HomeMy WebLinkAboutPermit M02-027 - HALBERT RESIDENCEM02 -027
Halbert
Residence
4030 S 117P1
EX9RED
OCT 2 8 2002
Parcel No.:
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
City of Ttlikwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
7340600101
4030 S 117 PL TUKW
Address: ,
Contractor License No:
DESCRIPTION OF WORK:
INSTALL A NEW PROPANE POWERED FORCED AIRE FURNACE INTO ATTIC OF HOUSE.
Value of Construction: $2,000.00 Fees Collected: $56.94
Type of Fire Protection: N/A Uniform Mechnical Code Edition: 1997
Permit Center Authorized Signature:
HALBERT RESIDENCE
4030 S 117 PL, TUKWILA, WA
HALBERT JACK E+ JULIE L
4007 5 117 PL, TUKWILA WA
JACK HALBERT
4030 S 117 PL, TUKWILA WA
OWNER AFFIDAVIT ON FILE
MECHANICAL PERMIT
Expiration Date:
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 206 -439 -0352
Phone:
MO2 -027
03/05/2002
09/01/2002
Date: 0 2-
1 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 c ruction or the performance of work. I am authorized to sign and obtain this mechanical permit.
chn�_ c ti�b -3 S
Signature: ,�-�� Date: 1 / O
Print Name: ` ' ' -7t
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.
doc: Mech
MO2 -027
Printed: 03 -05 -2002
ACTIVITY NUMBER: MO2 -027
PROJECT NAME: JACK HALBERT RESIDENCE
SITE ADDRESS: 4030 SOUTH 117 PLACE
X : Original Plan Submittal
Response, to Correction Letter #
DATE: 02 -04 -02
Response to Incomplete Letter #
Revision # After Permit Is Issued
DEPARTMENTS:
£ qJ
Buildin 'vision 11 Fire Prevention
Public Works I I Structural U
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
TUES /THURS ROU ING:
Please Route Structural Review Required No further Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS: (ten days)
Approved n Approved with Conditions
CORRECTION DETERMINATION:
Approved
REVIEWER'S INITIALS:
\PRROUTE.DOC
5/99
11
PERMIT COORD Cp
PLAN REVIEW/ROU SLIP
Incomplete
Approved with Conditions
Not Approved (attach comments)
PERMIT COORD COPY
Planning Division
REVIEWER'S INITIALS: DATE:
DUE DATE
Not Approved (attach comments)
DATE:
Permit Coordinator
DUE DATE: 02-05-02
Not Applicable
DUE DATE 03 -05 -02
II
f
1
ACTIVITY: NUMBER: MO2 -027 DATE: 02 -04 -02
PROJECT NAME: TACK HALBERT RESIDENCE
SITE ADDRESS: 4030 SOUTH 117 PLACE
X Original Plan Submittal
_Response to Correction Letter #
Response to Incomplete Letter #
Revision # After Permit Is Issued
DEPARTMENTS:
Building Division
Public Works
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
TUES /THURS ROUTING:
Please Route
\PRROUTE.DOC
5/99
Approved n
PLAN REVIEW /ROUTING SLIP
n
REVIEWER'S INITIALS:
bit
n
Fire Prevention
Structural
Incomplete
APPROVALS OR CORRECTIONS: (ten days)
Approved n Approved with Conditions
REVIEWER'S INITIALS: Vi
CORRECTION DETERMINATION:
Structural Review Required
( (An—
n
Planning Division
Permit Coordinator
DUE DATE: 02-05-02
Not Applicable
Comments:
n No further Review Required
DATE:
DUE DATE 03 -05 -02
Not Approved (atta h co ments)
DATE: /2„ 5 02
DUE DATE
Approved with Conditions n Not Approved (attach comments)
REVIEWER'S INITIALS: DATE:
II
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PERMIT NO.: Mae -021 --�
MECHANICAL PERMIT APPLICATIONS
INSPECTIONS
❑ 2 Pre - construction
❑ 50 WSEC Residential
❑ 60 WA Ventilation/Indoor AQC
❑ 610 Chimney Installation/All Types
❑ 700 Framing
❑ 1080 Woodstove
❑ 1090 Smoke Detector Shut Off
1100 Rough -in Mechanical
1101 Mechanical Equipment/Controls
1102 Mechanical Pip /Duct Insul
1105 Underground Mech Rough -in
1115 Motor Inspection
1400 Fire - Final
1800 Mechanical - Final
❑ 4015 Special -Smoke Control System
0
0
0
CONDITIONS
10001 No changes to plans unless approved by Bldg
Div
10002 Plumbing permits shall be obtained through King
Co
10003 Electrical permits obtained through L & I
10005 All permits, insp records & approved plans
available
❑ 10014 Readily accessible access to roof mounted
equipment
10016 Exposed insulation backing material
10019 All construction to be done in conformance
w /approved plans
10027 Validity of Permit
10036 Manufacturers installation instructions required
on site
❑ 10041 Ventilation is required for all new rooms &
spaces
❑ 10042 Fuel burning appliances
❑ 10043 Appliances, which generate...
