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Permit M2000-275 - PATTON RESIDENCE
PATTON RESIDENCE M2000-275 11535 40 Ave. So. City of Tukwila (206) 431 -3670 Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188 Permit No: M2000 -275 Type: B -MECH Category: RES Address: 11535 40 AV S Location: Parcel #: 734060 -0184 Contractor License No: TENANT PATTON RESIDENCE 11535 40 AV S, TUKWILA, WA 98168 OWNER PATTON MATTHEW 11535 40TH AVE S, TUKWILA WA 98168 CONTACT MATT PATTON 727 S KENYON ST, SEATTLE, WA 98108 ******************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Description: INSTALL 1 GAS FURNACE W/4 TON COOLING COIL & ASSOC DUCTWORK; 1 GAS WATER HEATER & VENT; 2 GAS FIRE PLACES; AND 3 RESTROOM EXHAUST FANS. UMC Edition: 1997 Valuation: Total Permit Fee: ******************************************* *, * * * * * * * ** * * * * * * * * * * * * * * * * * * ** Signature: MECHANICAL PERMIT Status: ISSUED Issued: 12/12/2000 Expires: 06/10/2001 Phone: V Permit Center Q thorized Signature . Date 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 for and obtain this bull. A . p rm1t. Date : ,,, - % Date: r r r Phone: 206 -763 -1744 7,000.00 132.13 Print Name: Title:, � aG.c �r .Jrr �ris 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. 4 Address: 11535 40 AV S Suite: Tenant: PATTON RESIDENCE TyPe: B-MECH Parcel t: 734060-0184 CITY OF TUKWILA wmtgayo Permit No: M2000-275 Status: ISSUED Applied: 12/04/2000 Issued: 12/12/2000 *********A***************A**4***k****k***A*AM*******AA**k*4*****A******** Permit Conditionlp.: I. 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). 2. 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). 3 WATER HEATER SHALL PE ANCHORED TO RESIST EARTHQUAKE. U.P.C. 510.5. 4. No changes will be made to the plans unless approved by the Engineer 'and the Tukwila Building Division. 5. All pirmits, inspection records, and approved plant shall be available at the job site prior to the start of any con- struction. These documents are to be maintained and avail- able,until final inspection approval is granted, 6. All;ionstruction 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). 7. 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 ottiir ordinance of the Jurisdiction. No permit presuming to giveauthority to violate or cancel the provisions of this code,shall be valid. 8. Manufacturers installation instructions required on site for the building inspectors review, hereby certify that I hove read these conditions and will comply with them as outlined, All provisions of law and ordihances 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 work or local laws regulating construction or the performance of work. Date; Project Name/Tenant / �• {�vi , siii - cc� iZED AGENT: .. Value of M h :i ment: 1 - ��I� ui .� (�(� Site Address : ` ,.� 1 •1.i1 0 ^ • City State/Zip: A YE 5 1 \ `itst(a Tax Parcel Number: 734 06o-- U1 - 0 c' Property Owner: M Aoki- ak i n 1" a� \-o rJ Fax #: (A4 )7, gSla -:23F9 Phone: ( Tut. ) � — t - 1 N Street Address: 5 3 5 14o T N AVe.. ..S . City State/Zip: ---., kw;1 Tel EK, Fax #: ( ) Z - 7(�� -- -2,'3, br1 Contractor: L vQ L r] ` 5A City k%2� �p,.. 4510, State /Zip: Phone: (2� ). 7 63 -7 6 .., Fax #: (.to`) � _ I'1 44 t, � Street'Address: J - - - -- 7� �/ J ��2r�.,jyrJ Contact Person: �^ et � � Phone: (7. } 9 Street Address: � .� 3 r City State/Zip: o. `1 r+t o v Fax #: (Zot,) '76'3 — J BUILDING OWNER OR AU iZED AGENT: .. Signature: 1.;?..,:". ,r,,,t' /,�!1'!r Date: . Print name: Phone: (74.4.:1776 �4 /z CI t�tte/ZIjj:: Fax #: (A4 )7, gSla -:23F9 f A 9 !-"3� era: .410 _ . CITY OF T 'T WiLA Permit Center 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 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. MECHANICAL PERMIT REVIEW AND APPROVAL REQUESTED: (TO BE FILLED OUT BY APPLICANT) Description of work to be done (please be specific): InA e `! F .r hA(.Q WI 4 - TU N..._ Coal i ∎ 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 I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TIIE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHIORiZED 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: 11/1/99 plea permit doc Date (o L1OI plication expires: a Application tea n by: (initials) ✓ 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 C RESIDENTIAL: Two complete sets of attachments required with application submittal ye NOTE: Water heaters and vents are included in the Uniform Mechanical Code — please include any water heaters or vents being installed or replaced. Submittal