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Permit M97-0073 - DOAK HOMES
City of Tukwila Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100. • Tukwila, Washington 98188 MECHANICAL PERMIT Permit No: M97 -0073 Type B -MECH Category: RES Address: 4052 S 148 ST Location: Parcel #: 004000 -0958 Contractor License No: AEHEATI *155MA TENANT DOAK HOMES INC 4052 S 148 ST, TUKWILA WA OWNER DOAK DARRYL 11917 4TH AVE SOUTH, SEATTLE, WA 98146 CONTACT SUE BOCKELMAN - PO BOX 884, NORTH:_BEND"WA 98045- CONTRACTOR A & E HEATINGYINC PO BOX.884,.NORTH•BEND WA 98045 * * * * * * * * * * * * * * * * * ** ************************ *'* * ***•k*** ** *** ** **** * * * *. ** * * ** Permit Descript INSTALL ; GAS FURNACE,, GAS HOT .W'ATER. TANK, AND, GAS„ FIREP UMC Edition: 1994 ******* i4* tk ***************************** * * * * * * * * * * * * * * * * * * * * * *4* * * * * ** Permit Authorized Signature Valuation: Total Permit Fee: Date (206) 431-3670 Status: ISSUED Issued: 06/05/1997 Expires: 12/02/1997 Phone: 206 246 -6587 Phone: 425 831 -6800 Phone: 425 831 -6800 000.00 64.06 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 construction or the performance of work. . •I am authorized to sign for and obtain this building permit. . Signature: ` J2 � ��L �. Date: b ` 'J r ' 17 Print Name: Title: This permit shall become 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 day's from the last inspection. Prole Description of Work to be done: -r L (-- 6;4•S F112424- / 0tA_c_T WcR ,PL r 601-*b /+wr, C./1-S t - 'lR6PC4C . C'■ p1PC-:'ro PUki» c wr ; 'Le.. ; Ge- Value of Construction: =ova list • 0 Above Ground Tanks LJ Antennas/Satellite Dishes Bulkhead/Docks iJ Commerolai Reroof ' ' ❑ Demotltlon • 0 Fence Mechanical ❑ Manufactured Housing - Replacement only 0 Parking Lots 0 Retaining Watts Temporary Pedestrian Protection/Exit Systems , Temporary Facilities • ❑ Tree Cutting amelTenant: .Site'Address: /h� "/� T ; ' /� yI. t: • .40.52 Z S / I ¶/ City,Stale/Zip: a frwit-/� �'' /,i Tax Par cellNumber: Q W CAID - i� 56 ' • Property Ow or: .. p g 6-S S rJC_ Phone: • Zao - z 4 ^-6,68 ,Street Address: / /q / ' l E ' / �9v �GtJ City State/Zip: • 564 i L 9 , Fax #: ' : •' • • Genteel Person:, ,. , • O ckthnctil Phone:, • • ' �/ ZS - - 8 3 -6 eoc) • ws ' "' 6e.A. - • Street Address: t.. • City State/Zip: Contractor" • ' 1 ¢ •� / s,¢ �t/G - T_iVC_ Phone • 4 2 5 - 83/• - 4,13 Street Address: • . :: • ''I• :, , , :, 41Di :'EN City State/Zip: '`'a Fax #: Z . - '44L5 Architect: • ' • Phone: Street Address: City State/Zip: Fax #: ' Engineer:. • Phone: • Street Address: City State/Zip: Fax 0: • • . r,.t Pr r• 0 A: Or i1.7rr`ir;.C• , r:, 44e, ;Pi v"v0. vAm..kn ( ✓MD ate• 4,� f v.; nr., rrrivr .r.- .,,,v..,•••;•,....., v. .'eV� ,!1 ze 'v 41 .V. O ' ` �1 lacgVg A A VJ4w �► o l �r ttf S ; '. ' .0.0 INA1 �l? .Al 711,.4_ AN 17 `. v w ; Description of Work to be done: -r L (-- 6;4•S F112424- / 0tA_c_T WcR ,PL r 601-*b /+wr, C./1-S t - 'lR6PC4C . C'■ p1PC-:'ro PUki» c wr ; 'Le.. ; Ge- Will there be storage of flammable/combustible hazardous material in the building? ❑ yes rg" no of materials and atom a location on se crate 8 1/2 X 11aer Indicstin uantitIes 8, Material Safy Data Shears . =ova list • 0 Above Ground Tanks LJ Antennas/Satellite Dishes Bulkhead/Docks iJ Commerolai Reroof ' ' ❑ Demotltlon • 0 Fence Mechanical ❑ Manufactured Housing - Replacement only 0 Parking Lots 0 Retaining Watts Temporary Pedestrian Protection/Exit Systems , Temporary Facilities • ❑ Tree Cutting • • JUN 03 '97 11 :25AM TUKWILA DCD /PW CITY OF TU. , •WILA Permit Center 6300 Southoenter Boulevard, Suite 100 Tukwila, WA 98186 (20c. 431 -3670 Miscell, r ! neous Permit Application Application and plans must be complete In order to be accepted for plan review. Applications will not be accepted through the mall or facsimile., 0 ;1.1 n?,g" `r';i*`r'! .;.t'r %..c g! /AP1L Afv7'+i1REGiUJES7 F(f fMIsc8 t P 6 7�r nd,r. RV trI( n`F'drs �i " < "'4 Nf; O, U$} F,!' C1Bl: l' GitVIt; GGp. �iKS�P., �1�Tj!! I' T5? �' �4 hh • . ' r���'��,>.�1�rstus�+x:,S? -�3; v':�? ■ >� Channelizatlon/Strlping • Curb cut/Access /Sidewalk • Fire Loop /Hydrant (main to vault) #: Size(s): O Flood Control Zone 0 Land Altering: 0 Cut._ . cubic yards 0 Fill cublo yards 0 sq, ft.grading/clearing 0 Landscape Irrigation 0 Sanitary Side Sewer #' ❑ Sewer Main Extension () Private 0 Public ❑ Storm Drainage d Street Use 0 Water Main Extension 0 Private 0 Public ❑ Water Meter /Exempt 0 ._ Size(s): 0 Deduct 0 Water Only ❑ Water Meter /Permanent 0 ' Slze(s): _ . O Water Meter Temp 0 Size(a: Est, quantity: gal Schedule: O Miscellaneous Moving Oversized Load/Hauling IACIN.;ri lt.~ • 6 !#:11; :6, 6 / (NO Name: 'Address: • Address; 0 Water i /rrr+ AT ne17- - 7 Ft me 0 Sewer .WA1 f: E137D tl SIX /.REF,t'lt tt3 /Lilli4 s '.�;t� Name: City /State/Zip: 0 Metro • City /State/Zip: 0 Standby P. 4/b ..:ti: Man :Mat ,. @T.y .Y.•,Fr'nf' (.$ i ..1 i %Z.• Phone: � l.��!�• ,A�.�' ,,nnlr,'i< .r,� . w , , ':�.f;f: .�.�il.•::�•' tw Z ". 9 rt•" '�i .. y � t.iv: ?:9 :i'bi. ��:. } 4 'r� i fs• 1 'w' » 1 .6� .., ,. 1 c i , '7�y�py JS��a �•� .r:i'• ,ti.. A �' . %HC;•Rnt'i'.