❑ 10044 Water heater shall be anchored....
Additional Conditions:
TENANT NAME: SC1/4)°";, n i
FEES
Basic Fee (Y/N)
Supplemental Fee (Y/N)
Plan Check Fee (Y/N)
Furnace /Burner
to 100,000 BTU (qty)
Over 100,000 BTU (qty)
Plan Reviewer:
Permit Tech:
Floor Furnace (qty)
Suspended/Wall/Floor - mounted Heater (qty)
Appliance Vent (qty)
Heating/Refrig/Cooling Unit/System (qty)
Boiler /Compressor
to 3 HP /100,000 BTU (qty)
to 15 HP /500,000 BTU (qty)
to 30 HP /1,000,000 BTU (qty)
to 50 HP /1,750,000 BTU (qty)
over 50 HP /1,750,000 BTU (qty)
Air Handling Unit
to 10,000 cfm (qty)
over 10,000 cfm (qty)
Evaporative Cooler (qty)
Ventilation Fan (qty)
Ventilation System (qty)
Hood (qty)
Incinerator - Domestic (qty)
Incinerator - Comm /Ind (qty)
Other Mechanical Equipment (qty)
Other Mechanical Fee (enter $$)
Add'l Fees - Work w/o Permit (Y/N)
Insp Outside Normal Hours (hrs)
Reinspections (hrs)
Miscellaneous Inspections (hrs)
Add'l Plan Review (hrs)
Date: _ /� #
2.
Date: - K' D
ACTIVITY NUMBER: MO2 -027
PROJECT NAME: IACK HALBERT RESIDENCE
SITE ADDRESS 4030 SOUTH 117 PLACE
X Original Plan Submittal
Response to Correction Letter #
DATE: 02 -04 -02
Response to Incomplete Letter #
Revision # After Permit Is Issued
DEPARTMENTS:
Building Division
Public Works
Please Route
Approved
\PRROUTE.DOC
5/99
PLAN REVIEW /ROUTING SLIP
n
n
n
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete Incomplete
Comments:
TUES /THURS ROUTING:
REVIEWER'S INITIALS:
CORRECTION DETERMINATION:
Fire Prevention
Structural
Structural Review Required
APPROVALS OR CORRECTIONS: (ten days)
Approved El Approved with Conditions
Approved with Conditions
REVIEWER'S INITIALS:
n
n
Planning Division
Permit Coordinator
DUE DATE: 02-05-02
Not Applicable
No further Review Required
DUE DATE 03 -05 -02
DATE: ZA LQ a a
Not Approved (attach comments) n
REVIEWER'S INITIALS: DATE:
DUE DATE
Not Approved (attach comments) n
DATE:
Project Name/Tenant: �,
t (
- tL.
Value of
echanicalauipment:
QO 0 • G p .
Site Address : X10 7 S t �� j��_
C ity State/Zip:
10K- )1�CI (A 14 clKIR'
Fax Parcel Number:
"73 ( - -l bi'o _ D(O(
Property Owner:` ^� s�L.tL
l
Address: t .,(4 ,- 1 . 0 5 1.) -tr r y
Phone:(,) �.c o
/ r
, ,� J Z _
Street Address: \ ' City State/Zip:
l 'a
13 05 47 L l—) 70140 C i C`1) C (a')61(
Fax #:
(.,)
�� 3 � t ' 0
Contractor:
Phone: (
)
Street Address:
City State/Zip:
Fax #: (
)
Contact Person:
Phone: (
)
Street Address:
City State/Zip:
Fax #: (
)
"BUILDING'OWNER'O THORIZED a:
Signature: G.c4,�
Date: g14,2_
Print name: J A,r l am.) ID—c- r--"1",
Phone: (Da:, ) L 13 cli e3 S,' Fax #: (fit,) L(3 9 ('
30
Address: t .,(4 ,- 1 . 0 5 1.) -tr r y
City/ State/Zip: .> ILI.V 1 t.c.1 LLB 7(145,..."
CITY OF T, . CWI LA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
SiAI I; USE ()NI Y
Project Number:
Permit Number:
o\ o 0 2 - O
Mechanical Permit Application
Application and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or facsimile.
ECHANICAL PERMIT ;REVIEWAND'APPROVALREQUESTED: (TO BE FILLED OUT BY APPLICANT)
Description of work to be done (please be specific):
.1 n a -14 l.. b C
0 V 0 r
•
Ur C' tql YL.
Current copy of Washington State Department of Labor and Industries Valid Contractor's License. If not available at the time of
application, a copy of this license will be required before the permit is issued OR submit Form H-4, "Affidavit in Lieu of Contractor
Registration ".
Building Owner /Authorized Agent: If the applicant is other than the owner, registered architect/engineer, or contractor licensed by the
State of Washington, a notarized letter from the property owner authorizing the agent to submit this permit application and obtain the
permit will be required as part of this submittal.
I HEREBY CERTIFY THAT 1 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.
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 114.4 of the Uniform Mechanical Code (current edition). No application shall be
extended more than once.
Date application accepted:
Date application expires:
Application taken by: (initials)
SkS
11/2/99
wed,peneh.doc
✓
Submittal Requirements
Floor plan and system layout
Roof plan required to identify individual equipment and the location of each installation (Uniform
Mechanical Code 504 (e))
Details and elevations (for roof mounted equipment) and proposed screening
Heat Loss Calculations or Washington State Energy Code Form #H -7
H.V.A.C. over 2,000 CFM (approximately 5 ton and larger) must be provided with smoke detection shut-
off and will be routed to the Fire Prevention division for additional comments (Uniform Mechanical
Code 1009).
Specifications must be provided to show that replacement equipment complies with the efficiency ratings
and other applicable requirements of the Washington State Nonresidential Energy Code.
Structural engineer's analysis is required for new and the replacement of existing roof equipment
weighing 400 pounds and greater (Uniform Building Code 1632.1). Structural documentation shall be
stamped by a Washington State licensed Structural Engineer.
Mechanical Permits
COMMERCIAL: Two complete sets of drawings and attachments required with application submittal
NOTE: Water heaters and vents are included in the Uniform Mechanical Code — please include any water
heaters or vents being installed or replaced.
RESIDENTIAL: Two complete sets of attachments required with application submittal
Submittal Requirements
New Single Family Residence
Heat Toss calculations or Form H -6.
Equipment specifications.
Narrative with specification of equipment and chimney type.
If using existing chimney, provide a letter by a certified chimney sweep stating that the chimney is in safe
condition:
11/2/99
miscpml.doc
Change -out or replacement of existing mechanical equipment
Narrative of work to be done, including modification to duct work.
Installation of Gas Fireplace
NOTE: 'Water heaters and vents are included in the Uniform Mechanical Code — please include any water .
heaters or vents being installed or replaced.
City of Tukwila
Parcel No.: 7340600101
Address: 4030 S 117 PL TUKW
Suite No:
Tenant: HALBERT RESIDENCE
Print Name:
doc: Conditions
L
PERMIT CONDITIONS
MO2 -027
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Number: MO2 -027
Status: ISSUED
Applied Date: 02/04/2002
Issue Date: 03/05/2002
1: ** *BUILDING DEPARTMENT * **
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
(248- 6630).
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 identi- fication
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 con- strued 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.
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
regulating construction or the performance of work.
Signature: �N--- �J�� -�` Date: .. 3I'0Z
Printed: 03 -05 -2002
Parcel No.: 7340600101 Permit Number: MO2 -027
Address: 4030 S 117 PL TUKW Status: APPROVED
Suite No: Applied Date: 02/04/2002
Applicant: HALBERT RESIDENCE Issue Date:
Receipt No.: R020000306 Payment Amount: 56.94
Initials: KAS Payment Date: 03/05/2002 02:06 PM
User ID: 1684 Balance: $0.00
Payee: JACK E. HALBERT
TRANSACTION LIST:
ACCOUNT ITEM LIST:
doc: Receipt
Current Pmts
Amount
Payment Check 5266 56.94
MECHANICAL - RES
PLAN CHECK - RES
City of 'Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Type Method Description
Description Account Code
000/322.100 45.55
000/345.830 11.39
Total: 56.94
.:545 03/07 9716 TOTAL 56.94
Printed: 03 -05 -2002
COMMENTS:
0 Z 4 A7 6 A 2 4-77 (5 P4-
(3 74 7 ..1 7
Date called:
Special instructions:
(4
,C.V') '47 e ...5- 0 6%, ,471/6
46 - d-a:A/ ___.4 Pi-& (
-ia7 - r ,-.)-t/
- \
Project:
1 117e r 1-
Type of Inspection:
/ pe/ P UC +— incui
Address:
H Oa° / ( 11
Date called:
Special instructions:
(4
DattyancL
P.m.
Requeiter:
..,1 C( C L
Phone:
/ .
r
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 (
IX Approved per applicable codes. Corrections required prior to approval.
6,2_9 ct
Date:
7.00 REINSPECTION E REQUIRED. 'or to inspection, fee must be paid
at 6300 Southcenter Blv ., Suite 100. C I to schedule reinspection.
Receipt No:
Date:
1')
,
. . • .
___________________
•
GAS FURNACE
stria
UGPH- SERIES
Mode's with Input Rates from
45,000 to 150,000 BTUIHR
rice m iut kun
SILHOUETTE II
80% A.F.U.E.t
UPFLOWi
HORIZONTAL
GAS FURNACES
FORM NO. G22-448 REV. 2
Supersedes Form No. 022-448 Rev. 1
The Ruud' silhouette° I line of upfiow/horizontal gas fur-
naces am designed for utility rooms, closets, alcoves, or
attics. Sarum of the Siboustle's low-profile 34 Inch
moit) height, the Imam model can also be used to
satisfy most applications that traditionally call for a
horizoM& furnace.
The design is certified by the American Gas Association.
Canadian models are certified by the Canadian Gas
Association.
Features
• Patented Turbulex• Heat Exchanger, constructed of both
stainless and aluminized steel for the maximum in corro-
sion resistance.
• Low profile "34 inch" design is lighter and easier to han-
dle, and leaves room for optional equipment.
• Convertible from upllow b horizontal left or right without
field Conn.
• Left or right side gas and electric inlet connections with
quick, simple change.
• Hot surface ignition models equipped with remote sense,
feature an integrated board with humidifier and electronic
air cleaner hookups.
■
RECEIVED
CITY OF TUKWILA
FEB 0 4 2007
PERMIT CENTEI;
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12t 13261
10 1263]
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(2921
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4 (1021 m
0
1
(251
3 1761
6 (15212)
85 (35.6)
06, 07
11
(4451
16 (415]
12 (306)
- m
15
(381]
0
3 (76) m
0
1
(25)
3 (76)
6 (152) m
105147.6)
10 (A)
17
16 (415)
12 (306[
m
15
(381)
0
3 (76) m
0
1
[25]
3 (761
6 (152[ m
115 [52.2)
10 (B)
21
15331
19 (504]
13 (352)
m
18
1470)
0
0
, 0
1
(25)
3 [76]
6 [152] 2
120 (54.4)
- 12
24
(622)
23 (593]
1514 (397)
m
22
(5591
0
0
0
1
[25]
3 [76)
6 [152] ®
140 (63.51
15
24
(622)
23 (593)
15 (397)
0)
22
(559)
0
0
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1
(251
3 (76]
6 [152] cis
150 (681
11
1
LEFT ENO
244:•
(622 mm)
(••-- 24 mm) --«
..14'11' 1366 mm1•
• - 1141•
(292 mml
C GAS LOW VOLTAGE
CONNECTION ELECTRICAL
I CONNECTION
26 4M*. 6 26W
(661 mm)
( 1 Designates Metrlc Conversions
qb•
(>p rm.
FRONT
DOTTOM VIEW
TABLE 1. DIMENSIONS AND CLEARANCE TO COMBUSTIBLE MATERIAL (INCHES) [mm)
23+"13.a (596 mm)
1
R.A.
i
RIGHT ENO
RECEIVED
CITY OF TUKWILA
FEB 0 4 2002
PERMIT CENTER
E
NOTES: O May require a 3' (76 mm) to 4'1102 mm) or 3' [76 mm] to 5' (127 mm) adapter.
m May be 010 mm) with type B vent. �� �', �'t . �°itl.h
Few miM be vented sd In accontanes with ANSI 221.47.1993 • CAN/CGA- 2.3•M13 venting table guidelines Included witlaic fu n c e, and In accordance
w1M local cedes. „ i
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THAN
THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT.
September 9, 2002
Mr. Jack Halbert
4030 S 117 PI
Tukwila, WA 98168
City of Tukwila
Department of Community Development Steve Lancaster, Director
RE: Permit Application No. MO2 -027
Location: Halbert Residence
4030 S 117 PI.
Dear Permit Holder:
In reviewing our current records the above noted permit has not received a final inspection by the City of
Tukwila Building Division. Per the Uniform Building Code and /or Uniform Mechanical Code, every permit
issued by the Building Official under the provisions of this code shall expire by limitation and become null
and void if the building or work authorized by such permit is not commenced within 180 days from the date
of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time
after the work is commenced for a period of 180 days.
Based on the above, you are hereby advised to:
•Call the City Of Tukwila Permit Center at (206) 431 -3670 to
scheduled inspection
This inspection is intended to determine if substantial work has been accomplished
permit or last inspection; or if the project should be considered abandoned.
Thank you for your cooperation in this matter.
Sincerely,
CirthL(,(,f
Kathryn A. Stetson
Permit Technician
Xc :'Permit File No.MO2-027
Bob Benedicto, Building Official
Steven M. Mullet, Mayor
arrange for the next
since issuance of the
The Building Code does allow the Building Official to approve a one -time extension up to 180 days.
Extension requests must be in writing and provide satisfactory reasons why circumstances beyond the
applicant's control have prevented action from being taken.
In the event you do not call for the above inspection or request and receive an extension prior to October
20, 2002, your permit will become null and void and any further work on the project will require a new permit
and associated fees.
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206- 431 -3670 • Fax: 206 - 431 -3665
STATE OF WASHINGTON
COUNTY OF KING
Jack Halbert
s s.
CITY OF Tll � NILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
, states as follows:
1. I have made application for a building permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the
Revised Code Washington, a copy of which is printed on the reverse side of this Affidavit. I have
read or am familiar with RCW 18.27.090.
3. I understand that prior to issuance of a building permit for work which is to be done by any
contractor, the City of Tukwila must verify either that the contractor is registered by the State of
Washington, or that one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby
attest that after reading the exemptions from the registration requirement of RCW 18.27.090, 1
consider the work authorized under this building permit to be exempt under No. 1z-- , and
will therefore not be performed by a registered contractor.
understand that I may be waiving certain rights that I might otherwise have under state law in any decision to
engage an unregistered contractor to perform construction work.
AFFCONT 1/13/00
APPLICANT
_ = A. D %%
fi? . 11.
i :'off NOTARY 1 � � � J day of M arch 20 O Z
l e i PUBUC • i � •
1 t`''• • . S ���.tce.
Z. N
I
����W�- - " NOTARY PUBLIC in an d fd'r the State of Washington,
Signed and sworn to before me this
residing at X r73
Name as commissioned:
My commission expires:
County.
Alice 4. i :acy
b - 16 - 04
H -4
211; iv
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Balance Due: $ 519 q4 aci) 6(-6
v -
eed Current Contractor •Registration Card: 4 • Yes 0 No
eed to Enter Contractor Information in Sierra E) Yes E] No
File: M 02 -0027
35mm Drawing
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