Requirements New Sin le Famil Residence 11/249 mtscpmcdor Chan tbri re lacement of existin: mechanical e ul men( done includin modification to duct work. Installation of Gas Fireplace Narrative with specification of equipment and chimney type. If using existing chimney, provide a latter by a certified chimney sweep Mating that the chimney is in safe condition. NOTff Water heater and vents are Included In the Uniform Mechanical Code — please include any water. heaters Or vents b&ng installed or replaced. • **** ** ** * * * * * * ** * *#* a ** ***Rah *** *** **** *****,4* * ** * *4** ****4k* t"CY OF 11110111.A. WA ThAMbr�11 * * ** ,* �4********* * * * ** *�F*�4 �4* *I4 *** ***4 **k* * *** **** *** TRANSMIT Number: 89000405 Amount: Pavaiont:Method: CHECK Notation: MATTHEW PATTQN Znit: TL3 Permit Na: M2000-275 Tvoa: 0-MCCH Parse! No: 734060.0104 ti Addr+ es: 11533 40 AV 13 132.13 12/12/00 1024V MECHANICAL PERMIT ibe fowl l•b es: . 132.13 h i b Payment 132.13 . t ata 1 ALL Pmts: 132.1:1 0a1 :not: .00 * * * * * * * * ** ** * * * ** * *** * * * * * * ** *** ► ** * ** * * * * ** * * **** * * * ** * * *o AccOunt •Code cr i ut i on Amount 0OO /345.030 PLAN CHECK - HLV 1u.43 000/322.100 MECHANICAL - REU 105.70 S1 01 S• S 1 w M 64. W M M i o N F s_ W W W_ r W r M R Y I r W 07.12 i2 /i4 9710 TOTAL 11 Project: • ,(11a h' ( /Vi; AC/6/4 . Type of tispection: _ _ /nor. Ad • r f 0 y4 4 , •$ Date Called /9 Special Instructions: Date Warr_ a ...0 ., Requester':- (I fi t'hone � 5 INSPECTION NO. INSPtd RECORD 5 Retain a copy with permit W PO - ., PERMIT •.� � CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431.3670 A pproved per applicable codes. ❑ Corrections required prior to approval, COMMENTSI Ei $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection, P W 'ect: Typ • " f Inspe t . n: I. � - fY C dress„ C" ,(\, , Date called: l } Special instructions: _,,, Date wanted: ..7 / 4 • �.m. Requester: ,/�� 1 l "t i t Phone. y LA .00 REINSPECTIO EE REQUIRED. Pfior o inspection, fee must be paid a 300 Southcen(er Blvd. Suites 100. Call to chedulo reinseoctlon. ec No: Date: INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Sauthcenter Blvd, #100, Tukwila, WA 98188 ❑ Approved per applicable codes, :2I Corrections required prior to approval. COMMENTSs COMMENTS: &I /i / '7/ Raj 1- e 4/ 111571 ,d :.. hio 4 Da emir/ 0 t 7© C lP'/2 PV I Won 'M Dae P Req e ter: it Plot , % - r(I itt 41.4A . _ . At ,d :.. hio 4 Da al d: Special instructions: 4 6$butt *Sri AUG' 4 1 cPC.Ar, too (4.-0 t tr: 0 IA - 40 c iNfirk► . Dae A . I Req e ter: it Plot , % - INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 9818 INSPECTION RECORD Retain a ropy with permit MZtt- ,- PERMIT NO. (206)431-3 V pproved per applicable codes. Corrections required prior to approval. Date: 100 REINSPECTION FEE ' (QUIRE), P/ or to inspection, fee must be paid at 6300 Southcenter Olvd., S ite 100. Call to schedule ro,ns.ectlon. Receipt No: Date: 1§ January 6, 2003 Mr. Matt Patton 727 S Kenyon St. Seattle, WA 98108 RE: Permit Application No, M2000.275 Location: Patton Residence 11535 40 Av S 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, ovary 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 limo after the work is commenced for a period of 180 days. Based on the above, you ore hereby advised to: •Call the City Of Tukwila Permit Center at (206) 431.3070 to arrange for the next scheduled inspection This inspection is intended to determine if substantial work has boon accomplished since issuance of the permit or lost inspection; or if the project should be considered abandoned. The Building Code does allow the Building Official to approve a f1g7mlon uD tcaBO_d, 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 February 13 2003, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter, Sincerely, Kathryn A. Stetson Permit Technician City of Tukwila Department of Community Development Xc: Permit File No.M2000.275 Bob Benedicto, Building Official Steven M. Mullet, Mayor Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206.431 -3670 • Fax: 206.431.3665 City of Tukwila Department of Community Development 6300 Southcenter Blvd. Suite 100 Tukwila WA 98188 RE Permit Application D2000 -391 & M2000 -275 I would like to take this opportunity to ask for a one -time extension ofmy permits, listed above. I am now building out of pocket, & solo. I'm very close to completion, but way behind on my projected schedule. I am basically down to trim work, final completion ofmy custom iron railings, (which are extremely time