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M03 -120
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 1422600110
Address: 3809 S 132 PL TUKW
Suite No:
Tenant:
Name: CASCADE GLEN - LOT 11
Address: 3809 S 132 PL, TUKWILA WA
Owner:
Name: DREAMCATCHER HOMES LLC
Address: 13407 51 AV W, EDMONDS WA
Contact Person:
Name: 3AY KEIROUZ
Address: PMB 1190, 13619 MUKILTEO SPEEDWAY, #P5
Contractor:
Name: 3 A K DEV & CONST CORP
Address: 13407 51ST AVE WEST, SEATTLE WA
Contractor License No: 3AKDECCO23NS
MECHANICAL PERMIT
Permit Number: M03 -120
Issue Date: 08/19/2003
Permit Expires On: 02/15/2004
Phone:
Phone: 206- 300 -6874
Phone: 206 - 300 -6874
Expiration Date:09 /04/2004
DESCRIPTION OF WORK:
INSTALL FORCED AIR HEATING SYSTEM W /GAS PIPING AND DUCT WORK FOR NEW SINGLE
FAMILY RESIDENCE.
Value of Construction: $4,500.00
Type of Fire Protection: NONE
Permit Center Authorized Signature:
doc: Mech
M03 -120
Fees Collected:
Uniform Mechnical Code Edition:
$83.56
1997
Date: e-/f- 3
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 cons '•nor the performanc- of work. I am authorized to sign and obtain this mechanical permit.
Signature: Date: 8,1(6
Print Name: ,t>L4..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: 08 -19 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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3: Plumbing permits shall be obtained through the Seattle -King County Department of Public Health. Plumbing will be = a uj
inspected by that agency, including all gas piping (296- 4722). z
4: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical z
work will be inspected by that agency (206- 835 - 1111). w
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5: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any p
construction. These documents are to be maintained and available until final inspection approval is granted. o
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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 v
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition). 0
z
Parcel
f-
Parcel No.: 1422600110
Address: 3809 S 132 PL TUKW
Suite No:
Tenant: CASCADE GLEN - LOT 11
1: ** *BUILDING DEPARTMENT CONDITIONS * **
PERMIT CONDITIONS
Permit Number: M03-120
Status: ISSUED
Applied Date: 07/24/2003
Issue Date: 08/19/2003
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
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
doc: Conditions
M03 -120
Printed: 08 -19 -2003
regulating construction or the performance of work.
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Print Name: V !/bl,ap
Date: / lb
M03 -120 Printed: 08 -19 -2003
Site Address:
Name:
Mailing Address:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registration Number:
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record
Contact Person:
E -Mail Address:
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 5outhcenter Blvd., Suite 100
Tukwila, WA 98188
c &'1 Z Z t — c_ h
Contact Person:
E -Mail Address:
■applicationr'permit application (3.2003)
3noo3
Page 1
New Tenant:
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**
❑ ... Yes
City State Zip
Floor:
King Co Assessor's Tax No.:
36a Sb CT t' (3z Suite Number:
Tenant Name: CY' .0 c ( T 11
Property Owners Name: C311►c
Mailing Address: % pat? 136 (0) 11 owJ e-e) "t>g 1c jj '&
City State Zip
❑ ..No
.CONTACT.PERSON .:
Day Telephone Z 6) 36 6 8 74
Fax Number: Qi 29 7Z { Zt*z 3 L-
GENERAL CONTRACTOR INFORMATION
City
Day Telephone:
Fax Number:
State
Zip
Expiration Date:
"An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance**
Company Name:
Mailing Address:
city
Day Telephone:
Fax Number:
State
State
Zip
ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
Zip
City
Day Telephone:
Fax Number:
�.'a:a.F;t•_• ",i`v', ;';��ix �i.: hL: a ir.:: v:: V� 29�; �'. rvkYa55�4f *.'ti � e,+..,.— .oa�...,�.m+++
Valuation of Project (contractor's bid price): S 1 1110. tl■ a Existing Building Valuation: S
Scope of Work (please provide detailed inforr ^'ion): C6AS1Q.�et I IS 0
Will there be new rack S torage? ❑ ..Yes No If "yes ", see Handout No. for requirements.
Number of Parking Stalls Provided: Standard:
a appliationepnmil application (3.2003)
t noot
Provide All Building Areas in Square Footage Below .. ;
Addition to
Existing
Structure
. Floor
3'a Floor
Floors thru
:Basement
Accessory
Attached Garage
Detached: Garage
Attached Carport.
Detached Carport
Covered Deck
Uncovered Deck
New
1 474
ray
1 5 7
110
Type of
Construction
per UBC
TYPe of
Occupancy 'per
UBC
wrl
PLANNING DIVISION: n
Single- family building footprint (area aft foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) UAL"
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): 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.
Compact: Handicap:
Will there be a change in use? (] ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ ..Sprinklers [..Automatic Fire Alarm []..None ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ ..Yes ❑ .. No
If "yes", attach list of materials and storage locations on a separate 8-1/2 x 11 paper indicating quantities and Material Safety Data Sheets.
Page 2
Scope of Work (please provide detailed information):
Water District
[...Tukwila ... Water District 1/125
[...Water Availability Provided
Sewer District
❑...Tukwila R.. ValVue ❑ .. Renton 0 ...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.
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
0 ...Construction /Excavation/Fill - Right -of -way
Non Right -of -way
...Total Cut km:, cubic yards
cubic yards
gl._ Total Fill f tt-0
❑...Sanitary Side Sewer
0 ...Cap or Remove Utilities
❑...Frontage Improvements
❑ ...Traffic Control
❑...Backtlow Prevention - Fire Protection
Irrigation
Domestic Water
❑...Permanent Water Meter Size...
❑...Temporary Water Meter Size..
...Water Only Meter Size
❑ ...Sewer Main Extension Public _
❑ ...Water Main Extension Public _
FINANCE INFORMATION
Fire Line Size at Property Line
0 ... Water
Monthly Service Billing to:
Name:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
tappliationdparmit application (3.2002)
3x2003
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
...Sewer
II 1
Call before you Dig: 1- 800 -424 -5555
.. • Abandon Septic Tank
.. ▪ Curb Cut
.. • Pavement Cut
.. • Looped Fire Line
WON
WON
WON
Private
Private
Page 3
0 .. Highline
❑ ...Renton
.. Geotechnical Report ❑...Traffic Impact Analysis
[] .. Maintenance Agreement(s) ❑...Hold Harmless
0 .. Right -of -way Use - Profit for less than 72 hours
0 .. Right -of -way Use — Potential Disturbance
0 .. Work in Flood Zone
0 .. Storm Drainage
Number of Public Fire Hydrant(s)
0...Sewage Treatment
City
City
.. • Grease Interceptor
0 .. Channelization
.. • Trench Excavation
.. • Utility Undergrounding
0...Deduct Water Meter Size
Day Telephone:
Slate
State
Zip
Day Telephone:
Zip
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <IOOK BTU
I
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Furnace> lOOK BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
Flour Furnace
Ventilation Fan
3
15 -30 HP/I.000,000 BTU
Suspended /Wall /Floor
Mounted Heater
Ventilation System
30 -50 HP /1,750,000 BTU
Appliance Vent
A
Hood
1
50+ HP /1,750,000 BTU
Heat/Refrig /Cooling
System
I
Incinerator - Domestic
Air Handling Unit
<= 10,000 CFM
Incinerator- Comm /Ind
MECHANICAL PERMITINFORMA i ION -206-431-3670
•
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City state Zip
Contact Person: _SY!?' K--€ t)Z Day Telephone: c bC)Qj. -e-o C
E -Mail Address: (�£ 1lleg• J Z ' .- L- doh Fax Number: q. 74 1 74 3 A ,
Contractor Registration Number: Expiration Date: 1
•
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): S
Scope of Work (please provide detailed information): 1 MT %t [ s4 t.ft.6 P4
1+w1r t v CL S y s 6
Use: Residential:
Commercial:
Fuel Type: Electric
4
New ...Kt Replacement ....E
New .... fl Replacement ....
0 Gas J Other:
Indicate type of mechanical work being installed and the quantity below:
PERMIT 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
detined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once.
1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TFIE 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 OWNE: • ; AUTHORIZED
Signature:
Print Name: 1•114"
Mailing Address: Salk. r t'A
Lpplicauanatparmit application (3.2003)
312003
Page 4
Date: 1/ la "I
Day Telephone: 266 6f5 7y
City
State Zip
Date Application Accepted: Date Application Expires: Staff 'fiats:
7-a--03 /— ZO-O
1,1
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Payee: DREAMCATCHER HOMES
I Payment Check 2254
I
ACCOUNT ITEM LIST:
Description
MECHANICAL - RES
PLAN CHECK - RES
RECEIPT
Parcel No.: 1422600110 Permit Number: MO3-120
Address: 3809 S 132 PL TUKW Status: APPROVED
Suite No: Applied Date: 07/24/2003
Applicant: CASCADE GLEN - LOT 11 Issue Date:
Receipt No.: R03 -01019 Payment Amount: 83.56
Initials: SKS Payment Date: 08/19/2003 02:32 PM
User ID: 1165 Balance: $0.00
TRANSACTION LIST:
Type Method Description Amount
83.56
Account Code Current Pmts
000/322.100 66.85
000/345.830 16.71
Total: 83.56
!.730 00/20 9716 TOTAL 22A9.01
doc: Receipt Printed: 08 -19 -2003
.
147 ect: 4 t 0 664-64 C71114 1/
Type of Ins mkt!):
.......-1
, ;.......,
Adc , tesF e l C 13z 1 d 1 1
r I t
Date CaIIe .
a.?
SpeciPinstructions:
Date Wanted:
•
Requester: A ji
c......
Phpeisl
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
15 Approved per applicable codes.
PER
(20.)431-3670
El Corrections required prior to approval.
COMMENTS:
6e7N-,
1\
Date:
$4 .00 REINSPECTION FEE REQUIAD. Prior to inspection, fee /
must be
pa ld at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
(Receipt No.:
'Date:
. ••
.
sect: (
I
Type of Ins16ctiot :
(1
Ad S 1 1
Date Called
Sp cial Instru lions:
Date Wanted e, //� 6420
t � .
�
Requester: M ILK
�r
P hone o:
, n
oae . 4LX2
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
INSPECTION NO.
(V\ 03°-1Z81
PER
j
(206)431 -3670
J Approved per applicable codes.
COMMENTS:
vin � Hlfk1 Fl.e,��a " /ricnnu
Ins ctor
I c-u iCGt
Date; r2 ' /e4'
$47p0 REINSPECTION FEE REQUIRES! Prior to inspection, fee must be
pad at 6300 Southcenter Blvd., Suite 00. Call to schedule reinspection.
[Receipt No.:
Corrections required prior to approval.
Date:
f/g.
q�ect "` Pr C G _ la I 1
Type of In Sion: ‘401.V-1 - I i
_� "i
Addrr 6 ^ 5 ' 1 3 , t ql p/ i
Date Called: I S !
J D3
Special Instructions:
Date Wanted: Cam.. J 1 /O 3 p•m•
Requester:
Phone No
7 'e -730- - a .q(e�
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206)431 -3679
Approved per applicable codes. DCorrections required prior to approval.
COMMENTS:
1 V
uNJL/Li
>s k
i 9,, — A do ( A..-,
r
e4._4 /
Date:
//
47.00 REINSPECTION$EE REQUIRED. Pri r to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Callao schedule reinspection.
(Receipt No.:
Date:
Effective: 7/1/02
CITY OF 1 cJKWI LA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
FILE
Residential Heating and Ventilation Compliance Form
(Complete Sections I and II for Group R Occupancies n 4 n Stories or Less)
MECHANICAL PERMIT APPLICATION NO.: I D — (Z.D
BUILDING PERMIT APPLICATION NO.:
Project Name: S c � &T Lt ^ '� 1
Site Address: 3 8 6'' z j 1� L e-C^
I. WASHINGTON STATE ENERGY CODE HEATING DESIGN METHOD (select A, 13 or C below):
A. ❑ System Analysis — W.S.E.C. Chapter 4 (submit documentation)
B. ❑ Component Performance Approach — W.S.E.C. Chapter 5 (submit documentation)
C. I._i Prescriptive Option — W.S.E.C. Chapter 6 (for prescriptive, complete the following calculation):
House Square Footage (heated space): 3 a3
X 20 BTU /h
4,o2QM
Tl 0k 1\‘KO
❑ Heating System Installed, (check system type belo0
ximum BTU of Heating System Output
RECEIVED
ray (IF st IKWILA
1. 0 Electric esistance
2. 1=1 Electric (forced air) WC3 • -
3. Other Fuels (gas, heat pump) i
II. WASHINGTON STATE VENTILATION AND INDOOR Al ' • UALITY CODE (select A or B below):
jut 2 4 2003
PERMIT CENTER
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' "
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 e 3
2. House Number of Bedrooms: L
3. Required Outdoor Air Table 3 -2: Minimum - cfm
Maximum - 65 cfm
Floor
Area, ft2
Bedrooms
Maximum Length
Feet
2 or less
3
4
5
6
7
8
25
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
.'-'501- 1000 :..:
''55:`
80:?:•'
'' .70'`°
;105:
•.85.
•128
100.
150
"115 "'
.173.
'130
195'
.145
.218
1001 -1500
60
90
75
113
90
135
105
158
120
180
135
203
150
225
-;', "1501 = 2000`.•
•`65'''
' :98 ::
: -''80
:.120.
'.95
143
1110"
:165..:'125
188•
.140.
210
.155
:233
2001 -2500
70
105
85
128
100
150
115
173
130
195
145
218
160
240
-'':'2501-3000: :`:
• ; 75'':-
'1 13 : ±
' ' 90;:
135."
. 105'
:158:
'..1120'
`180 :.
135`.
2034
, 150.
=225
165 -
. 248
3001 -3500
80
120
95
143
110
165
125
188
140
210
155
233
170
255
;. 3501= 4000- :''
':85`:
= x128
';1.00::.
x.150
115"‘
•: 195
.145`
218
:160 ":
:'240:
- 175
. :263
4001 -5000
95
143
110
165
125
188
140
210
155
233
170
255
185
278
'.:?.'
• 105'
158 -'
:'Y120. •
•:180
1357.
'103 , .:150.
1 225t
' 165"
. 248
'.180E:
','
-' 195 ••
'=293 -
6001 -7000
115
173
130
195
145
218
160
240
175
263
190
285
205
308
: :T, ?'7001:=8000,. ::
':'•125•
'188'
': ?140` :
-210,
7
' ;
1 70 :
':255;...185'.
`278:.
'200':
-300..:
215 '
-'323
8001 -9000
135
203
150
225
165
248
180
270
195
293
210
315
225
338
' °: ''
`:.145
;
':: :160:..:.240,'.
::..175:
-:263::::1'90`
.285 :. 205.:
.308.
.220.
:330.
:235":
''353:;
Fan Tested CFM
a 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
'50 ..
5'irich' .,
..
' <90..:
5 inch' , .
.. '.
1 100::,:; ;
.,3..
.
50
6 inch
No Limit
6 inch
No Limit
3
80:?:•'
'4 inch
NA' •
: 4 inch.
20. •
. 3'
80
5 inch
15
5 inch
100
3
80.1 . •
.
.:6 inch
.
..90 ,
'6 inch ..
No"Lirnit" .
.3
'.
100
5 inch'
NA
5 inch
50
3
•'100.
, .,.
. “,. .'i::'*6'•inch ...
I
,. :45.
?
t;' 6 inch . ,,
. No limit'
125
6 inch
15
6 inch
No Limit
3
' ” - 1125' '
':'
':7 inch .
70• ":.,
.....' 7 , inch '' . .. .
..
No Lirilit=':. ,
3 '
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 elbow subtract 10 feet from length.
2. Flex ducts of this diameter are not permitted with fans of this size.
Effective: 7/1/02
TABLE 3 -3
PRESCRIPTIVE EXHAUST DUCT SIZING
Dauments/routing slIp.doc
2-28-02
DEPARTMENTS:
t 41 ti441 AUX, a -fO3
Buirding Division J
Public Works ❑
I -ERM JT COORD ti f ,'
CO��
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: M03 -120
PROJECT NAME: CASCADE GLEN - LOT 11
SITE ADDRESS: 3809 S 132 PLACE
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #
DATE: 07 -24 -03
Revision # After permit Is Issued
j7,' ►- 7-260-03
Fire Prevention [�
REVIEWER'S INITIALS:
Planning Division
Structural ❑ Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 07 -29 -03
Complete 91 Incomplete ❑
Comments:
l�MI COMBO COPY
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire 0 Ping ❑ PW ❑ Staff Initials:
TUES /THURS R9UTING:
Please Route Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS: DUE DATE: 08 -25 -03
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: