HomeMy WebLinkAboutPermit D97-0171 - HAMASAKI NOBUYOSHI - SHED REMOVALCity of Tukwila �-
Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188
WARNING: IF CONSTRUCTION BEGINS BEFORE APPEAL PERIOD EXPIRES,
APPLICANT IS PROCEEDING AT THEIR OWN RISK.
Parcel No: 032304 -9200
Address: 10215 BEACON AV S
Suite No:
Location:
Category: AGAR
Type: DEVPERM
Zoning: LDR
Const Type:
Gas /Elec.:
Units: 001
Setbacks: North:
Water: SEATTLE
Wetlands:
Contractor License No:
DEVELOPMENT PERMIT
.0 South: .0
Sewer: SEATTLE
Slopes: N
Permit Center Authorized Signature:
■
Permit No:
Status:
Issued:
Expires:
(206) 431 -3670
D97 -0171
ISSUED
06/04/1997
12/01/1997
Occupancy: PRIVATE GARAGE
UBC: 1994
Fire Protection:
East: .0 West: .0
Streams:
Phone: 206 722 -4945
Phone: 206.722-4945
OCCUPANT HAMASAKI NOBUYOSHI
10215. BEACON: AV S, TUKWILA WA 98178
OWNER HAMASAKI NOBUYOSHI
3523 S PORTLAND ST, SEATTLE WA 98118
CONTACT KAZUE HAMASAKI
10215 BEACON AV S, TUKWILA WA 98178
***********• k***************************************** * * * * * * * * * * ** * * ** * * * * * * * * ** * * ***
Permit Description:
REMOVAL OF 131 S.F. OF A SHED TO. MEET PROPERTY
SET -BACK REQUIREMENTS.
**************'*************************************** * * * * * * * * * ** * * * * * * * * * * * * * * * * * * **
Construction Valuation: $ 300.00
PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr:
Curb Cut /Access /Sidewalk /CSS N
Fire Loop Hydrant: N No Size(in): .00
Flood Control Zone: N
Hauling: N Start Time End Time
Land Altering: N Cut: . Fill:
Landscape Irrigation: N
Moving Oversized Load: N Start Time: End Time:
Sanitary Side Sewer: N No:
Sewer Main Extension: N Private: N . Public: N
Storm Drainage: N
Street Use: N
Water Main Extension: N Private: N Public: N
***************************************************** * * * * * * * * * * * * * * * * * * * * * * * ** * * * * **
TOTAL DEVELOPMENT PERMIT FEES: $ 39.15
***************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
6L-MIIM? Date: ^ CD_
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 provision of any other state or local laws regulating construction
or the performance of work. I am authorized to sign for and obtain this
development permit. /I
Signature:
Print Name :.; h ? U ___4ZIA ,J ?< f
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.
Date: -- L -97
SE
. CTION
developer /authorized
NAME OF DEVELOPMENT: Nan7a5a M l ) N01914
DEVELOPMENT ADDRESS: / 0,R /5 ' �4
CASH ASSIGNMENT
SHALL BE REFUNDED
BY MAILING TO:
(please print)
CITY/STATE/ZIP j `/ / CO / L ff
DESCRIPTION OF ITEMS TO BE COMPLETED (REFERENCE
PLANS/DOCUMENTS WHERE ITEMS ARE DESCRIBED):
RL-'111� ✓ / SC AgE • fGE % D/ f ST/ , JL . 4;73 11
S'N�n Cs�ok F 5/1E
e:co . pletc . by<;CI s
THIS FUND IS AUTHORIZED TO BE ACCEPTED.
SIGNED: 1 - < &c C711
AMOUNT: `' 7 00
0 CASH Q CASH EQUIVALENT
C CEIPT NO.
1 1
DEPARTMENT HEAD: `'
DEPOSITED THIS DATE:
RECEIVED BY:
nec "ts . -20 lino
sea u' "ter . c n
}S•w»s•m, ? } }:ti } }: } }: iii• }} } }:f:4 }:;Niitif }iff } }i }:iiIX•i}}} ja» »v. »vrrro,+k•A }iii• %':(f]i{iti V' M'ti4liv]K,1dCifaidfitiii tiXiiii wJ a ',W"Liv }}:�iwititi4iliiliAWi.Viii Viii, \i»4tiirelTNiaW`.i9:Jj tifaa yq: 0. ya» f.\\ iCfvXfi f' �v; A\' L{ 4: ifNriiw 'ja„•ivnf:ri• ;v:Jdib"m9:i<Prr};i
As the owner, or authorized agent of the owner, I hereby submit cash or cash equivalent in the amount of
$ - 750 . oa ($150% of value to complete work described above) and attach supporting
documentation for value of work. I will have this work carried out and call for a final inspection by this date:
( q / '1!" / /1'17); or risk having the City use these funds to carry out the work with their own contractor or
in -house manpower. If I fail to carry out the work, I hereby authorize the City to go onto the property to carry out
completion of the above deficiencies. I further agree to complete all work listed above prior to requesting inspection and
release of these funds. SIGNED: C 6
�., sc C•Lrti'.
TITLE:
:. v vvnwm . . vaw:.» vnwnfn» a vwiif: i. vLtiifiiiti ,'iiu,riifii:riv+:ie•.v:v;•iLwirii
.........................
�CT/ON�j
COnr p/eted >b
CHECKED BY:
e:cpmplete
NAME:
72 HOUR NOTIFICATION
INSPECTION AND RELEASE
DEVELOPER'S REPRESENTATIVE:
sta ff) :
d
FOR
OF FUNDS
CASH CITY CHECK NO. 9 �
City of Tukwila
r
if DEVELOPER'S PFaJECT WARRANTY
REQUEST FORM
S'
ADDRESS: / p
DATE: C - / - cj 7
I have reviewed the above work and found it acceptable and therefore
authorize the release of the above cash assignment.
AUTHORIZED BY:
ECTION d (to; completed:by
I ty sta
2 CASH EQUIVALENT - LETTER AUTHORIZING RELEASE
Upon completion through Section 2, Finance personnel shall
send copies to: - Developer
- Finance Department
- Permit Coordinator, DCD
RELEASED THIS DATE:
DATE: 5- a 7 -
PERMIT NO.:
dq - 7-a (7/
TEL. NO. 2, 6
U� �D UT/'
9 ,r/71
AMOUNT: • r . 0 C`_)
DEPARTMENT:
4/
All work identified in Section 1 of this form has now been completed
and returned to department which authorized warranty. I hereby
request inspection and release of my cash/cash equivalent.
RELEASED B All : JA �ti,F!NANCE DEPT.
i;;:,.: ;;;i i:iiiwii; «;: iii..:f f,if; }. }:;:i.:v w; :..::.i;. }:;:: >::<;,.: }:; f;f:�::i: „f;} :.i »~f:; • }�� ,,. »YU...N,� , »,»„w�w.,X • A ; , »,
Upon completion of entire form, Finance personnel shall
send copies to: - Developer
- Finance Department
- Permit Coordinator, DCD
09113/93
'CITY''OF TUKWILA:
Addre s 10215 BEACON AV Pe -m i . D9 -0
Su to
T.e n a n;t _
• ISSUED
Type: DEVPERM Appl "ied:: 05/27/.1997
Farce l `.:#. !0323 -9200 Issued: 06/04/1.997
* *`'k* k.Ai:A* *, A**:*• k- k*'' k- k**• kAi• k*• k*' k * * * * *•k* * *•k **A; *•k*. *, ** k• k: k*. Ar *,•k.k,4.1,A. * * ** *`k*
Permit Condi '.tian ;s
I changes. will made to the plans' unless approved by the
Tukwi la Building Div:ision
All permits; inspec,tian re.cords apprrove plans she 11 .be
available at t he fop. site prior .t the s tart a.f an con
5truction These`f.:,documents' =arse itdOb e maintained and avai 1,..
able un til final ins t`:i
peco,1 a pproyal is grante`d
Validity a f'A'F'e`rmi t, r The` i s ,ante of . a e ^ r
pmi t r , - o app of
plans, spe�cLf i,Cati and c ompu t ations she`) l net bez con
stru :to a 0e f 6 r.. , • S :o r~ an"approval ot, -an violat
Of.. any oft ., the, provisions of •the buil CO ng code or '6:0 a rim '
ot her ap n
inac t .j uris;dict-io�n ::No permit p,r,esuni
give, pi 4.thor`•ity to violate cancel. . the pro visionsy -ot this
code :,shal.i .be .vat id.
Project Name/Tenant:
/1 Al -tA S A- 1 I i1in_ ayi, sill
Type of work: ❑ New Single - Family Residence ❑ Addition - Single- Family Residence
❑ Interior Remodel- Single - Family Residence 171 Residential Accessory Structure*
Remodel /Addition to Accessory Structure ` ❑ Garage(s)
Deck(s) - Covered & Uncovered ❑ Residential Reroof
Value of o � jon:
U V
Site Address: r
/G' .) /4 PEtJ(_y/>,c.) 'SC;, •u51s11�.i4 Id
City State/Zip:
gfry 7S'
Tax Parcel Number:
03a3bei- •- 9a00 --vs'
Phone:
CZ 00 Toga — 4L5' /AC
,
Property Owner:
/4Ar1A / A/DBY c C.N/ a;A7c.IG)
Street Address: City State/Zip:
3,5 • Sr-,. ff' el A D - i . 5 t:71rre_r- 1,0 A 90)
Fax #:
Contractor:
S/= L F
Phone:
(ROO 7 — 4< /4/..-
Street Address:
-:- 3 4 ;;R -:- 3 4 ;;R SP . feve1 cr-} n _ .�1 f , e E
City State /Zip:
Id') . 9kwe
Fax #:
Architect:
Phone:
Street Address:
City State /Zip:
Fax #:
Engineer:
Phone:
Street Address:
City State /Zip:
Fax #:
Contact Person:
Phone:
Street Address:
City State /Zip:
Fax #:
Description of work to be done: 1 GA
, E)-•i e v c X 2 6 Le g pc� i G " Fr- . 5 ' 3 ,5" Li 4-g F i 5 ' 1
Type of work: ❑ New Single - Family Residence ❑ Addition - Single- Family Residence
❑ Interior Remodel- Single - Family Residence 171 Residential Accessory Structure*
Remodel /Addition to Accessory Structure ` ❑ Garage(s)
Deck(s) - Covered & Uncovered ❑ Residential Reroof
Is this site served by: ❑ Sewer ❑ Septic (King County Health Dept. approval required - 296 -4722) AO
Existing Square Footage for Structure: sq. ft. Dwelling sq. ft. Covered Deck(s)
sq. ft. Garage /Carport .42 L- sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Proposed New Square Footage: • sq. ft. Dwelling sq. ft. Covered Deck(s)
sq. ft. Garage /Carport :3 ci,i sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Floor Area Ratio: (total floor area of all structures divided by the area of the lot)
For an Accessory dwelling, provide the following:
Lot area Floor area of principal dwelling Floor area of accessory dwelling
' Provide documentation that shows the principal owner lives in one of the dwellings as his or her primary residence.
Single - Family Residential Permit Application
CITY OF TUI WILA
Permit Center
6300 Southcenter Blvd., Suite 100, Tukwila, WA 98188
(206) 431 -3670
FIR STAFF USE ONLY
Project Nibnber --�j
Permit Number:
Application and plans must be complete In order to be accepted for plan review.
Applications will not be accepted through the mall or facsimile.
APPLICANT REQUEST FOR PUBLIC WORKS,SITE/CIVIL PLAN REVIEW OF THE FOLLOWING:
(Additional reviews shall be determined by the Public Works Department)
❑ Channelization /Striping ❑ Curb cut /Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s):
❑ Flood Control Zone ❑ Hauling ❑ Land Altering: 0 Cut cubic yds. 0 Fill cubic yds.
❑ Moving an Oversized Load: Start Time: End Time:
❑ Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Private 0 Public
❑ Storm Drainage ❑ Street Use ❑ Water Main Extension 0 Private 0 Public
❑ Water Meter /Permanent # Size(s):
❑ Water Meter Temp # Size(s): Est. quantity: gal Schedule:
El Miscellaneous
Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be re-
viewed 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 ex-
pire 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.
D ate application accepted:
PLEASE SIGN BACK OF APPLICATION FORM
SFPERMlT.DOC 2/13/97
Date application expires:
- a - 7- q - 7
Application taken by: (initials)
P
BUILDING OWNER OR AU HORIZED AGENT:
Signature L.. /'I Ci.42 C iL - A—i-r _J
Date: 5 _ 2 .. 2 _ `/
Print name: /
f:-.4 z4r � . Y /f'I 1 , 1 fI �/J -g.J
��� ��.). _ 446 54.c
Fax #:
Address: /, [ _ / )' /74 [ �
L' --�J_2 -Ad (7',1� /I i `, ,
City /State/Zip: �
-r it 41. /V / / t'u . /� Z- 4 1 2s/7
/,
ALL SINGLE- FAMILY RESIDENT • PERMIT APPLICATIONS MUST B - .UBMITTED WITH THE FOLLOWING:
• DRAWINGS PREPARED BY , REGISTERED ARCHITECT OR PRL c:SSIONAL ENGINEER MAY BE
REQUIRED BY THE BUILDING OFFICIAL
➢ ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN
• BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED
N/A SUBMITTED
❑ ❑ Copy of recorded Legal Description from King County
❑ ❑ Certificate of water /fire flow availability (Form H -11 a). Contact the Public Works Department
(206) 433 -0179 for servicing district.
❑ ❑ Certificate of sewer availability (Form H -11). Contact the Public Works Department (206) 433-
0179 for servicing district.
❑ ❑ Metro: Residential Sewer Certification (if Tukwila Sewer District) (Form H -12)
❑ ❑ King County Health Department approval for septic - 296 -4722
Four (4) sets of working drawings, which include:
❑ ❑ Site Plan (see example Form H -16)
1. Existing fire hydrant location(s).
2. Proposed access road.
3. Driveway location- driveway shall be 10' wide minimum and 20' wide maximum. If driveway is over
150' long, driveway shall be 20' wide and have an approved turnaround (City Ordinance 1741).
4. North arrow and scale.
5. Building setback from property lines. Any proposed or existing easements must be shown on plan.
6. Public Works review requires the following on site plan: driveway location (10' min., 20' max. width),
show proposed and existing power, water and sewer lines, existing storm drainage system,
downspouts and foundation drains, and where drains tie -in.
7. Parking plan.
8. Lowest building elevation (if in Flood Control Zone).
9. Estimated /proposed topography at 2' intervals and proposed elevation of lowest floor level.
10. Identify location of sensitive areas slopes 20% or greater, wetlands, watercourses and their buffers.
11. Identify location and size of significant trees that are located in sensitive areas and buffers or the
shoreline zone. Of those, identify which are to be removed (Title 18, City of Tukwila Zoning Code).
12. Identify location of high water mark of the Green /Duwamish River if site is located within 200' of the
high water mark.
13. See Public Works Checklist for detailed site plan information required for Public Works Review (Form
H -9).
❑ ❑ Foundation plan and details
❑ ❑ Floor plan
❑ ❑ Roof plan
❑ ❑ Building elevations (all views)
❑ ❑ Building height
❑ ❑ Building cross- section
❑ ❑ Structural framing plans and details necessary to completely describe construction
❑ ❑ Washington State Energy Code Data (Gas /Electric /Oil /Propane /Heat Pump) Form H -15 available
at Permit Center OR Prescriptive Heating System Sizing Chap 9 Form H -6.
❑ ❑ Complete Land Use Applications if not previously submitted (i.e., Reasonable Use Exception,
Variance, Shoreline or Tree Permit).
❑ ❑ Attach plans, reports or other documentation required to comply with Sensitive Area Ordinance
and other land use or SEPA decisions.
❑ ❑ If dwelling has a septic tank, and a bedroom or bathroom are added, provide written approval
from the King County Health Department or the Tukwila Public Works Department prior to
submittal of permit application.
❑ ❑ 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, unless the homeowner will be the builder 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 ! 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.
SF1'ERMIT.DOC 2/13/97
k** *** **k k•kF**Ak **.A* Ir k �rFol * *k *k
CITY OF TUKWILA. WA : "l 0 t TRANSMIT
**h****** k** 4**. **+F.*- k ** ** *A� * *A * ** ** * ** ** **!r ** *** *** * *4** * * *•4 *:4•
TRANSMIT: Number: R9700586 Amount: 789.15 05/27/97 16:20
Payment Method: CHECK Notation:: N HAMASiaKI 'nit: KJP
Permit. No: D97-0171 Type: DEVPEflM DEVELOPMEt11 PERMIT
Parcel No 032304 -9200
Site Address: 10215 BEACON AV S
Total Fees: 789.15
This Payment 789.15 Total ALL Pmts: 789.1.5
Balance:. .00
* * ***. ***•A** ** *i * **k ** ** Irk********• h*** •k * * *** **1%***1***** * ***•A ****
Account Code
000/322.100
000/345.830
000/386.904
000/386.908
Description
BUILDING -• RES
PLAN CHECK - RES
STATE BUILDING SURCHARGE
BONDS /DEPOSITS
Amount
21.00
13.65
4.50
750.00
0931 06/03 9717 TOTAL 789,15
P oject: •
A 4
mak sm. a.. ! .
Typ • o •beticl. t ' - 1
aka_ bill
3 (
oa
Special instructions:.
D ante m.
Re stye ter:
Phon• -e , L 1"1 Li t
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 8188
Approved per applicable codes.
PERMIT NO.
. (206) 431 -3670
C ) 1<41_ 2
Inspector: Pt i
Date: J 1 l q
Corrections required prior to approval.
$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:
Project:
[ Y-1
(y,►i'W1
Type of inspection:-
..
0
N1 AC-.7
Address: Q
2
1 ! ge,a,Ca Ate.
Date called: ,
Special instructions:
Date wanted: S f t
l
1
P m
Requester:
Phone No.:
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 9818
Approved per applicable codes.
Receipt No.:
AorrarrootoLccooPlaab
/R NSPECTION RECORD
etain a copy with permit
C to 1
PERMIT NO.
(206) 431 -3670.
COMMENTS:
Inspector:
Date: %I 7
Corrections required prior to approval.
$42.00 .REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Date:
M1
ra ,/
,�
Tine of insgiog u)
Addke ca.
D Called:
Special
instructions:
yo„„.A'\Qn 60R. ,
D wanteil:
top 10. �"l P.m.
R q�este • `
hone No.:
2.... 4 6 1.)-\ 5
proved per applicable codes.
INSPECTION RECORD
°-
-Retain a copy with perntit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PERMIT NO.
(206) 431 -3670
Corrections required prior to approval
C OQ. 2 akim
COMMENTS:
o A..._
Inspector:
Date:
1
El $42.00 •REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Procy; _ _ _ ' '
T y p e of inspectig
..^
Ad ss; I �- ig , 0
It /4
'`,/
: $
Date called: • ' 5
; .9 1
( 1
Special instructions:
�'�� Ci{ 'V
'41./1 3 'G L�^/' MG
Date wanted— ,
i4 �%il
`T � l dt
R equeste�w:_
fVlY ,f-fl
1 -7
Phone No.: Z .-
40
"INSPECTION RECORD
Retain a copy with permit
INSPE(XrION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 .Southcenter Blvd., #100, Tukwila, WA 9818
Approved per applicable codes.
PERMIT NO.
(206) 431 -3670
COMMENTS:
Mir /
Inspecto
Date: /(„r
Corrections required prior to approval.
I $42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
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Land Surveyor's Certificate: °I 4 " z C:
This Boundary Line Adjustment/Lot Consolidation correctly
represents a survey* made by me or under my direction in
conformance with the requirements of appropriate State statute.
Name: RERT ki (1/4- 47°6*-5 818
CPc4/044/6TH eAssoc , -Y..4.1t- P., - -ra./rrae
Date' -3 5 193
Certificate No. 95 7
* A lot consolidation does not require a survey of the
perimeter unless the lines are adjusted. 54 g /2.1A/R4'&1111-.11,
Fticd--■
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1 74.16
FOUND OF TUKWILA
APPROqD .
e., .
JUN 0 3 1007
AS NO FLU
BUILDING 13117
e "4- el- • e -
Direction:
Scale:
Stamp:
/
Page
Map on File in Vault
1/11 iiiiii III mio 111114
a
14 3
ITORIDIUMIITATUDM.
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REVIEWERS INITIAL
REVIEWERS INITIAL
APPROVED ❑
REVIEWERS INITIAL
C:ROUTE -F
DETERMINATION OF COMPLETENESS: (T,Th)
COMPLETE DA NOT COMPLETE ❑
COMMENTS
CORRECTION DETERMINATION:
DATE
DATE
DATE
- Pcc mid Cani. CCU
PLAN REVIEW / ROUTING SLIP
DUE DATE
NOT APPLICABLE ❑
ACTIVITY NUMBER D9 0 11 1 DATE 5 017- q7
PROJECT NAME l km of ` , v d1J u. Ohl
DEPARTMENT:
-0. B,� G D 3SI N El FIRE PREVENTION ❑ P G DMSION ❑
DINATOR I.
4
(0 97
TUES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED ❑
ROUTED BY STAFF ❑ (If routed by staff, make copy to master file & enter Sierra.)
1
a
DUE DATE (` I - 9 7
APPROVALS OR CORRECTIONS: (ten days)
APPROVED I I APPROVED W/ CONDITIONS ❑ NOT APPROVED (attach comments) ❑
1
DUE DATE
APPROVED W/ CONDITIONS ❑ NOT APPROVED (attach comments) ❑
(Certification of occupancy required.
y','.MMAil�+�f'c['.�ivT.sni''
COMPLETE
COMMENTS
REVIEWERS INITIAL
APPROVED Q
REVIEWERS INITIAL
C:ROUTE -F N
r.
.AXFAM 1.44.
PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER 91- C) 11 1 DATE 6 c3-7 c / 7
PROJECT NAME am O c,0 ` K O y) U&, or)
DEPARTMENT:
BUILDING DIVISION FIRE PREVENTION n PLANNING DIVISION El
PUBLIC WORKS STRUCTURAL En PERMIT COORDINATOR Q
1
DETERMINATION OF COMPLETENESS: (T,Th)
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TUES /THURS ROUTING: PLEASE ROUTE n NO FURTHER REVIEW REQUIRED
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REVIEWERS INITIAL DATE �P
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CORRECTION DETERMINATION:
DATE (O / J'
DATE
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DUE DATE 67 - 3- 97
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DUEDATE G 17
DUE DATE
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DETERMINATION OF COMPLETENESS: (T,Th)
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DATE
DATE
PLANNING DIVISION' ❑
PERMIT COORDINATOR ❑
DUE D A T E 67 _ - 9 7
DUE DATE G
DUE DATE
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(Certification of occupancy required. )
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ACTIVITY NUMBER i 91- 0 t 1 1 DATE 5 017- q 7
PROJECT NAME -l am O��)O 'h ` , 1� 0 uJ U� OSI'1 l
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REVIEWERS INITIAL
CORRECTION DETERMINATION; DUE DATE
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PLAN REVIEW / ROUTING SLIP
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STRUCTURAL E PERMIT COORDINATOR Q
DATE
DATE
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DATE ZW- 7
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NO FURTHER REVIEW REQUIRED RI
DUE DATE 69' I 17
NOT APPROVED (attach comments) 0
(Certification of occupancy required. )
ACTIVITY NUMBER D9 DATE 6- 0 1 -7 —C /7
PROJECT NAME K do U.U �O�f 11
DEPARTMENT:
BUILDING DIVISION FIRE PREVENTION C PLANNING DIVISION U
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DETERMINATION OF COMPLETENESS: (T,Th)
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COMMENTS •
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TUES /THURS ROUTING: PLEASE ROUTE I I NO FURTHER REVIEW REQUIRED
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APPROVALS OR CORRECTIONS: (ten days)
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REVIEWERS INITIAL
C:ROUTE -F
DATE Q/
DATE
DATE
DUE D A T E 6 2 — 9 7 3
NOT APPLICABLE
DUE DATE (c7' I 7 1
APPROVED W/ CONDITIONS I 1 NOT APPROVED (attach comments) f I
DUE DATE
NOT APPROVED (attach comments) 0
(Certificadon of occupancy required. )