�. • $.s. :., ..a••••h r dl�rd:Y�•.c.1,: �h•5!H'L �' rti My4'[`k��i +•.; i,�. Phone: • , • 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, OW Pate application accepted: (, - l / Data application expires: Application taken by: (init4ls)1" D WITI! THE FOLLOWING: eC IiPI L1C TIONS MUST 133E SUBMI A ALL DRAWINGS SHALL b AT A LEGIBLE SCALE AND NEATLY DRAWN A BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED A ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT; > STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED STRUCTUFAL ENGINEER • A CiVIUSITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.) SUtIMIT APPLICATION AND REQUIRED CHE KLISTS FOR PERMIT REVIEW t : A • w iings /Pi tri:o �1 r 1 kMy • S ?L!�< { i �sijtJ �C;csii�trYre il at . ab i Ii 16 1 1 1I'.ab'�.' v i lYttin Y 9,p•'•.? r•' a : © �:'� rr . r' �k 1 5 1. ItNt� t 1 1 }`!t !L � ( �h A' r A v4. Milli tiotea;t1s HON titti s� 'F y,il3t i j t MOntut 'i tUt''eti;H;i gi #6 W1 Si a Glrl ' ,J4 *(,ha y, r >> >.;t r.; / �F't ti't ,, • I , (4� /,< },� , +•+•+. \.Fi.. :f.]r.... M.0 2t;' K : 74(( . L .+.r • C'. �lD ?� iitii #O.iY�'i's�t 'elil tia` tilliilliii' �l t 4%• r73�� 'j<�r''Ki; ?.'.".4 Vri:.tr I rer', '11 t4• %3(4 .p � 1h`a i.46 ia!' 3yii= f1'`�q.... {y •tr k3 %? Siibrriitt' ZrF s" f eatENee REM i tpc; `''' 4Stib'ini ltlis"t •NQ t‘ CSIIENAIttalfeeki t51: : Faris lAi �V > ': :r io. b l ,r. t � s `� � '' A Fla' Sii t'ffiil{4 ?r;fi' iof geotd '��7LaS'ii'4:1`1;1: 1; *w " Ky�t�'E i7 +7 Sy• S t i t4' ,j E 'a i!# y Ike •x t i ` ,��' : :3Ar;. p C �' x ; �(�'. .,, I� �, ti a1• .Y,)" � �. :Silbri'i tt� "fi�c lid' �`Nl�`t ,ii�l � !° gV ' r'i ?� : 1' < �s _ t v i! + .k, � ( X�Sf.g„t`J�?� 1 r• + "• < y r A ! ( k, r1S.3� ti#4, 'atJ+� +'� ro <'' 1 } 5 ) (•L'. i . L t t 'i \a`t.' ors s , ,•. j..(, s (, i +�'p ��` the ' �f �`3h 1+�3� ;:b: � ` t�,`7. ,•: i �s. �'' 11 � r ! ; { } J ►►ty, °•C I> i nto J: t + , ,, ;� �H v .+.,, b..'1TN:.., 1,'iSlMj;.c h'fi }: •rl.,, li �'4t�� k•�J'.; Y:,R <�j.'S�M,tp,d. 8`d r�i,:,, �• nS'1� � 1 <Ft00i ;c10214/ Fi :;�.� 0 tTpt irii0 bWi1 • �i y gift3tit5pa i t'ile { 1 K 1, 0 ',•, k �.dr•>, .'.1D'1b i� t;. y� 1Egr k S ,.dw• ;,Zt,+ tfatt7 •' C" lw y •h 1 av+ ! i,'Ppy Kit sr;� `�'� ;�, • i"fir ,w ,i Ci el, �.' ,r, p VC, F � :�``' ^�'( f�' �� , 4.� `i'vt•a Si�b�"' ,r rr' ; :1. 1 ` �c :r^ _ %;.tV6 •K , . _✓ �ri�( u�lv :iA,rf..,i ;tL,�A�:ti.t �s�::,:lr:�b.'V.0 ,,,�.:.t: + �;,tC( , {:.:,. ,^ , rr3 c U�Tllt'�C Rbtal IitrWll�r a ir, +. o2rt¢V, +M r1f: jCYl Gpr'.'#'� �efat ��' °;i: r , ` o•'c,,,. � ;�,�,�. 7;i -.... r 4t `' v �1( ,�. j r~' yy,..•`+i• y.,. ( ii « � Y'r jA ;' �Sr''t '' , is :f�.,'�iiY ? ;. <:�i� .., :.`r� •,i�{I: ;Pl, ,�%.r ;. :' •s.:. . ..S.DS4 �+ �J:f•.,hln ;i �?j dL`A s. f)aii0 iAt' • �f 1.4<:JK TaalifiliiiliMaled yo- 'S li j.(�j��:? titi ;7J '" 4 s . ' .. i,1 1" r ,+ "� :44tc7 rAt 4 r1/4i) :M?? �JS:'f 7 t 1� " (Aa l eft ''•. .`� h i tl PP b �e4R`l Sty��'a1 N6M ` , ':. J s fV ;t: I.F ',: i "r1 �q ,. . t,).,. 