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HomeMy WebLinkAboutPermit 0061-M - Pelchls MeatsCITY OF TUKWILA 47. Building Division 6200 Southcenter Boulevard Tukwila, Washington 98188 (206) 433 - IMP? BUILDING PERMIT Work to be done HVAC Site Address 1150 ANDOVER PK E. Building Use N/A Property Owner PETCHLS MEATS Address 1417 13TH AVENUE Contractor ROWLEY REF. Address 16529 SIMONDS RD, N.E. PERMIT # Control # 88 -056 -M Suite # Tenant PFTCHI S fr1FATS Assessors Account # 262304- 9089 -0 Phone #_ s - g Zip 122 Phone # 488 -2812 SEATTLE. WA #ROWLEI212KY FOR BUILDING PERMIT•ONLY APPROVED FOR ISSUANCE BY: Sq. Ft. ist F1: ` Office 2nd FT. 3rd F1. Storage/ Warehouse Retail Other Occ. Load Total Fire Protection: ❑ Sprinklers ❑ Detectors Zoning Type of Construction Special Conditions Zip 98011 DATE: 7 sq. ft. @ 1st F1. $ sq. ft. @ 2nd F1. $ sq. ft. @ other $ sq. ft. @ other $ Total Valuation of Construction $ Bldg. Permit Fee Receipt #4,(-5":3$ Plan Check Fee Receipt # q i-53$ Demolition Receipt # $ Surcharges Receipt # $ Other Receipt # $ Other Receipt # $ TOTAL 30,000 33.00 8.25 $ 41.25 FOR SIGN PERMIT ONLY [] Permanent [] Temporary ❑ Single Face [] Double Face [] Wall Mounted [] Free Standing ❑ Other Building face Setbacks: Front Side Side Rear Square Footage of each sign face Total square footage of sign Special Conditions THIS PERRI! BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK i5 SUSPENDED OR ABANDONEU FUR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WI COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DUES NOT PRESUME TU GIVE AUTHORITY TO THE PR VIOLATE OR CANCE Signed DNS of ANY OTHER STATE OR LOCAL LAN REGULATING CONSTRUCTTION OR THE PERFORMANCE OF CONSTRUCTION. Date „34/ ? i.e.9' LICENSED CONTRACTORS DECLARATION I hereby affirm that I am ensed, r provi ions of the Business and Professions Code, and my license is in full force and effect. Contractor (signature) Date Ci +v _2-, OWNER - BUILDER DECLARATION ( ) 1, as owner of the property, or my employees, with wages as their sole compensation, will do the work, and the structure offered for sale. ( ) 1, as owner of the property, am exclusively contracting with licensed contractor's to construct the project. Owner (signature) Date is not intended or CITY OF TUKWILA Building Division 6200 Southcenter Boulevard Tukwila, Washington 98188 (206) 433 - IS4q BUILDING PERMIT Work to be done HVAC Site Address 1150 ANDOVER PK E Building Use NIA Property Owner Address Contractor Address PERMIT # Control # 88 -056 -M Suite # Tenant PFTCHIS MEATS Assessors Account # 262304- 9089 -0 Phone #_321:2154u77___________ Zip Phone # 488 -2812 Zip 98011 PETCHLS MEATS 1417 13TH AVENUE SEATTLE. WA ROWLEY REF. #ROWLEI212KY 16529 S IMONDS RD. N.E. BOTHE WA FOR BUILDING PERMIT ONLY APPROVED FOR ISSUANCE BY: DATE: • `; Sq. Ft. "ITE—FT. Office Storage/ Warehouse Retail Other Occ. Load 2nd F1. 3rd F1. Total Fire Protection: ❑ Sprinklers ❑ Detectors Zoning Special Conditions Type of Construction 4es sq. ft. sq. ft. sq. ft. sq. ft. Total Valuation 1st F1. $ 2nd F1. $ other $ other $ of Construction $ 30 000 Bldg. Permit Fee Receipt # uy -; j $ 33.00 Plan Check Fee Receipt # ,,j, -S3$ 8.25 Demolition Receipt # $ Surcharges Receipt # $ Other Receipt # $ Other Receipt # $ TOTAL E 41.25 FOR SIGN PERMIT ONLY [[ Permanent [] Temporary 0 Single Face ❑ Double Face ❑ Wall Mounted ❑ Free Standing Building face Setbacks: Front Side Square Footage of each sign face Special Conditions Side [] Other Rear Total square footage of sign THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZEO IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEU FUR A PERIOD OF 180 DAYS AT ANY TINE AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ ANO EXAMINED THIS APPLICATION AND KNOW THE SANE TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WI COMPLIED WITH WHETHER SPECIFIED HEREIN 011 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL., THE PR 1 NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. Signed 1 �c' ogee < .4/ `7 >? LICENSED CONTRACTORS DECLARATION 1 hereby affirm that 1 aa ensed ra4r prowl ions of the Business and Professions Code, and my license is in full force and effect. /!/)/' Contractor (signature) Date )C -1 y j OWNER- BUILDER DECLARATION ( ) 1. as owner of the property, or my employees, with wages as their sole compensation, will do the work, and the structure Is not intended or offered for sale. ( ) 1, as owner of the property, am exclusively contracting with licensed contractor's to construct the project. Owner (signature) Date CITY OF TUKWILA Building Division Tukwila,,tWashinoton Boulevard 98188. (206) 433 -1849 Type of Inspection Site Address / /5-c) 4 q-Jr J Pi 6. .Requestor Special Instructions INSPECTION RECORD PERMIT # a66 / -,x/ Date Wanted r «y 52.27- Project Phone # Inspection Results /Comments: - Inspector.lj�/'(/li't Date THE FOLLOWING COMMENTS APPLY TO AND BECOME PART OF THE APPROVED PLANS UNDER TUKWYLA BUILDINe PERMIT NUMBER ( 66L-A1,___. 1. No changes will be made to plans unless approved by Architect and Tukwila Building Department. 2. Electrical work to be inspected by'8tate Electrical Inspectors and 011 required electrical permits obtained through that agency. ,All permits to be posted at job situ prior to start of Any construction. All-construction to be done in Conformance with approved pl ans .aAnd: requirements.of the Uniform. Building Code (1983 Edition), Unjfarm Mechanical Code (1908 : Edition) ,' Washington State Energy Codes (A1986 Ed.itian) , and Wa hington State Regulationea for Barrier `;Fri Facility (1986 Edition). BULLETIN DCUM -1 HEATCF,AFT INC. • TEL No . 919 791 3V--' Jul 1288 10:18 F . 01 PERFORMANCE LOW TEMPERATURE R -502 CONDENSING UNITS COND. UNIT MODEL 110. DCUM O30AL5 050AL6 07510.5 100AL5 030AL6 050AL6 MAWS- 100AL5 AMBIENT TIMPERATURE 90 .10 SUCTION TEMPERATURE • P •7O •O0 .40 MIN SER MIN RIR MIN EER MBN !SR 26.40 4,08 36.30 4.48 52.30 4,32 70.20 5.00 55.40 5.25 42.60 4,60 030AL5 050AL6 075AL5 •6 100 5.63 20.40 5.65 26.00 5,64 41.30 4.67 5.07 4.96 16.20 21.20 31.50 11.00 16.40 23,70 31.70 3.33 3.91 3.69 3.96 25.40 , 5.33 19.60 4.61 14.60 3,67 35.20 16.36 27.90 4.61 21,40 4.27 50.20 5,34 39.50 4.71 30.30 4,10 67,70 5,60 53.40 4.99 40.00 4,37 24.40 34.00 40.10 100AL5 65.30 COND. UNIT MODEL NO. DCUM 050AR7 075AR7 050AR7 100AR7 050AR7 0754R7 060AR7 10DAR7 050AR7 075AR7 060AR7 100AR? 5.03 5.11 5.04 5,31 18.80 26.00 37,80 4.36 4.58 4,47 51,10 4.71 14.00 20.60 28.80 30.30 10.50 15.50 22.60 30,40 3.18 3,74 3,51 3.79 3.60 9,10 3.00 4,05 15.10 3.56 3.68 28.40 3.31 4.16 29,00 3.58 MEDIUM TEMPERATURE R•502 CONDENSING UNITS AMBIENT TEMPERATURE °P , COND. UNIT MODEL NO. DCUM 050AR7 075AR7 080AR7 100AR7 050AR7 075AR7 080AR7 100AR7 050AR7 075AR7 000AR7 100AR7 SUCTION TEMPERATURE •P +21 +20 +10 +0 MIN an MOH !ER MON 90 95 100 !ER MON SIR 64,40 6.45 49,90 5.09 41.40 7.26 33.70 6.37 78.90 8.16 71.00 7.70 59.10 7,04 47,80 6.30 91.00 6.67 04,30 8.29 69.70 7,43 50.40 6.53 112.50 9.21 103.40 0.79 65.10 7.66 70.60 6.85 62.60 7.93 48.20 7.60 39.00 6.82 32.80 6,03 76.50 1.74 69.60 7.37 57.10 6.67 46.20 5.98 88,50 6.16 81.20 7.81 67.30 7.03 54.50 6.21 100.30 8.64 99.50 6.26 62.80 7.41 67,90 6,59 60.80 +7.45 40.50 7.14 30.50 6.43 31.40 6.66 74.00 7.32 67.30 7.06 55.20 6,31 44,60 5,57 65.20 7,70 76.20 7.37 64,60 6.65 52.60 5.59 104.00 8,11 95.60 7.75 79.60 J.. 8.06 65,20 6.22 HIGH TEMPERATURE R•22 CONDENSING UNITS AMBIENT TIMPIRATURI •P 00 65 100 SUCTION TIMPERATURI °P +40 +10 +29 +20 +10 MIN EER MIN ERR MOM SEP MIN SIR MIN SER 70.50 9.62 68.40 9.08 52.05 8.63 47.50 8.16 38.00 7,22 97.00 9.00 8040 0.90 72,95 0.38 65.50 7.05 52.40 8.60 121,30 10.74 101.40 9.75 91.10 9.10 83.00 6.64 66.60 7.50 144.10 11.01 120.70 10.06 100.60 9.54 98.90 9.01 79.60 7.80 60.60 9.23 ' 56.70 ' 1.53 51.36 0.10 46.00 1.68 36.70 8.76 94.40 9.34 71.20 0.41 70.65 7,92 03.70 7.43 51.00 6.46 117.60 10.11 ' 98.20 9.17 80.30 5.66 60.40 0.16 64.40 7.09 130.50 10.30 116.90 0.44 101.35 5.95 95,10 9.45 76.90 7.42 86.00 016 ' 55.00 $.01 49.90 7.62 44.60 1.23 35.50 0.37 91.70 9.60 11.00 7,94 00.95 7.49 61,90 7.03 49.60 5.14 113.60 9.50 95.00 8.81 66.35 0.16 77.70 7.17 62.10 8.70 134,70 912 113.00 9.04 102.00 0.30 02.60 7.93 74.30 0.98 HEATCRAFT INC. TEL No. 919 791 3447 Jul 12,88 10:20 P.03 ELECTRICAL DATA DCUM MODEL NO. POWER SUPPLY COMPRESSOR ALA LRA COND. PAN TOTAL AMPS, MCA 030AL641 030AL527 050AL501 050AL541 050AL527 075AC541' 075AL 527 100AL541 1004L527 050AR 711 '050AR727 LOW TEMPERATURE R•502 CONDENSING UNITS 208/230 -3 -60 13.9 480 -3.80 6.9 230 -1 -60 206/230 -3 -60 460 -3 -80 208/230 -3 -60 460.3.60 208/230-3-60 460 -3 -80 28.3 17,3 10.3 28.2 14.4 37.2 16.0 102.0 4,4 52.0 2.2 125,0 115.0 53.0 39.0 20.0 45.0 25,0 4.4 4.4 2.2 48.6 39.0 19.9 181.0 83.0 6.8 4.4 215.0 8.8 106.0 4 4 88.0 40.0 70.0 45,0 30.0 DEFROST /Mt MAXIMUM AMPS. UNIT COOLER PAN MTRS, 5,1' 4,4 8.8' 8.8' . 4,4 80.0 45,0 15,3 7,7 DEFROST HEATERS 39 20 71.4 100,0 15.3 40.0 45 0 7.1 MEDIUM TEMPERATURE R•582 CONDENSING UNITS NIGH TEMPERATURE R -22 CONDENSINO UNITS 075AR741 07501727 208/230.3.60 460.3 -80 208/230-3-60 460 -3 -80 23.2 10.3 080AA741 208/230-3-80 060AR727 460.3 -80 25.5 14,1 38.6 18.0 150,0 4.4 75.0 2.2 175.0 8.8 75.0 4,4 43.0 19.9 88.0 40,0 60.0 25.0 80.0 45,0 215.0 8.8 70.9 100.0 108.0 4,4 40.0 45.0 100AF1741 208/230 -3.60 39.1 215,0 6,8 82,0 100.0 100AR727 _ 400.3-60 18,0 108.0 _ 4.4 48.0 80.0 ALA - Ral•d Load Amps MCA • Minimum Circuit Ampacity • LRA • locked Aotor Amps MFS - Maximum Fuso Sire t Doltost kits .are standard low temporatura units and optional on the rest. ' These unit' cooler fan motor Toads ars single phase. 8.8' 4,4 39 39 20 88 40 68 40 39 20 80 40 68 40 82 48 HEATCRAFT INC DCUM 400EL rNO. TEL No. 919 791 34 2, 3u1 12,88 10 :20 P.02 1l SPECIFICATIONS COMPRESSOR MODEL HP NO. ,3DAL5 '50AL5 ISAL5 00415 5 DI$PL. CPH ROWS SEEP CONDENSER RECEIVER PACE sus. PAN(S) MOTOR(II) AREA COOLER r ($O. PT.) CIRCUIT NO. DIA. HP RPM CPU DIA. LOTH. LOW TEMPERATURE 0-1102 CONDENSING UNITS MDD -0300 823 4 7.16 M0A -0500 1080 4 7.16 71/2 10 368 -0750 1820 3 14.08 308.1000 2120 4 14.06 YES 1 24 YES 1 24 YES YES 24 24 3/4 1140 4077 10.75 16 3/4 1140 4077 10.75 18 3/4 3/4 1140 1140 MEDIUM TEMPERATURE 0-802 CONDENSING UNITS HIGH TEMPERATURE 0-22 CONDENSING UNITS CAPACITY eSO% (Ibs.) 45 45 6700 8200 8.825 8.625 53 53 92 92 ..;0AR7 1 5 SAR7 71/2 SQAR7 71/2 00AR7 10 MOD.0500 MDA-0750 304 -0750 308 -1000 823 1080 1375 1620 4 7.16 2 14.06 3 4 14.06 14.06 YES YES YES YES 24 24 24 24 3/4 3/4 3/4 3/4 1140 4077 10.75 1140 9300 8.625 1140 8700 8.625 1140 5200 6.825 16 53 45 92 53 92 63 92 DIMENSIONAL DATA +nit Sizes 030 thru.100 CONTROL PANEL LIOUID CONN. 13 62 11.00 7.60 4 2.56 SUCTION CONN. CONDENSING UNI1 MODEL NO pIMINSIONS (INCHED)CONNECTIONS C O 41.1/4 41.1/4 52 52 52 (ODM)_ T Li UID 1/2 5/8 6/0 5/6 i 7/0 .. APP$O><IMATI $HIPP(NO, WEIGHT (1111 588. 679 950 650 1.025 A p $UCT101� 1 -3/0 1.3/ ': 1.3/6 ' 1.3/5 1:3/0 030 ,: .. 050 AM. . 060 _• . .100. • . 41.1/2 41 -1/2 59.1/4 69.1/4 59 1/ 31 31 30.5/6 30.5/0 �.._.43.13i16 34.1/4 34.1/4 43.13/16 43.13/16. , 4Hs • ENGINEERING GUIDE SPECIFICATIONS . r, w .. iL -... - ./.., • ...I _ _ .... . GENERAL - Furnish and install where shown on piens McOuay air cooled condensing unit(s), model DCUM. The unit shall be completely factory, assembled and shall be leak tested, evacuated and charged with a refrigerant holding charge. The units shall operate on - __._ volts. _._` hertz, phase electrical service. All units shall have labels to indicate caution areas and 10 aid unit service, Electrical wiring diagrams shall be attached to unit installation and maintenance bulletins • Shall be supplied with each unit. Units shall be specifically designed for outdoor application and shall have lifting holes for handling. CAPACITY - The unit shall have a capacity of not less than BTUH, with ambient air entering the condenser at °F and saturated suction temperature at the com- pressor 01 - _.__ °F. CABINET AND BASE - The unit shall be constructed of heavy gauge galvanized steel. The cabinet exterior panels shall be constructed of G90 galvanized steer Removable front louvers end hinged top shall be furnished to provide quick and easy access to the unit interior for service and maintenance. Unit snall be totally serviceable from air discharge side. Louvers shall be provided on air discharge side for safely. COMPRESSOR - Compressor shall be discus - accessible hermetic type with suction and discharge service valves, crankcase heater. oil sight glass and oil charging con- nection; compressor shall have a force -fed lubrication system with reversible oil pump and sentronic oil pressure safely control. Compressor shall have an operating oil charge Compressor motor shall be high torque. hermetic induction type, 1750 rpm and shall be protected against overload, single phasing and locked motor conditions. Compressor shalt be rigid mounted to minimize vibration and noise. CONDENSER - The condenser coil shalt be constructed of 3/8" Q.D. seamless copper tubes arranged in a stag- gered pattern and mechanically expanded Into high efficiency rippled aluminum fins for maximum heat transfer. The tins shall have full drawn collars to com- pletely cover the copper tube to assure a permanent primary to secondary surface bond. SUBCOOLING SECTION - A subcooling section she's be Integral with the main condenser coil but piped after the liquid receiver and shall provloe sufficient I;quld sub - cooling without sacrificing head pressure for improved system performance and longer piping runs without feast• gas. CONDENSER FAN AND MOTORS - The direct drive con- denser tans) shalt be propeller Type, statically balanced and operationally designed for low tip speeds to minimize noise and vibration transmissions. The fan blades shall be aluminum and securely riveted to a zinc plated steel hub. The condenser tan motor(s) shall be weather protected and have inherent thermal overload protection. Each fan shall be protected by a heavy -gauge ten guard. RECEIVERS - The receivers shall be Insulated and complete with fusible plug on 3 and 5 HP, relief valve on 7)G and 10 HP units. The units receiver shall be constructed of carbon steel. LOW AMBIENT CONTROL • Fixed head pressure system shall assure sufficient refrigerant flow, even at subzero temperatures. SEASONMISER! - Heed pressure control condensing units shall be furnished with the energy saving SEASON - MISERS variable head pressure control system. CONTROLS - All controls Such as senirOnic oit failure switch and dual pressure control shall be enclosed within the cabinet. Dual pressure control, condenser fan motor capacltorisl and compressor end condenser fan motor contactors shall be furnished as Standard equipment. A factory installed electric defrost kit shall be furnished on all heater low temperature units. The kit shall consist of timer, a defrost interlock to prevent defrost heater operation during pumpdown, a unit cooler tan motor Contactor on 71/2 and 10 HP units, and a terminal block for field wiring The control panel component shall be factory, mounted and wired. REFRIGERANT PIPING - Units shall have a factory mounted suction line filter. liquid tine sightglass and fitter-drier, A solenoid valve and room then moslat shall be avertable as field installed accessories • 4'. .r;.Glnce pro et"t Pk • fir 1. • `A ,. ?+r •jl jr. ' �• h •.tRt •, ±��TAI rC i";•, !v� /. !)'•�i.'' • 1u ., i1 f( r,• ):� uct lmprovemen • coat }nu ng effort at McOvey; we reierve t e r1pht to mike changes n.apeclltcst ans • • s...�..G -.,t. W It s, p..�.w.• •.V r t.' • o : orrivo ldzWON.7 c DCU M 3 HP thru 10 HP Outdoor Air Cooled Condensing Unit with 'Discus Compressor and Sentronic OH Pressure Control FEATURES • Discus compressor provides higher efficiency, quiet operation and reliability, • Suction and discharge service valves simplify servicing. •High accuracy Sentronic 011 Pressure Sensing System minimizes nuisance trips and compressor failures. Eliminates leaks due to oil pressure switch because there are no capillary tubes. • Crankcase heater minimizes refrigerant migration to the crankcase. • Crankcase oil level eight glass permits observation of oil level. •Compressor over current and over temperature protection Improves reliability. • Galvanized steel base and cabinet prolongs life of exterior. *Large condenser with integral sub000ler coil lowers oper- ating cost. • Thermally protected, permanently lubricated PSC condenser Ian molor(s) provides peak performance and long life. MODEL NOMENCLATURE. •Oversized receiver provides sufficient pumpdown capacity. Insulation on the receiver assists start -up in cold weather, •Fusible plug (3 and 5 HP) and relief valve (7'h and 10 HP) provide added protection. • Head Pressure Valve maintains heed pressure required to teed the expansion valve when the ambient temperature is low, Optional Sessonmieer valve provides energy savings when the outside emblent felts below 80' F. •Factory Installed liquid line filler -drier removes moisture, foreign matters and acids which protects refrigeration system against contamination, • Liquid line sight glass will indicate the presence of moisture as well as shortage of refrigerant in the system, •Suction filter protects the compressor frorn foreign matter. • H1nped electric control panel is located on the outside of cabinet for easy serviceability. • Control panel houses compressor contactor, condenser tan motor capacitor(s), and defrost controls (electric defrost units only) and unit cooler fan contactor (selected units). D•Discus -- Condensing Unll MCQuay Compressor Horsepower 030a3HP 050'6HP 078 • 71i HP 060 • 7'A HP 100 = 10 HP Electric Characteristics 01 =230.60.1127 =460460.3; 41 =208/230.60.3 A-- Refrigerant s•R•5o2; 701.22/R•502 Temperature VLOw R•Hiph a Medium. Vintage,. CITY OF TUKWILA Building Division 6200 southcenter Boulevard MECHANICAL PERMIT APPLICATION Tukwila, Washinotnn 0,1180 (206)- 433 -1849 Site Address 11570 MNDaveE PK Project Name /Tenant pe7 e hls j eDTS Valuation of work !f WO Assessors Account # 30Y•_ .3-9 -0 Property Owner Phi Gh /S /2e-,z 7) Phone Y,y Address Zip c ,/ ) 2 Phone 4f Srfr )-Sr/ ‹i %7o..D S 401 /v 6'F e Zip 9,:y d % ( Architect /Engineer (ip 0//e/ %e f,, r ,-40 7 --4, Phone Address 14 4/ go Tl, ed Zip 95-0 Contractor Re y,/ /,py 4 eY License# R, �i,� /;•cp Phone -/..1 Address /z :.;)q 5- //-70„, _ ,Qf B #The /J Zip 9, r/ Describe work to be done .7,11,57.0 Avem, %� h"-re N� e u ri r e 7 # ' ,4, .. i T ex: s %!✓c- E' 4 c, Indicate the type of equipment to be installed, rating /size of equipment, and number of each: TYPE RATING /SIZE NUMBER CONTROL# 0'054 -n1 Suite# Floor# Applicant Rp,,,,�� Address !� k,e�., y P,,T „4✓ L • tip Two (2) sets of plans must be submitted meeting the application requirements of Section 302(b) and (c), 1985 Uniform Mechanical Code. Roof -top equipment work requires submission of building elevations. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CJRRECT AND THAT I HAVE THE PROPERTY OWNER'S AUTHOORIZA TION TO DO THIS WORK. Applicant /Authorized Agent (signature) �� Date (print name) Contact Person (please print)��y ,,,,(�,, Phone 9 .2V J_ OFFICE USE ONLY FEES: Basic Permit Fee (000/322.100) Unit Fee (000/322.100) Plan Check Fee (000/345.830) Other ( / ) RA KIN 1 • BLDG PL NG gteot. 7-11-Ft Receipt# ei� 3 Date Paid .2 _x1. ;3 Receipt# Date Paid Receipt # -= Date Paid Receipt# Date Paid TOTAL Q/, a5 (OWES: S I/1, as 9- 13 -88S ?-26-01✓, Approved for Issuance Approved (Initials) RECIVED l t�i�Ci maxima DWG'