HomeMy WebLinkAboutPermit M04-110 - WGW CONSTRUCTION - LOT 8WGW CONSTRUCTION
LOT 8
4220 S 116 ST
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Tenant:
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Owner:
Name:
Address:
Contact Person:
Name:
Address:
Value of Construction:
Type of Fire Protection:
doc: Mech
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3347400035
Address: 4220 S 116 ST TUKW
Suite No:
Permit Center Authorized Signature:
WGW CONSTRUCTION - LOT 8
4220 S 116 ST, TUKWILA WA
WGW CONSTRUCTION
329 NW 2 PL, RENTON WA
KEITH MENGES
329 NW 2 PL, RENTON WA
Contractor:
Name: W G W CONSTRUCTION
Address: 329 NW SECOND PL, RENTON WA
Contractor License No: WGWCOGW962JR
MECHANICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 425 - 246 -0740
Phone: 425 246 -0740
Expiration Date:04 /19/2006
DESCRIPTION OF WORK:
INSTALL FURNACE, WATER HEATER, AND ASSOCIATED DUCT WORK FOR NEW SINGLE FAMILY
RESIDENCE.
$0.00 Fees Collected:
Uniform Mechnical Code Edition:
M04 -110
12/07/2004
06/05/2005
$83.56
1997
Date: /2 - 0/
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 performance of work. I am authorized to sign and obtain this mechanical permit.
Signature: A)& c-7_ t ��
Print Name: ,gyp U 3 6Z f i S r
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.
M04 -110
Date: /a -0?-0
Printed: 12 -07 -2004
Building Official.
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3347400035
Address: 4220 S 116 ST TUKW
Suite No:
Tenant: WGW CONSTRUCTION - LOT 8
1: ** *BUILDING DEPARTMENT CONDITIONS * **
PERMIT CONDITIONS
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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 N d
start of any construction. These documents shall be maintained and made available until final inspection approval is w
granted. z
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4: All construction shall be done in conformance with the approved plans and the requirements of the International w
Code or International Residential Code, International Mechanical Code, Washington State Energy Code. ? o Building
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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 c
International Building Code and the Washington State Ventilation and Indoor Air Quality Code. u. ~O
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Permit Number: M04 -110
Status: ISSUED
Applied Date: 06/22/2004
Issue Date: 12/07/2004
5: Manufacturers installation instructions shall be available on the job site at the time of inspection.
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 **
M04 -110
Printed: 12 -07 -2004
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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.
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.
Signature:
Print Name:
,eo
vs 7
doc: Conditions
M04 -110
of law and ordinances
other work or local laws
Date: / —07 — b 7
Printed: 12 -07 -2004
.;1
Site Address:
Tenant Name:
Name:
E-Mail Address:
Company Name: ..—I
Mailing Address:
Company Name:
Contact Person:
E-Mail Address:
%applications\ permit application (3.2003)
3/200)
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
47-7-0 1/40.
Property Owners Name: Weir' W ‘0A15 Ti
Mailing Address:
Company Name: W
Mailing Address:___NAL,4
gxril 4a-a4-65
Contact Person:
E-Mail Address:
Contractor Registration Number:
**An original or notarized cop of current Washington
ARCHITECT OF RECORD :=..:4.11 plans inUit.beWit Record:
Contact Persotr.........—LaNI
ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record
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Mailing Address:Aii‘airrelt- / Z" th
6
4- /7
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Page 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**
=-&:■%0Voi
Suite Number:
New Tenant:
King Co Assessor's Tax No.: -; 003S
Floor:
II.. Yes D..No
.e/67/7 •YgdVer4Ig'' Day Telephone: C4Z 5 ) Z4(0 - 0740
Mailing Address: _XVI AtIV
City State Zip
Fax Number:
GENERAL CONTRACTOR INFORMATION .
Zoxi-row 1401- ggas
City tate Zip
Day Telephone:) 7fj4, - Q 1+0
Fax Number:
Expiration Date:
tate Contractor License must be presented at the time of permit issuance**
City State Zip
Day TelephoneQLS) ZSO
E-Mail Address: Fax Number:(41. zz-7-
rrr 4 rie .040/ Eweizirt lyz.9(
City I State
Day Telephone: (4Z-S) oz57,
Fax Number:
Valuation I* t.
tor's bid price): $
Scope of Work (please provide detailed information):
n } � • � y
Existing Building Valuatjon: $
Will there be new rack storage? ❑ ..Yes .. No if "yes ", see Handout No. for requirements.
Provide All Building Areas in Square Footage Below
1 Floor
2
fi
" Floor
3f Floor.:
Floors
Basement
Accessory Structure
Attached Garage
• Detached: Garage
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
Existing
61
Interior
Remodel
9
Addition to
Existing
Structure
lgo
New
Type of
Construction
per UBC
Type of
Occupancy per
UBC
PLANNING DIVISION: L
Single - family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) / Z46 04-
*For an Accessory dwelling, provide the following: j
Lot Area (sq ft): Ae. 2 Floor area of principal dwelling: Floor area for accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
0.. Sprinklers ❑ ..Automatic Fire Alarm
..None ❑ . Other (specify)
Will there be storage or use of flammable, combustible or h rdous materials in the building? 0 .. Yes ❑ ..No
If "yes", attach list of materials and storage locations on a se orate 8-1 /2 x 11 paper indicating quantities and Material Safety Data Sheets.
tapplications\permit application (3.2003)
3/2003
Page 2
:v..;iaad a;.