1 r Z:1p. bf o). :t•Q`:3" t,e.Sl..a?.i,; j+'b •,1 .:x J Copy of Washington State Department of Labor,and Industries Valid Contractor's' License: `Ii • not available at the'time of application, a copy of this license will be required before the permit is Issued, unless the homeowner will be the builder OR submit Form H4, "Affidavit • in Lieu of Contractor Registration ". i tl j r O • � V'V of • o y kk I e�, 1:I b f re . J' , { ,, . • �Jkep4 , e irEY iii' �nrfio:►b ?c{ € •I�iritr �::i�c'= ri•' � ' rH Y ' r :146" f+(d i c i y r � + + ".'a f �' ' y ` ' ` +,�. ty "E ' `t I HEREBY CERTIFY THAT ! I HA VE READ AND EXAMINED 77.11S APPLICATION AND KNOW THE SAME TO BE TRUE UNDER: PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED ro APPLY FOR THIS. • „ PERM!T . , : d illai1faft)WNER. f3 #7500:091ZA ,'��, F'..�: ;; ;tgaVAA Signature: ..F i- : ;.tt'>39h7P,r:!:'i, tM J) " • . ' S' . r 13x11 ••, • Date: - Pho e: clt Ottge/ZIP: g 4j b , (A) !O Print name: SUS AtJ Address: Po Bc •rte — �..... ' MISCPMT.DOC 7/117/96 Permit N Address: `4052 S 148 ST Suite :, Tenant:. DOAK HOMES INC Type : B -MECH Parcel #: 004000 -0958 * * **fir ***'k * **.k *•k k***,**• k *,•k•k•kk *•k * * * * * *** * * ** *•k*•k *'k k k.k•k* *•k•k *•k k * k•k **•k k* b k* Perm•it'Condit ions: ' 1. No. changes wi 1.1 be made to the plans unless approved by the 'Architect 'or Engineer and the T,u4wi 1a Building Division. Al 1 :permits; ' inspection. re;udr cis,' and-r =;approved plans shat i be .available at the job si't'e ' p'rior to . the °.:sta of any con structien. These ;jd,o'c are td&be Ira intalne;o and avai 1 :able until firazl .:tnspe'c approval is g : All construction to be'°dorie yin ; approved plans and ,trequirenients:,, the .Uniform gull d`.in .•C o de ,k1:994 Edition) .as a mended.,`' Uni ,forrn Mechani`ca.l,,,Code (1:'994 , and WasfSiri�oto State n 'orgy Code C1994 Edition)'.: Validi.ty,;of. Permit. '-'The issuance of a permit. or app,rova4 p1ans,i,; .'pe.oif i cat i:onc, and,'' c;omputa',t,ions shall. not :ties, con ' ='. strued �tobe a permit fo rt, ..Jr an approval of, an y vi:olati'o of l'4' of;' "this provisions of the, bui lding code or of any other ordina of the:;:.juri s;d`i ct tom.; No permit presuming t'o`: give : authorit J to violat•e•"•or�r, cancel the provisions ;this T co r l : sha1 be i d 5, MANUFACTURERS INSTALLATION INSTRUCTIONS REOUIRED ON FO s,THE f I.N.SPE ` • REVI i 1 ( 'Y P1 robing . rri Os sha « obtained `,through. the Seattle -K Co n; y t D e' par t: reri't ` _ of. -i ub 1,i`c -Hea th'. ;,' will lie in r " ct ° ei ^tby thai~0 agenc`y,,4 .,lttdln� y ° al,gas piping ti" 'Y ra - r! l 2 ` 47220 T� `' ti'k.+�.,,, *' .<;,' •s , \ 0 t4::'-;-.7"-. .