92-101574 iMOMOMMEMMOOMM
,
_ 57Y9%),)%1
CITY OF
33530 First Way South B LT I L D I NG P E�I T PERMIT
9
ISSUED: 10/20/92
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FLF
661-4000 EXPIRES: 10/13/94
RENEWED PERMIT
ADDRESS:33704 37 PL SW
NO . : 109961-0910
PROJECT DESCRIPTION:RENOVATION OF FRONT PORCH. PERMIT RENEWED 10/18/93 & CANNOT BE RENEWED AGAIN. EXTENSION GRANTED FROM 4/8/94 FOR ANOTHER 6 MOS.
OWNER CONTRACTOR LENDER
.41[
T.E. FABRE
33704 37TH PL SW
FEDERAL NAY WA
838-0592
BLD?:X NEC?:? PLM?:? FLR--EXIST--PROP--- DWELLING UNITS 0 COMP PLAN -SR? FEES: ^TYPE OF WORK:ALT USE:RES 1ST.: 0: 0:sf STORIES • 0 REQUIRED PARKING..: ? SPRINKLERS' •/ FINAL PLAN CHECK...* $ 35.10
CENSUS CATEGORY •650 2ND.: 0: 0:sf HEIGHT 0.00 ft RAZARO CLASS. .:? BUILDING PERMIT....* $ 54.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VA_UATION REQUIRED SETBACKS FIRE FLOW....: 0 gps SBCC SURCHARGE * $ 4.50
:R3 :? :? :? : OTHR: 0: 0:sf EXIST..$: 0 FRONT.........: 20.00 ft PUB WORKS-PLAN CHECK $ 35.00
TYPE OF CONSTRUCTION BS?.T: 0: 0:sf PROP...$: 3000 SIDE • 5.00 ft WATER SERVICE..:FED BUILDING PERMIT....* $ 27.00
:5N :? :? :? DECK: 0: 289:sf REAR • 5.00:ft SEWER SERVICE..:FED
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:09/22/92
0: 0: 0: 0: TOIL: 0: 289:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS - 0 TOTAL FEES $ 155.60
III1GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP.....: 0 SHOWERS - 0 SUMPS - 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONY BURNER: 0 FURN>100K . 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
BBQ - 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC VTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN NSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS . TER : :ORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFO'PAT ON FURN Alp. TRU AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGEN" -- r5��®I." DATE e ANf � _77
FILE COPY 13 8`;,1-5Y-2 9I
(6Z $5C4gc/ Ad00m3IA
"1311 39 111* SIN3030100341 AVN MUM JO A1I3 3190111dd% 3611 ONV 390111O01 AM .10 1539 3111 01 133HNO3 OW? 3051 SI 3k A&-03SI1010.1 NOIIVMAOf111 301 ISM A1I1N33 I
'33NVOSSI JO 3100 0311V 10131 100 3111013 S1.IWH3d 911100115 01W 1VI10301S11 'O1111VIS SI ISO* ON 1I 130V16SI S3110'SAVO 001 311IdX3 SIIIN13d
-'---- - -_ ._._ _. r..._ _..-_ ,,s-,-...--_._
0 :'O0AO1194130101 0 :813 000'01 t 0 ...5901 SV9
0 :'''S11100 NHS* NOV1 0 •0Nlf419 1A09V 0 :813 000`01=4 r, - 390VM
0 :'S311OI IJ 113010 0 :`"-5831030 NI* 9313 -S1NV1 1301 SLIM 90110110H 1110 0 :"113A110 SV9
0 :91311Nf1 N*01 0 SS3HSV* H510 0 - dH +5 0 - 35111 0 090
0 • 58I00 0 - S1NIS 0 - dH 0S-OF 0 - 1001(0801 0 41311d09 MO
0 :"'5113103119 IVA 0 - S31SOIVAV1 0 - dH OF-51 0 :'"S3AOIS 0000 0 - IAN SO5 .
0 - 541105 0 • SIMMS 0 • dH 514 0 - 18101 13110 0 :"-1001401101
0 'I0001 90110180 0 : """ '5901 NISI 0 - dH f-0 0 - 0000 11 0 :'901dld SV9
09'551 $ S331 10101 0 • SIVNIlO 0 S135013 11310* SSOSS3MdM03/5831109 0 SNVJ i i:'S3dA1 130.1
0:'603110 3A111SN3S Is 0 :33011105 A113dM1 g ,< ' -k 11t,. :0 :0 :0 :0 :
t-t '46/ZZ n +' _.________-MI 11010130
031:-'33IA111S 811:15 11:00'5 - NV3. °" ' .^M :
"� ;,n I Z . Ian i� i� i.: NS:
00-LZ $ x""'1IM113d 90101109 031:"33IA83S 8310* 41 00' a* - 442 . :� ` :0 SU -1011388151103 JO 3dAl
00"5f $ 13303 NVId-S1, : , ',Y, : ',,,4 .' AV' pf '��� .o ,I O : t fit,,„} i. i. i f11:
Oct a 398Vlf311O5 3395 . ° . . - ,r S r' , A Y- - , ',`
3 r <.
00"i5 i'" '1101134 981011118 v "v , ---i ' -400119 A�iVdO130
, ' - .241P ” �' r ,'0 3µ :. a,. 059" AS0531V3 SOSN33
0I'5c I x'"133H0 NVld I0N11 is "-iSN311NINdS Z :-9NI1d'd 031110f3H t : 531d01,; 00 .0 =; IS1 S311:3S0 110:1800 10 3dAl
'5331 .NS- N01d 41103'"r ` f CITyry aNT-ri d ---dodd-- --1111 L:alld 4:0311 X:1019
2650-8FH
ON AVO 1083031
MS ld NM POLFF
311901 100 _.
1101:1081003 .,_...-.__.,� .__. _..._ 11
`SOW Q 03010110 1101 i6/8/i 11081 03111V8'9 NO15M]IX3 -0IV9V 03130311 19 IONNVO 8 16/91/06 03131:1'1 lllSid 0080,1 111081 JO NOl1VA0N3H:NOI1dI2i3S3O-1;;33rOdd
0160-196601 : "ON
MS id L2 00L2£:SS3?JOGti
P6/5'1 O1 :S38IdX3 0006-190
3'13 :A9 Oi'it-199 slsanbaa uo!goedsul 6uTP1xni 20086 VM `AAM IeaapA.3
POZZ-26018 :ON11
1IW83d ITIArdad Oy1r102 AeM At1M 1V1i3O33 TJ00A113
Az /oto6
Ad00 013Id
,-4—',/7C- 300 ,....„,w-,-0 ---7---- rz- 1N39V dO 43NN0
"1311 38 11101S1N3M1810ll38 ON 1V831131 10 0,113 318V311ddV 3111 ONV 3903100011 All 30 1538 1H1 01 1338803 ONV 3A 1 S)! 311 Ad 03$I$8fli IW11V111103IgI 3111 lV11! 13111133 I
'33NVtlSSI JO 'IVO 8313V 81,31 3110 3dIdX3 S1IN83d 90IOV89 ONV 1VIIN1OIS38 "(1318V15 SI 18011 ON 11 3' 83I1V S1d3O 081 38IdX3 SlIN83d
0 "'0NfiO8983ONti 0 :1133 000'01 < 0 :"'S301 SV9
0 :'"S11100 VIN$ 140VI 0 :0NAO89 3A08V 0 :1131 000'0I:> 0 - 3908
0 :'538111X13 113010 0 :'""5831V3H SIN 3313 --SXNV1 13A3 SIINM 9NIT0NVN 8IV 0 :"83180 SO
0 :S831I{NI8dS 1111V1 0 - 583NSVN HSIO 0 - dN +S 0 - 35I$ 0 - 088
0 . SWIV110 0 - SIINIS 0 - dN 0S-0f 0 - 9001018f03 0 "113111108 AN03
0 :"'S831(V3118 3VA 0 - 531801VAH1 0 • dH 0£-S1 0 :"'S3AO!S 0000 0 • 1NNI SV9
0 • SdNOS 0 • S83NO16 0 • d11 SI-7 0 - IVON 1300 0 :"X001)$dfl3
0 :'!111103 9$11N180 0 - SBflt $IVB 0 :-'. ...dR f-0 0 "''' 00011 11 0 :'9NIdId SV9 •
09 SSI $ S333 10101 0 S1VNIV0 0 - Si3SO13 1131V0 SSOSS38dNO3/5831108 0 1SNV1 i i:'S3dAl 13113
N:'iSV3lV 3AIlISN35 15 0 :33V3dfl5 A83dMI 1 " ' 1✓ :0 :0 :0 :0 :
lZi� + - ,. O01 INVdfl330
033:"331A835 83035 11:00'5 - 8V38 - l� F S is is is NS:
00'LZ $ t"'""11W83d 9N1ft1108 033:"331A835 113iuN 11 00'5 3, ii 2 `` d ,1 ���
�,�„•�� �, , -N0I1�1SN03 30 3dAI
DO'S£ $ ]33111d 5]8 t. '-104:1) .,„ ��dr'�� i - 1 Mao, ,, 13 ��:it''� fife ` : is is is f8:
tis"� $ 3 t1V11311t15 3385 ����i t -- t i 138 -- '> A i.1 ,v_44,100,.„.14,, _, ._moo
A3IVdii330
a.
00"t►S $ t""111183d 9NI0139' _ �f it ,a 1� :0 f v'0111 049- A80931V3 SQSN33
01"S£ $ s"'133H3 NVId 1Vl113S33! .. i51131101tdd5 z : 9NIY8VdN01dlff033 3I801S is :0= "° SI 538:3S1t 11d:U80N 30 3dA1
�� ' d08d--1 -11] L:LIIld ;.:0311X:i018
.__ . _
1650-8f8
VN AV* 1V113033411/
Id HIL( NUT
3V8V3 '3'1
801aV811109 -.---.....,-----. 8311110
'VIV9V 0113138 iv IONNV? 9 f6/I3i/01 03113$311 HIlR13d '14380d 1I0111 3O NOIIVA01138:NOIldIa3S30 103L'O21d
OT6O-19660T : "ON
MS id LF tr0L22:SS311aati
d llW83d 03M3N3d
v6/911170 :S38 1 I d}<3 000t+-T 99'
.313 :Af3 OVTl'-T99 slsonbaa uoTloedsul 6utpI Tne 20096 VM 'ARM TeAepaj
nos Aemt'OZZ6-/Z60113 :ONnlIW?J3d ‘■ , I Pilla dON ICI'1 I fl y�AVM 1V13-303A isJx300TSFT A1I5
,._ __...__,--,
CITY OF FEDERAL WAY B U I L D I N G PER I\/I I T PERMIT NO.: SLD92-2204
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/20/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 33704 37 PL SW
PARCEL NO.: 1099610910
PROJECT DESCRIPTION: RENOVATION OF FRONT PORCH
— OWNER CONTRACTOR LENDER
T.E. FABRE *OWNER IS CONTRACTOR*
33704 37TH PL SW
FEDERAL WAY WA
0592
*OWNER*
BLD?:X MEC?:? PLM?:? FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •SR? FEES:
TYPE OF WORK:? USE:? 1ST.: 0: 0:sf STORIES • 0 REQUIRED PARKING..: 2 SPRINKLERS?......:? FINAL PLAN CHECK...* $ 35.10
CENSUS CATEGORY .7 2ND.: 0: O:sf HEIGHT • 0.00 ft HAZARD CLASS •7 BUILDING PERMIT....* $ 54.00
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION ; REQUIRED SETBACKS FIRE FLOW • 0 gpm SBCC SURCHARGE.....* $ 4.50
:R3 :? :? :? OTHR: 0: 0:sf EXIST..$: 0 I FRONT • 20.00 ft PUB WORKS-PLAN CHECK $ 35.00
TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP...$: 3000 SIDE • 5.00 ft WATER SERVICE..:FED
:5N :? :? :? DECK: 0: 289:sf REAR • 5.O0:ft SEWER SERVICE..:FED
OCCUPANT LOAD GAR.: 0: O:sf RECEIVED.:09/22/92
0: 0: 0: 0: TOTL: 0: 289:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS I WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 128.60
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 1 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
-AO LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
ALL PERMITS EXPIRE 180 DAYS AFTER ISS E IF NO •: . IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMAT ON FURNI ED Y M- '1 E A ib CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT —............ DATE '..
bld_prmt 07/31/92
a
SET BACKS AND FOOTINGSGSO.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE j/f/f>L BY SIL t)_ DATE _- BY DATE -_- BY ..--
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE.... -_.....BY _ GAS PIPING O.K._ __. DATE _..... BY -_
O.K. TO ENCLOSE FRAM NG / INSULATION WALL BOARD AND FIRE WALL
DATE ..1_0
..� B....__..._ ........,i... -_ DATE .....- ._ BY - .._._ DATE -_.. BY
FINAL O. . TOO ICUP
Y r
�J I'��/ DCD PSD FD
DATE 1.._-....... .... .B(Y .......
•
• • , .
• •mit # J( 1) 9?- 0) a/
RECEIVED CITY OF FEDERAL WAY
SEP 2 2 1992 BUILDING PERMIT APPLICATION
CM(O 'F'i, FiA8.WAY
— Please Print—
atifteltrei-BEPT
BOX 1 TENANT NAME:
OWNER MR.
i !LIES :,z' 711x.. SITE LOCATION 37c --7 Pe_ -750-3.) r":4,-)
OWNER'S ADDRESS 33 7C;=/-5"7x. 'SCITY /'i.'=0c-1/J-c. W =eHONE -5p,C)/ _
' DESCRIBE JOB Fac Nto/A 77ci r Zc JT Poe- t.c
THE PROPERTY IS OWNED BY: SINGLE RRI) PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Ci.A.D#..)e 2_- CONTRACTOR'S REG. # --
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE —
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. --
BOX 3 CONTACT PERSON %x,21 V c--)12-- Z Thr y ,r1l�31 PHONE 6O S 2--
BOX 4 SEWER DISTRICT f=c} Z24c_ cull-Y WATER DISTRICT %/1 C-: r-1
BOX 5 ESTIMATED PROJECT COST l' �� EXISTING BUILDING VALUATION 'L -5c., C)oCC
BOX 6 PROPERTY TAX ACCOUNT NUMBER /reit,/-- i rp — c
LEGAL DESCRIPTION L.v-i 7( 1- tCcLLIC4 D coe. DidOs,,6 2_
(If necessary, please submit a separate page with the Igga1 description.)
K.C. Plat Recording # /0L0r4c /07/ iCp 6. /.-,--, /‘, Al,v D 17
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK /7's''/ (7'Y" GARAGE /
BOX 8 (v). SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY C3./‘'('' SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$ _.
NO. `&-. WATERCLOSETS GAS PIPING, FEET -�_- $
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS IR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE __ _ $_
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS
IR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER
—TOTAL FIXTURES $`
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
MADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OFFEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLO •'ON T ' ,CC ACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: '�� �- DATE: I-f 2 - '2
ANP-O08 3/90
9)40/ 57y
CITY
335300 First Way South F FEDERAL BUILDING P EF:M I T PER ISSUED: 10/20/92MIT NO: 04
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FLF
661-4000 EXPIRES: 04/16/94
RENEWED PERMIT
ADDRESS:33704 37 PL SW
NO. : 109961-0910
PROJECT DESCRIPTION:RENOVATION OF FRONT PORCH. PERMIT RENEWED 10/18/93 & CANNOT BE RENEWED AGAIN.
= OWNER — CONTRACTOR — LENDER
T.E. FABRE
33704 37TH PL SW
0 FEDERAL WAY NA
838-0592
BLD?:X NEC?:? PIN?:? FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •SR? FEES:
TYPE OF WORK:ALT USE:RES 1ST.: 0: 0:sf STORIES • 0 REQUIRED PARKING..: 2 SPRINKLERS?......:? FINAL PLAN CHECK...* $ 35.10 A
CENSUS CATEGORY -650 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS •' BUILDING PER81T....* $ 54.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gp. SBCC SURCHARGE * $ 4.50
:R3 :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 20.00 ft PUB WORKS-PLAN CHECK $ 35.00
TYPE OF CONSTRUCTION 8SMT: 0: 0:sf PROP...=: 3000 SIDE • 5.00 ft MATER SERVICE..:FED BUILDING PERMIT....* $ 27.00
:5N :? :? :? DECK: 0: 289:sf REAR • 5.00:ft SEWER SERVICE..:FED
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:09/22/92
0: 0: 0: 0: TOTL: 0: 289:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS . 0 URINALS • 0 TOTAL FEES $ 155.60
4110 GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<IOOK..: 0 DUCT WORK - 0 3-15 HP • 0 SHOWERS. - 0 SUMPS - 0
GAS HNT • 0 WOOD STOVES...: 0 15-30 HP . 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONY BURNER: 0 FURN)100K • 0 30-50 HP • 0 SINKS... • 0 DRAINS - 0
BBQ ' 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC MTF HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN NSHR OUTLTS...: 0
GAS LOGS...: 0 ) 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 D. S AFTER 1 I;K IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE FORMAT - FURNI`•. BY MEJ E AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT _-__1_11r�" DATE f,�
FILE COPY