LIC: WORKS:PERMLT:IN - 1 RIVLATION 4 206 =433 =01
F i' - i�i. d k4.t� �1 k �br+�t F .si��f: Es „� c�i:`txi• ra .•L t.� dA a 4 ti 1 ''
Scope of Work (please provide detailed information): ! /0 ,5/44/6
Water District
❑ ...Tukwila ❑... Water District #125
❑ ...Water Availability Provided
Submitted with Application (mark boxes which apply):
❑ ...Civil Plans (Maximum Paper Size — 22” x 34 ")
❑ ...Technical Information Report (Storm Drainage)
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s)
Proposed Activities (mark boxes that apply):
❑ ...Right -of -way Use - Nonprofit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way
❑ ...Total Cut
❑ ...Total Fill
applications\ permit application (3.2003)
3/2003
cubic yards
cubic yards
❑...Sanitary Side Sewer
❑...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑...Permanent Water Meter Size... WO#
❑...Temporary Water Meter Size.. WO#
❑...Water Only Meter Size 9 1 WO#
❑ ...Sewer Main Extension Public Private
❑ ...Water Main Extension Public _ Private
Call before you Dig: 1- 800 - 424 -5555
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
❑ .. Highline
❑ .. Right -of -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
Page 3
❑ ...Renton
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑ ...Deduct Water Meter Size
'Please refer to Public Works Bulletin #1 for fees'and sheet.
Sewer District
❑ ...Tukwila ❑ ... ValVue ❑ .. Renton ❑ ...Seattle
❑ ...Sewer Use Certificate ❑... Sewer Availability Provided ❑ .. Approved Septic Plans Provided
❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department.
❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑ .. Maintenance Agreement(s) ❑...Hold Harmless
FINANCE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
❑ ...Water
Monthly Service Billing to:
Name:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
❑ ...Sewer ❑ ...Sewage Treatment
Day Telephone:
City
State Zip
Day Telephone:
City
State Zip
Unit Type: '...
Qty
Unit Type `
Qty
Unit Type:
Qty ,
Boiler/Compressor:
Qty
Furnace <100K BTU
/
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
15 -30 HP /1,000,000 BTU
Suspended /Wall /Floor
Mounted Heater
Ventilation System
30 -50 HP /1,750,000 BTU
Appliance Vent
/
Hood
Incinerator - Domestic
50+ HP /I,750,000 BTU
Heat/Refrig/Cooling
System
Air Handling Unit
<= 10,000 CFM
Incinerator – Comm/Ind
1y
E CHANICAIf PERMITR INFO_ .NATION: - ZO6- 431136
MECHANICAL CONTRACTOR INFORMATION
TrsO, **U'. c . L
Company Name:
Mailing Address:
City State Zip
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 **
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
Use: Residential: New .... to Replacement .... ❑
Commercial: New .... ❑ Replacement .... ❑
Fuel Type: Electric ❑ Gas .. Other:
indicate type of mechanical work being installed and the quantity below:
41T AP PLICATION: NOTES ` Applicable to' all pelt:ituits 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 P RIURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWN R OR THORIZED AGENT:
Signature ✓ t
Print Nam ..—O/y
Mailing Address:
Date Application Accepted:
Date Application Expires:
Staff Initials:
lapplicationatpermit application (3.2003)
3/2003
i7 �,� fi e,
Page 4
Date: , f /J t Yd l f
ot
Day Telephone: COO Z Z G
W4 Igo
City State Zip
ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3347400035 Permit Number: M04-110
Address: 4220 S 116 ST TUKW Status: APPROVED
Suite No: Applied Date: 06/22/2004
Applicant: WGW CONSTRUCTION - LOT 8 Issue Date:
Receipt No.: R04 -01637 Payment Amount: 83.56
Initials: BLH Payment Date: 12/07/2004 11:28 AM
User ID: ADMIN Balance: $0.00
Payee: EDMONDS PLAT LLC
TRANSACTION LIST:
Type Method Description Amount
Payment Check 5266
MECHANICAL - RES
PLAN CHECK - RES
RECEIPT
83.56
Account Code Current Pmts
000/322.100 66.85
000/345.830 16.71
Total: 83.56
12/0? 9716 TOTAL 30373.22
Printed: 12 -07 -2004
Project: } /�
otig , / c C. "d7(!s f / •211 /
Type of Inspection: •
I ,i1/A /
Address: 22d
/ /
`
Date Called: Z a �
Special Instructions:
Date Wanted: - „ 1 -
Li-- �7 _ v,5
a.m.
p.m.
Requester:
Phone No:
•
U.-
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206)431 -3670
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
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Date:
. 00 REINSPECTION EE REQUIR . Prior to inspection, fee must be
a id at 6300 Southcente Blvd., Su' 100. Call to schedule reinspection.
ceipt No.: 'Date:
Pr
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Jype of Inspec • rr:
2
Ad ess d
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S
ate Called:
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Spe ial Instructions:
Date Wanted:
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p .m
Requester:
D - 0 2
Phone No:
INSPECT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
40C
roved per applicable codes.
COMMENTS:
INSPECTION RECORD
Retain a copy with permit
PER
Corrections required prior to approval.
S ��--- 1-
Inspector
Date:
(206)431 -3670
O._,
El $58. 0 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
(Receipt No.:
'Date:
17
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Spell Instructions:
Date Wanted: L — a.in.
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Requester:
Phon `
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INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PER AU
.( A
(206)431 -3670
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
El $58.00 REINSPECf FEE RirQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
(Receipt No.:
'Date:
Project:
LGLc) CoYSa -.
Type nspection:,
ove - %
Address:
'1.)-r)0 11 le St
Date Called:
Special Instructions:
Date Wanted:
2 z 3 0 c
a,m._
(P.m
Requester:
Phone No:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
t' HO
(206)431 -3670
ISZ Approved per applicable codes. [] Corrections required prior to approval.
COMMENTS:
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Cow\ 014 --e c,vr,Q odroui -i
Inspector: ( A/Y\
Date: a 3 _ 0 5
Ei S47.00 REINSPECTION FEE REQUIRED. Prior to Inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
COMMENTS: I' r
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Date ailed: i /
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Date Wanted: ,
2- 4/$ /0
17
Requester: — au(
Phone No:
.(316 43
3(7
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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 NO.
(206)431-3670
Et
Corrections required prior to approval.
Inspector:
Date:
r )- /5 - 0 2-1
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
" paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
TOM ,101,143.4...107SP.,/,
Project Name:
A.
B. ❑
C.
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 Storie
• or Less)
0
ID .
1704- U9
MECHANICAL PERMIT APPLICATION NO.:
BUILDING PERMIT APPLICATION NO.:
Site Address: . . . X 2 2 0. s . : I ( . 7! ...
Pertlia Center /Building Division:
206 -431 -3670
Public Works Department:
206 - 433 -0179
Planning Division:
206 -431 -3670
PILE cop
Pen ni ,. AI..
• WASHINGTON STATE;ENERGY CODE HEATING DESIGM•METHOD (select A, B or C below):
System Analysis — W.S.E.C. Chapter 4 (submit documentation)
Comaonent 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): (170
X 20 BTU/h
❑ Heating System Installed, (check system type below):
1. El Electric Resistance '
2 ❑ Electric (forced air)
3. Other Fuels (gas, heat pump)
SE? 2 :3 2004
U kwiia
II. WASHINGTON STATE VE TILATION AND INDOOR AIR e U LITY' ca®4ibw):
_ ..331 ' = ". 1j. - rM 0 He ting System Output
CODE
3. Required Outdoor Air Table 3 -2: Minimum - P*4 cfm
Maximum - 1Z'2 cfm
Effective: 711102
tapplicationstheatinp and ventilation system — form h-6 (7 -2002)
bo+lIO
A ❑ Ventilation by Performance or Design Method - W.S. : 'c:Qnection 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 h"
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: (O1C2
2. House Number of Bedrooms: 3
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190
285
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308
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115
173
130
195
145
218
160
240
175
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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 irich
70 •
3
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• 50
6 inch
No Limit
6 inch
No Limit
3
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IN .W n
t•��:�t� t ,,., .fit
80
5 inch
15 .
5 inch
100
.. 3
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50
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125
6 inch
15
6 inch ,
No Limit
3
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4:044:4144,401110
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. -
1. For each additional e bow subtract 10 feet from length.
2. Flex ducts of this diameter are not permitted with fans of this size.
Effective:: 7/1/02
tapplicationsth.atinp and ventilation system - form h-6 (7.2002)
TABLE 3 -3
PRESCRIPTIVE EXHAUST DUCT SIZING
.:.+a: _ .. ....:,t -:.,,, «• + .,,:,., ::.:sv:aue:au .w:a.a:..■.'ti • " ::»�.cµwr+.+;:s,v:tr.:�✓
ACTIVITY NUMBER: M04 -110
PROJECT NAME: WGW CONSTRUCTION - LOT 8
SITE ADDRESS: SOUTH 116 STREET
DATE: 06 -22 -04
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # afterrbefore permit is issued
DEPARTMENTS:
�o s -( °`f
Building b ivision �j
Public Works ❑
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
Fire Prevention 12?
Structural
REVIEWER'S INITIALS:
Documents /routing sllp.doc
2.28.02
PERMIT COORD COPY
Planning Division
❑ Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 06 -2 04
Complete [ Incomplete ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS RO)ITING:
Please Route L j(J Structural Review Required ❑ No further Review Required ❑
Not Applicable ❑
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS: DUE DATE: 07 -2404
Approved ❑ Approved with Conditions L Not Approved (attach comments) ❑
PP PP ( )
Notation:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
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