`: E1 ec - 1 a 4 4; ermi is shall be obta 1 n.e th ough- ►the Wa`'si i ng'ton Sta . , vi iron µ of Labor and Indus ;ies ~- and.,al,�1 e l ectri 1 wort i 1 1 -, e.. l n s \ ' + A a;,� . it ected by that a e r oy (444- 6630) . i ; i 1 S' dp : M97 -.0073 Status: ISSUED Appl ied 06/04/.1997 Issued 06/05/1997 l;.,,i «fi'i1r ( f`;iS '':�'.iii!3%r , N,'Z; "L'.t r, gF,!•z �'�i ' ?t ,- +�5. .'.} r ,L tyy .7t Ay }N "t�`:'GYS ":`tl £w'Iyy.O: .;`YRTA' ,, ei!VVit;: i.... >P77.40 a '.100 twt, rnceNk• r. > �r.. v„ ACTIVITY NUMBER M97 -0073 PROJECT NAME DOAK HOMES INC. DEPARTMENT: BUILDING DIVISION r FIRE PREVENTION E] PLANNING DIVISION a PUBLIC WORKS STRUCTURAL 0 PERMIT COORDINATOR 0 DETERMINATION OF COMPLETENESS: (T,Th) COMPLETE COMMENTS TUES /THURS ROUTING: PLEASE ROUTE [J NO FURTHER REVIEW REQUIRE ROUTED BY STAFF Ej (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL 1. V•Mall■....Ifil APPROVALS OR CORRECTIONS: (ten days) CORRECTION DETERMINATION: APPROVED 0 REVIEWERS INITIAL C:ROUTE -F PLAN REVIEW / ROUTING SLIP NOT COMPLETE E NOT APPLICABLE 0 DATE DATE DATE 6/04/97 DUE DATE 6/05/97 DUE DATE 6/19/97 APPROVED n APPROVED W/ CONDITIONS 2 NOT APPROVED (attach comments) 17 •S-,, REVIEWERS INITIAL 4 �" DATE ( DUE DATE APPROVED W/ CONDITIONS Fi NOT APPROVED (attach comments) 0 (Certification of occupancy required. ) v a..Y: fin`StlYVgrbt15,1t0I017.127e.1 Project: Type of inspect i ._ Address: 2 RNS2. S. ti(Y Date called: Special instructions: Date wanted: S � ') 0 a.m. p.m. Requester: Phone No.: INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 I Approved per applicable codes. COMMENTS: Inspector: I Receipt No.: INSPECTION RECO"' Retain a copy with p , sit yv\' l - ooi3 PERMIT NO. (206) 431 -3670 Corrections required prior to approval. t . --- Date:( 11 fl] $42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspoction. Date: Project: Type of inspern ''" Date called: . , _ 9 is . Addr sz S , (c/ � `7 U s 1 _ Special instructions: 1..0 %h d Date wanted:, .T. , 2 '? —' '? Requester: Phone No.: 09 H. INSPECTION REC r Retain a copy with perniit INSPECTION NO. CITY. OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 6r3 PERMIT NO. (206) 431 -3670 Approved per applicable codes. Corrections' required prior to approval. COMMENTS: 1 1AZ v► `"C.7 ' h i Q' - (L P, Pte'S I a (-M- F: 1 " C Lth(t:A-f fW \M I Inspector: $42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: / / 1 t� Date: Project: &plc._ / Type of inspectio 46,X1-, Address: t'CZ `145 u Date called: Special instructions: l Date wanted: ..-- 2 ,'�- Requester: Phone No.: pproved per applicable codes. COMMENTS: Inspector: Receipt No.: INSPECTION RECDrl Retain a copy with p ._..4it INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 1 1 Date: PERMIT NO. (206) 431 -3670 Corrections required prior to approval. 1 $42,00 REINSPECTIO FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100, CaII to schedule reinspection. Date: ' • e6- 1- 1_0416 - Lar 4 sr Type of inspeti4 . ill i `` r a s ' Li g Date called: / 611 Special instructions: Date wanted :1 . n � Jy (a.rr Requester: b n gR`t ol CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 INSPECTION NO. Approved per applicable codes. [Corrections required prior to approval, COMMENTS: z .. e(c vt►a= 6 c z4 JOrT' QNNr 2 c ► t ) V 1 ru ckt.;a , iJ , GZ Date: 3 .q $42.00 REINSPECTION FEE REQUIRED. Prior ,to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Date; Inspector: I1 [Receipt No.: INSPECTION RECD Retain a copy with pit W\c'7 - Do PERMIT NO. (206) 431 -3670 r.4 .***********, k************.***** k***** *. * * *. * * * * * * * * * * * * * * * * * * * *A * * ** CITY OF TUKwzl a. 'WA TRANSMIT ** **' ** * ** *1k*R# *****,% * " ** i F* k* F **** * * *** ** * ** * ** * * * ****A *A*** TRANSMIT 8970059.3 Amount: 64..0t 06/05/97 14 :17' Pav'ment Method: CFIECK Natat`ian: A ti E HEATING • Inite 8Lp ,Permit 'No :M57:_ 00,73 Type: R'- •MECH. MECHANICAL PERMIT Parcel ' No: 004000• -0358 cite Address: 4052 8 1'48 ST Total Fees: 64.06 This Payment 64.06 Total ALL Pmts; 64.06 Balance: .00 * * * * * * *a * ** , *** * * * * ** * * ** ►******** * ** ***A4 * * * * * * * * * * * * * ** * * * ** ** Account Code 000/345.830 000/32.100 Description PLAN CHECK. -• • RE5 MECHANICAL RES Amount 1...81 51.25 Project Name: , Th 0 \-S C 1 4ne Address: 4952- s . /y 5 4 Residential Building Permit Number: 1J91 - 0 0 '73 1 . Prescriptive Option WS,E,C. Chapter 6, (check building permit option used): ❑ 1, ❑ II ❑ III, 0 IV. CI V. CJ vi. ❑ VII. ❑ VIII. 2, House Square Footage ( HSgFt) /e/i/ 3. Heating System installed, (check system type below): ❑ a. Electric Resistance /21 BTU /h per sq. ft. ❑ b, Electric (forced air) /24 BTU /h per sq. ft. a c, Other Fuels (gas, heat pump) /27 BTU /h per sq. ft. 1v 4. Equipment: a. Make R . _ b. Model cL. - 05 c. Size In BTU's `/4 000 010- 5. Calculation /(HSqFt) /$ /V. _ (see line 2 above) BTU /h X 2./ (see line 3 a, b, or c above) 1 /9 ? 7,? BTU Equipment Maximum Size Applicant's Sig ature: 7/9/96 11 ,Kol, TRW Permit Ceiter 6300 Southoenter 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 #: m • '5 P.2/5 H -6 Date: 7"' q7 . — -- '; +,.".- .•.�.:.;. ,,,,;,; �v,:,�,� sue ., "7F :1 - 7 - - :: �O'ss" •u.0 • '•"'^ ..__ ua�w�..u•u�.....�.u.0 • il�C ar4'. w:► S' wu' u �:. 'ua��wuti�i.'�'.�+�••�r_uaau..•• ••_ !: DL;RTMENT OF LABOR AND INDUS /2 .41,,:t,' • i�'�1'' %;EpEO18TRATIbtl t UMD R '' ;r;';4' ,..: .":4 + f' i.�iiPlgl�[ION uME n STATE OF WASHINGTON F625.052.000(3.92) .,�, �... +',,,,� .. u�• ^:S ^ w • 'u ^ ��wa�u1�1'�.'..S4T�S.� ^ .•V�'��`eZ • .i�••ua r _^'ti� `."i::__:,�':.^a�u��`y.. . +� e.,W�R,+• r �S_��'^.u^�:u ^.�i.�,Z•i