consuming), & a little mechanical tie in. The only reason I won't make my final inspections is I am getting married & leaving on my honeymoon. I expect to have all inspections final by October 1 Thanks: Matthew Patton ( Race o CITY OF TUKW lu AUG 0 9 Mt PERMIT CENTER July 3, 2002 Mr. Matt Patton 727 8 Kenyon St, Seattle, WA 98108 City of Tukwila Department of Community Development Steve Lancaster, Director RE: Permit Application No, M2000.275 Location: Patton Residence 1183840AvS 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 end /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) 431.3870 to schedule a progress or a final Inspection A progress inspection is intended to determine if substantial work has bean accomplished since Issuance of the permit or last inspection: or if the project should bo considered abandoned. If such determination Is made, the Building Code does allow the Building Official to approve a onetime extension on foiled/a. Extension requests must bo 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 August 13, 2002, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, Kathryn A. Stetson Permit Technician Xc: Permit File No.M2000.2 Bob Benedicto, Building Official Steven M. Mullet, Mayor 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431.3670 • Fax: 206. 431.3665 November 8, 2001 Mr. Matt Patton 11535 40th Av S Tukwila, WA 98168 RE: Permit Application No. M2000.275 Location: Patton Residence 11535 40th Av S Dear Permit Holden city of Tukwila Department of Community Development 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 ere hereby advised to: • Call the City Of Tukwila Permit Center at (206) 431.3670 to schedule a progress or a final Inspection A progress inspection Is intended to determine if substantial work has been accomplished since issuance of the permit or lest inspection: or if the project should be considered I.1. lndoned. If such determination is made, the Building Code does allow the Building Official to approve a onetime extension uo jo 180 dsva. 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 December 10, 2001, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation In this matter, Sincerely, KCtt(1 Kathryn A. Stetson Permit Technician Xc: Permit File No,M2000.275 Duane Griffin, Building Official Steven M. Mullet, Mayor Steve Lancaster, Director 6300 Southcenter 8oulevard,.Suite #100 • Tukwila, Washington 98188 • Phone: 206.431.3670 • Fax: 206.431.3665 September 5, 2001 Matt Patton 11535 40th Ave, So, Tukwila, WA 98168 RE: Request for Extension — Patton Residence Permit l M2000 -275 Dear Mr. Patton: Sincerely, IV /,. +4fns Duane �ariffM Building Of ficini DO /br , s City of Tukwila JO s �� Pile: Permit Nu. M2000.275 Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director This letter is in response to your written request for an extension to Permit No. M2000.275. to install a gas furnace, a gas water heater & vent, 2 gas fireplaces and 3 restroom exhaust fans. The City of Tukwila Building Division will he extending your permit 180 -days from the original expiration date, (June 10, 2001). This permit will now expire December 10, 2001. Please be advised that this will be the only extension granted for this project. If you should have any questions, please contact our office at (206) 433 -7I65. 6300 Southcenwr Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431.3670 • Fax: 206.431.3665 Request for Extension on Permit M200 -275 nos Zolvt City of Tukwila 630 Southcenter Boulevard, Suite #100 Tukwila WA 98188 RECEIVED SEP 0 4 2001 COMMUNITY DEVELOPMENT Dear, City of Tukwila Building Official. My name is Matt Patton of 11535 40` Ave So. Tukwila, WA 98168 I am running a little behind on my project and would appreciate it if you could please extend my permit of another 180 days, Please let me know if there is anything I need to do. I can always be reached at the phone number below. Sincerely: Matt P (206) 778 -6123 d. to 6,v August 20, 2001 Mr. Matt Patton 727 S Kenyon St Seattle, WA 98108 RE: Permit Status M200.0.275 Site Address' 11535 40th Ave. S. Dear Mr. Patton: Sincerely, K Cii of Tukwila a foto Kathryn A. Stetson Permit Technician Xc: Permit File No. M2000.275 Duane Griffin, Building Official 8/0 5 / AUG 2 3 2001 BY: Department of Community Development In reviewing our current permit flies, it appears that your permit for installation of furnace, ductwork and restroom exhaust fans at Patton residence issued on December 12, 2000, has not received a final inspection as of the date of this letter 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 provision of this code shall expire by limitation and become null and void Hulk) 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 afler the work is commenced for a period of I80 clays. Based on the above, if n final inspection is not called for within ten (10) business days from the date of this letter, the Permit Center will close your file and the work completed to date will be considered non - complying and not in conformance with the Uniform Building Code and /or Mechanical Code, Please contact the Permit Center at (206) 431.3670 if you wish to schedule a final inspection. 'Thank you for your cooperation in this matter. Steven M. Mullet, Mayor Steve Lancaster, Director frpt 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206.431 -3670 • Fax: 206.431.3665 Pro er c Name: 1 vt 'chit" , ti c' _ r Address: i 1 5 3 � �� `' 11 ,..irft. � 1 96 f (7% Residential Building Permit Number: 1. Prescriptive Option W,S,E,C, Chapter 6, (check building permit option used): ❑ I. ❑ II ❑ Ili. ❑ iv, ❑ v, ❑ VI, ❑ VII. ❑ VIII, 2, House Square Footage (HSqFt) xai 70 er -t 3. Heating System installed, (check system type below): �("1 ❑ a, Electric Resistance /21 BTU /h per sq. ft. 0A ‘: " . • ❑ b. Electric (forced air) /24 BTU /h per sq, .- --`----' (a 0. Other Fuels (gas, heat pump) /27 BTU /h per sq, ft. �,„ •rrn 4, Equipment: a. Make b. Model C. Size In BTU's 5. Calculation/(HSgFt) Z l H 1 F T2" (see line 2 above) BTU /h X Z.1 (see line 3 a, b, or c above) G C., (1 o BTU Equipment Maximum Size CITY OF TUKWILA ' Permit Center 6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188 Telephone: (206) 431 -3670 Prescriptive Heating System Sizing for Single Family Homes - New Construction Washington State Energy Code Chapter 9, Climate Zone 1 PERMIT APPLICATION q: MwGo 2i5 7/9/96 Applicant' Date: t PECiir.To CITY O i� �•� „ DEC 0 H -6 1ri00 PERMIT NO.: M 1 2CA( 179" MECHANICAL PERMIT APPLICATIONS INSPECTIONS ❑ 00002 Pre - construction ❑ 00050 WSEC Residential ❑ 00060 WA Ventilation/Indoor AQC Q/ 00610 Chimney Installation/All Types ❑ 00700 Framing ❑ 01080 Woodstove ❑ 01090 Smoke Detector Shut Off 01100 Rough -in Mechanical 01101 Mechanical Equipment/Controls 01102 Mechanical Pip/Duct Insul 01105 Underground Mech Rough -in 01115 Motor Inspection 1400 Fire Final 01800 Final Mechanical 04015 Special -Smoke Control System CONDITIONS 0001 No changes to plans unless approved by Bldg Div ❑ 0014 Readily accessible access to roof mounted equipment Eik 0016 Exposed Insulation backing material 0019 All construction to be done In conformance w /approved plans ce 0002 Plumbing permits shall be obtained through King Co 027 Validity of Permit 0003 Electrical permits obtained through L & I 0036 Manufacturers Installation Instructions required on site ❑ "BTU maximum allowed per 1997 WA State Energy Code" [) 0041 Ventilation Is required for all now rooms & spaces "Fuel burning appliances "Appliances, which generate...." "Water heater shall be anchored...." Additionrll Conditions: TENANT NAME: rre = l DE cE FEES Basic Fee (Y/N) Supplemental Fee (Y/N) Plan Check Fee (Y/N) Furnace/Burner to 100,000 BM (qty) t Over 100,000 BTU (qty) Floor Furnace (qty) Suspended/Wall/Floor - mounted Heater (qty) Appliance Vent (qty) Heating/Refrig/Cooiing 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 On (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 $5) Add' 1 Fees — Work w/o Permit (YIN) lnsp Outside Normal Hours (hrs) Reinspections (hrs) Miscellaneous inspections (hrs) Add'l Plan Review (hrs) Plan Reviewe Permit Tech: Date: (2- ''( .•00.11•-- Date: — ACTIVITY NUMBER: M2000 -275 DATE: 12 -04 -2000 PROJECT NAME: PATTON RESIDENCE SITE ADDRESS: _.1 40 AV S. SUITE NO: XX Original Plan Submittal Response to Incomplete Letter # ,Response to Correction Letter # ,Revision # After Permit is Issued 1EP_ARTMENTS: B i • �i g Division E (/ `� lit° Public Works ❑ DETERMINATION OF COMPLET S: (Tues., Thurs,) Complete Incomplete 121 Comments: TUES /TI IURS ROUTING: Please Route REVIEWER'S INITIALS: AP V&LS OR CORRECTIONS: (ten days) Approved Approved with Conditions REVIEWER'S INITIALS: .r CORRECTION DETE INATION: Approved PLAN REVIEW)Pc8PiNG SLIP Fire Prevention Structural Structural Review Required Approved with Conditions E REVIEWER'S INITIALS: Planning Division Permit Coordinator DUE DATE: 12 -05 -2000 Not Applicable ❑ No further Review Required DATE: DATE: DUE DATE 1- -200Q Not Approved (attach comments) ❑ DUE DATE Not Approved (attach comments) E DATE: