Expires:
State Zip
Staff Initials:
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 I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER O AGENT:
Signature: ,C - Date: 1 / -Z
(
Print Name: 1 t-t - Day Telephone: (4 6 3 C- t, C ti Lt-
i
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.: 1422600160 Permit Number: M04 -010
Address: 3829 S 132 PL TUKW Status: APPROVED
Suite No: Applied Date: 01/21/2004
Applicant: CASCADE GLEN - LOT 16 Issue Date:
Receipt No.: R04 -00243 Payment Amount: 83.56
Initials: LAW Payment Date: 02/27/2004 05:06 PM
User ID: 1630 Balance: $0.00
Payee: DREAMCATCHER HOMES LLC
TRANSACTION LIST:
Type Method Description Amount
Payment Check 2346
ACCOUNT ITEM LIST:
Description
doc: Receipt
MECHANICAL - RES
PLAN CHECK - RES
83.56
Account Code Current Pmts
000/322.100 66.85
000/345.830 16.71
Total: 83.56
9360 03/02 9716 TOTAL 194941.
Printed: 02 -27 -2004
CL
00
co 0
vow
• U.
w
u a
F =. w :
Z 0
113 Lij
0 N
W W '.
H
— 0
Z
U N
X.
z
tkis . ii: cad( Goa - Jo
Type of Insp On:
Fin 4
AV: s —,. ec9 1 0 pD/te
Called: 7 i,_t i Li
r
( &
Special Instructions:
Date Wanted: I 6 :011
f /.)._ /0 ( i p.m.
Requester:
. )a
ph0 (c 7 it
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
COMMENTS:
e ipt No.:
Approved per applicable codes. Corrections required prior to approval.
P-QA,,, (
-■•
Date:
'Date:
(20 )431-3670
.00 REINSPECTION E REQUIRED Prior to inspection, fee must be
d at 6300 Southcente Blvd., Suite 100. Call to schedule reinsmtion.
5
r ect:
g_rCdo (- - i
Type of Insp (ion:
V
4d ' ss: '
• -
/ /
ate Called:
• ec'.' " tr
ctions:
g ate Wante.
3
a.
Requester:
Ph l ft /i 0 ` ti LJ
GR - 7 1- 1 .-
t
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERM
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206 4 -3670
5 pproved per applicable codes.
7.00 REINSPECTION FE REQUIRED. P
paid at 6300 Southcenter BI d., Suite 10 .
Receipt No.:
O Corrections required prior to approval.
i6r to inspection, fee must be
Call to schedule reinspection.
Date:
COMMENTS:
(/) 7.,//u 4 6 f-e 6
' 1
Date:
- 30-
•
COMMENTS:
Type of InspQction:
Address:
���� y, /6 . P1
// i9 / o
L! /' m ;`AT / A/ ' C? / Pig t / -h/e. e (0 J - 7
/ � -cdio'
C/.' -� 4 a (/� ea .1 — r/ S
Date Wanted: a.m.
5 /7 -v4/ ca
2 - /9-430 tG
-Lc, /2 *Thf
/ 4 ✓
�Q"',O-
/.� -lg / l / u„' , .
I
1
1
Proj
P
Type of InspQction:
Address:
���� y, /6 . P1
Date Called:
/�
Special Instructions:
&' _
Date Wanted: a.m.
5 /7 -v4/ ca
Requester:
i
Phone No: 70 �96
a 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
PERMIT
( 206)4 1 -3670
Corrections required prior to approval.
Date:
?17 --O
$47.00 REINSPECT! ON FEE REQUIR D. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Sui a 100. Call to schedule reinspection.
Receipt No.:
Date:
Project Name:
Site Address:
A. ❑
B. ❑
C. El
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
RESIDENTIAL HEATING AND VENTILATION COMPLIANCE FORM
(Complete Sections I and II for Group R Occupancies 4 Stories or Less)
MECHANICAL PERMIT APPLICATION NO.: 4104 0/ 0
BUILDING PERMIT APPLICATION NO.: PC01 Ot
LC=
I. WASHINGTON STATE ENERGY CODE HEATING DESIGN METHOD (select A, B or C below):
System Analysis — W.S.E.C. Chapter 4 (submit documentation)
Component Performance Approach — W.S.E.C. Chapter 5 (submit documentation)
Prescriptive Option — W.S.E.C. Chapter 6 (for prescriptive, complete the following calculation):
House Square Footage (heated space): Z- Li v t7
X 20 BTU/h
'- g 0 Maximum BTU of Heating System Outpu
❑ Heating System Installed, (check system type below): CO OF TU'ttult
1. ❑ Electric Resistance APPROVED clTMnF71
2. ❑ Electric (forced air) FEB 2 5 200 AUTY 11 JAN 21 2
3. f � Other Fuels (gas, heat pump) tr,� i :v l �� n , PERMIT CEAITE
U. WASHINGTON STATE VENTILATION AND INDOOR AIR QUCODE (select A or B below):
A. ❑ Ventilation by Performance or Design Method - W.S.V.I.A.Q. Section 302 (submit documentation).
❑ 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'/"
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: 2 o-o
2. House Number of Bedrooms: 3
3. Required Outdoor Air Table 3 -2: Minimum -
Maximum -
Effective: 711102
tapplicalionstheatinp 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
cfm
cfm
FILE COPY
REC
KW11 n
Zc)y- ca Vero y -zva
Floor
Area, ft2
Bedrooms
, : s * , 's. ,?s..
% IX IFSs.
3
4
5
6
7
8
,&
'''•* '''`''
' Miri
ii1Oxic
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
.4 li
5
.75 41.t
65
98
80
120
95
143
110
165
125
188
140
210
,; .,t . VIdiKkli
Afty
100
*70.i!Y
005
s?;85''`;
028'
,:1:00
A1:50'
! ±1;1''S •g
"173:f
x•i130O.
4195.
-"fi 45' ='
?21.8:
1001 -1500
60
90
75
113
90
135
105
158
120
180
135
203
150
225
:..:150:1. -2000; ni
' 4$5'�'�
`98:•;
. 0
.'• ;k'
s. {95
t,;:143::.
AIM ,
�:465:g
A2M.
,.1'88?
f.:e1%10' >
?:'210'1:1.
..,156%
, !.:23V
2001 -2500
70 •
105
85
128
100
150
115
173
130
195
145
218
160
240
4; ..
hFa<��501= 3000�k, <.
'., ;t
.�75 ,:
,. ..'
i;�a13�
. ia•�
��i��90',�`=
j . :.?
.�7i35�i
'.f'05;-
j ', `
'. x'1:561 ,.
#;x20:.
r ,
�.tt'.1`80 <�
W i 1u
W1'35r:
}' 6
4�203t:
t it
'i�4'56.,'
"E,
•225'
t
L�16s4:.
rk
�248.n.
3001 -3500
80
120
95
143
110
165
125
188
140
210
155
233
170
255
=l£P 3501.- 4000:::x,'
. 435', r.
'1128 4
;100'
M50
ill
- f�173 9•
„%•30 `
-s4 951?
1,145,;
'2}8"x'
AttW.
i 240:+
; ` 7.S.:'i?
%263),,
4001 -5000
95
143
110
125
188
140
210
155
233
170
255
185
278
; ;y - 'lI
;,rj ?$.001:: 6000';u.�.<
:/
� {`105r
.'t1'S'S,r
G 1 ,
•��.120:, :
y 165
3
t 180E
,1'35'<
� rrQ
' !::'.:
.f- :20'3•.. •
L
�•1'S0 �
�
. '225,2
�rf`$5.;
1
: o
;✓2d8t
x::18'0 �
.'
lr 7
r Z'aa"h
410%i
! :
.; 29i
• 6001 -7000
115
173
130
195
145
218
160
240
175
263
190
285
205
308
7001 -800 'I...
•'125.-
`s1 88, <
' 1 ;40r
4161
OSV
!233 '
:3:110::
g. 255
485%
:WC ':
fi'200
'30D `.;
X 315
''21`5':'
. :'. 32 i
8001 -9000
135
203
150
225
165
248
180
270
195
293
210
225
338
, : : >;9000: °..';:
` ;1`4.5'•
ig218 a
160"
240`5'
``.1751
'`263 ?<
' 1 :900
'- 285:`s•
't205F
'3
•22
"330J,
1123 "5.:s
':',.',1
Fan Tested CFM
•. '@ 0.25" W.G.
Minimum Flex
Diameter
Maximum Length
Feet
Minimum Smooth
Diameter
Maximum Length
Feet
Maximum
Elbows'
50
4 inch
25
4 irich
70
3
� .•� l l+' : S•,
�.a.,:.rs� >,...50.
=t %`• t�':` �i i
;. :�,��,,.�...5inch <,..�. ✓
'' '; Yil
.,,,..a.�9o::< ., ..t
;�' .:M iG•�
..._.�,
A ' f
t�;:,:,>.,,.,...:.100�� :_,
` f. ..} F .
.:',�_,.•.:•v�.3�.. ,.�,- •:c:t,..
50
6 inch
No Limit
6 inch
No Limit
3
. { t
�,�_�;:�?,'�5�80, ��?�;�r:x?.r:
Z. 1 �.
��:�:;•4�iricfi, ��
�: 1 1�
` � cif. 7Y �l��i�j
te_.NA'7��� .
.<
♦Ir, � ;h nr: •J
�4,drith:�
�{� u � :.•�, "`i�t= fir,','•„
?.,• � �:, .Y
?e,�..i 20t...d
11: v: „ti' a t; 4! "1�:N
r.r:.� `^C.
�;,,, -;�:• 3:i:�.�. ...,M_
80
5 inch
15
5 inch
100
3
.�w f' { <KI,Z�h �
.: } i� ": +tti
>,.. •ts<�.80 Y_ :...:�. �:,r....
=::,; ...r1:'t::' r✓ , .4F. j rl Ce i•L
sFi <` , : �
�� =6arich d.... �; r;:
Y "� 5" � t
”. L' • , :i it'..i.
.N.1•
�: �. <:�, {4'. :i90`•:,�f:•�•:• '
ad .. :.5.' it t,r�.p .
:? t• <�1G r,.r��
.,•;:,... 6'�.iri ,•
..: ' _ "'r '. 'C.
K!l, 4'/, '�' >.
t ..,. z �t ,:.;
.. ",11'.4i` 4z.::: . �;: t •<
•r. l'4'� ��
�:k:.,.,.....3.r...�:.�,,, t
100
5 inch
NA
5 inch
50
3
• `7 :41, .. l: tom•{ :
:,�.t'��',�.k. *1.00.x �an�;1;,�•
1
�, C!'� .;11 t'
�r*!> �r i< �: li: iricN�:;, l_, �<.
�
:'?4 .-i,T: lw :ilh
. :.,. ;�• s•:.::�.�r(4 5 .- :�•:t.;r,;,,
..-i N' 4i3
�r� ,,:>� ,
t..l
:.1, '3' •,7i`i.
t•�a
,?s.: +_::No':Limif�?; -; a�
���s.�`'s�:t� 3: :ar.,,�:: ;:sr.,T
4. i t•N: `j iS 3 # ''
125
6 inch
15
6 inch
No Limit
3
°�ri. ':;(�� - •i { • .?;a�J� [ � `�•'tf. �V:'if �,t
�� p. ✓ , o- •, ,2:
w>,,' �': �` �:. �! 1�25t:.<. .K.r.::'��s'�r,<.,,x�7:irichs..� .�..<.i;
y 4 4fl•.'�^ .�:.`. } >� �i.'
.'
nt�.r...�> _,r7.0��t.. >,w ., ...,
f _. i
: ' C "r.'R'7 i�t <Y�: < •
x...,.._...fr7�incl�i%�......,a
. �.Xt ..,, 'n it:'
1.� .•J <,r �
�h:;:r: <.,_ Notl•'iinit��, - .,..
4 •::�: 1 ,.0 . ' �•P- ,
F .I ..�F..,.3•AI,: ' N•1r�5:Y. .
�,: _... ,.3,.._., err
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 fo 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.
,..... Zw�,:l in'lhai,.. .>.': 4.,.. 4 .. a.,..,..: •L...,.....+r�,.a`l.atlL;Li '.::.ours...- wa�a:u +.u'sLa.•.u�
ACTIVITY NUMBER: M04 -010 DATE: 01 -21 -04
PROJECT NAME: CASCADE GLEN - LOT 16
SITE ADDRESS: 3829 SOUTH 132 PLACE
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # • Revision # after /before permit is issued
DEPARTMENTS: �(
40(/ t -a '
Building Division [j
Public Works ❑
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
Fire Pre ion
Structural
DETERMIN N OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 01-22-04
ATI 27
Complete Incomplete ❑
APPROVALS OR CORRECTIONS:
REVIEWER'S INITIALS:
Documents /routing slip.doc
2 -28 -02
PERMIT COORD COPY
Planning Division
❑ Permit Coordinator
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS RO ING:
Please Route DI Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
DUE DATE: 02 -19 -04
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: