Loading...
HomeMy WebLinkAboutPermit File 3412 Cedar Glen Court �.T Y o,, CITY OF ANACORTES �� WASHINGTON cry BUILDING DEPARTMENT CERTIFICATE OF OCCUPANCY This is to certify that the(Description of Building or Structure): ' Single Family Residence Located At: 3412 Cedar Glen Court STREET/.NUMBER Owner: Irving Construction Constructed By: owner DATER OR CONTRACTOR Bldg. Permit#: BLD-2004-0181 rr, Date Issued: January 270 2005 . Occ.Group: 1t3 Use Zone: R2 Has Been Inspected And Occupancy Is Hereby Authorized. , This 2nd M Day offJ�I May 20 05 k AUTH !ZING ICIAL SEE REVERSE SIDE FOR SPECIAL REQUIREMENTS. I N ■riiiiin 1 • CITY OF ANACORTES "AS-BUILT" l Sewer Istop CONTRACTOR: - C. C fter JrAT/DIVISION: BLOCK Q,J Olen LOT ADDRESS- l IteL( gL(f Olen ( t DATE: 2 J ) /I OJc li PERMIT# SCALE ©© R Q_ ■■w■■■■■■■■ suss/ i f► ■ ■a■■ ►R ■■Ill■■■■■■■■■■■■■E iii 9 ■ ■■■s■ ■■s .a■■■■ ■■■■■■tau. ■ ■■ iii■su■■�■ ■■■ ■■■■i■ ■ ■■ ssu■ less■■■ ■ ■■■ ■■■bf■■ II sees► sees■■■■■ ■ ■■ste■% ■ s■ rn■■s■ ■■■see■■ ■ s ■■ ■■ ■ ■s■es■ a ■ss . ..es■ ... ■■■■■■=■■■essay- ■. ■s■ ■r■s e■■ ■■suss ■■■■s■■ ■■■Bumf■ ■■■ew■■■■■■a■e ■■■■■■. �■s ■■ ■■■ ■ rs■s■■■ ra■■■■ ■■■► s ■■ss�.■ ■■ sssu■■ ■ ■ ■1■n s ■� ��■ •■ � ■■■►�■■■■■ ■ rf■rt■■■■ sip ■■li ■s■■■■■■■■■ see !1■■■■ ■■is i■ ■■■■■►�r■■ �01l■■■■ ■■■■s ■■■■a■u ■a■rs ■■t■®N■■■■ ■■■■■ ■■■■a■ss■■►�■l■■ ■ri■I ■ ■ ■ ■Seen■.■■■■■■s■.■■s■LW■sii■s■ ■ ■ ■■■■ ■1■■■■■■e a■■■■■if■IH■■■ ■ ■■■ n ■■■■■s. ■■■■��all■■■■ ■ ■ ■s{■s■■■su■sw■eer■�■■s■H■�U■■■ see■■■■■■seeeTIuIe_.�ew■ Nc Mtee ■ ■uses■■ ■■■■■■■■■I ,■�i■■■■s■■■■ ■m■■au■s■■s ■ ■■i�■■■.■■►*■■u ■■ ■ ■■■■susses■■u■■■■■ti Uf■ ■■■�■i■■■■■■■■■ ■■suss ■■su ■■■■■■■■uu■■■s■■■euunu■■i1t■■`.■ LOCATE STREET(S)ON GRID MAP • G'1.t Y 9 ., City of Anacortes Permit#: BLD-2004-0181 904 6th Street Issue date: 01/27/2005 `7* r t,. P.O.Box 547 ,'i'' t ; Anacortes, WA 98221-0547 Expire date: 01/27/2006 {T„IAZ` (360) 293-1901 Job Address: 3412 CEDAR GLEN CT Permit Type: . Single Family Residence Permit ANACORTES WA 98221 Project: APN: P120982 Remarks: New single family residence. Owner: IRVING CONSTRUCTION Contractor: IRVING CONSTRUCTION CORP Address: 819 COMMERCIAL AVE Address: 819 COMMERCIAL AVE G G ANACORTES WA 98221 ANACORTES WA 98221 Phone: (360)293-6354 Phone: (360)293-6354 License#: IRVINCC044KG General Information: Fees: Basement Square Footage 584 Plan Review Deposit 100.00 Lot Area 8147 Building Permit Fee 803.00 1st Floor Square Footage 816 Plan Review Fee 421.95 2nd Floor Square Footage 1111 Mechanical Permit Fees 121.90 Garage Square Footage 664 Plumbing Permit Fee 153.00 Building Valuation 247612 State Building Code Fee 4.50 # Forced Air Furnace <=1,000 1 Sewer Inspection Fee 50.00 #of Bathtubs 2 Storm Drain GFC-Residential 1,126.00 #of Clothes Dryers 1 Sewer GFC-Residential 4,682.00 #of Clothes Washers 1 Park Impact Fee 615.00 #of Dishwashers 1 Traffic Impact Fee 900.00 #of Gas Fireplace 1 Total Calculated: 8,977.35 #of Gas Piping 1 Deposits/Receipts: 100.00 #of Gas Water Heaters 1 #of Water Piping 1 Total Due: 8,877.35 #of Hose Bibbs 3 #of Kitchen Sinks 1 4 of Lavatories 4 rz cr.�n #of Range Hoods 1 ? r3 #of Showers 2 rr moo, #of Slop Sinks 1 ma a #of Ventilation Fans 5 iv m ,J #of Water Closets 3 0 ' L. CO 0' 0 O CA .- ,C, -...- r CO --1 CO .. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR tFo lb 15' CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. 4 n HEREBY CERTIFY THAT I 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 WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OI`t4 8 NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER r3 STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE F OWNER OR AUTHOlkIZAGENT ISSUED BY 0434904-1 0005 12/14/2004 002 4 Permit Fees 006059 60.03 .��T. Y Off_ City of Anacortes Permit#: BLD-2004-0182 904 6th Street Issue date: 12/14/2004 P.O.Box 547 Expire date: 12/14/2005 Anacortes, WA 98221-0547 Job Address: 3412 CEDAR GLEN CT Permit Type: Foundation Permit ANACORTES WA 98221 Project: APN: P120982 Remarks: Foundation permit for new single family residence. Owner: IRVING CONSTRUCTION Contractor: IRVING CONSTRUCTION CORP Address: 819 COMMERCIAL AVE Address: 819 COMMERCIAL AVE G G ANACORTES WA 98221 ANACORTES WA 98221 Phone: (360)293-6354 Phone: (360)293-6354 License#: IRVINCC044KG General Information: Fees: Building Valuation 3000 Building Permit Fee 38.50 Plan Review Fee 25.03 State Building Code Fee 4.50 Total Calculated: 68.03 Deposits/Receipts: 0.00 Total Due: 68.03 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF I, CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I 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 WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATU OWNER OR AUTH ED AGENT ISSUED BY Ft '23 i , S`c ..7;; t �!sittz'v'.�•x r,[� t µ . 5 :u ,;:-`:: F'Fy ;yk i'r""-`�.r, s[-c a ri. e:" . 'Y` -t ',i�ah..Y Y.33' k�+�. R =vt h��--f tk nrv `"w ^{ ' m ., a�z Cns n �.Gi r...' '�' cf�'tY" `1 2 -: . ' s 1Rx 1 .2:;':t,Y� ,^1 :ptt.3; i 165'� "'L r1 6- ' I h°tt {��j st. *:' SI+Y.- . 41:1, '•i 3 key _ ., P 3 1 c Z`aK At ,aC,, vw 2�` :1 e"jr:t. ,3 Lq 4 ii� *�� ' ` � r h��y ati`;.0 5 ���ry is. �6 � � I.� na k, x�y"�tF'� 2�Y �p, 'fieb� s�t� Y # �yv 4 i�,� i, ....4 t' m s, raems .. R .-,'' �S t3 Ipllr," i•`�9�4�CkeNi0 3 li`�x'ii ry„m�' c hl" y#ry�rrs•s'°c,:43 • -,r �.s.:LS_,.,:J. , 0...:.-ii.aY:r_�i:a t .: "3�i3t .,_,.Land �-- £iz S :.1L'I 'Sr Al Site Address: 3412 Caq-IZ 6t t:A) &LOX Parcel No.: 422.5-- oop-ntl-Car Cmpt 6cEa hjt Lot: ri Block: Div: Addition: ` 3 . .w. t ..". v ." Add itio n ``c ;.`410)-tt/4C re1 .;r.Xif � 'y$nte� 3s ' iB >A4.!•rI fil' i.:,r Bl�s�:r9i�`Y. 4 ,. E B� x.'20I,N^ >1. Name p� Name Name ;RON6 CON StROcitoN tORPoRPCrlota *Viva 64,04 IRVtat& CDNS•fxUC1'io l C.a..flearret0P.1 Mailing Address Mailing Address Mailing Address 819 co•AM£Ra,Ac INE4uE, 5oLYE 6 Y.0. 8tt 586 gtq CoKME&CIAL Aug MDE, 5urrr 6 City: State: Zip: City: State: Zip: City: State: Zip: ANAtoRYES , W4 9BZZI 1,E1UMb444 / t44 95228 AN0.corates 1 IN A. 482.21 Contractor Lic.No.: I evt M GCC44-iez. Phone No.: 3btl ZR3 6354 Phone No.: 31oe "t33- $DSo Phone No.:3/aoZQ36354-ExpDate: Contact Person: 3o4p4 CAvd7.F.4 or Scot( 12Vent& Phone No.: 36o1) 293 40354- 7 , 2c a,"i ,,yy-- - ,c I xi e :,3' `7 +ss, y. }a .IF ro F v r". . 2.'J P Sj vy": o`. 4 k} v P{ b ' '' i'` A, eU}_;,'„' - ","`O a'4 H , f ., ' 9 ?t4.;sl' F{,a.... ' �r .`.r3 ,34� �r, .a. r„K54iM m x L, .-., 5�� a�� "�.�n iL �4^�,l- C� 1 I � ,�' ,� � +I k': � Ti�� (Check One) / Single Family:✓Multi-Family: _ Apartment: Condominimum: Senior Housing:_ Retail:_Office: Restaurant:! Manufacturing:_Storage: Bank:_Assembly:_Accessory:_Automotive Repair: Other(Specify) • DESCRIPTION OF WORK: 11/43E1AI Q25tbEMCr (la,-Lae.) 5r. F1z a vk. r'-'mn,-* .27 rxY vcD ..bVtr x j y @ FI t .".. : 'e a-4 x}ats Yr "rt"t. h • -I + V2,„..'r Fx-;;..? t-I"90a.. ,4YI qy 14tY IPl ,QS°� $ � 1 a 1� 4,Lc(�wiI4T ',9&1 . :05 s^ Pri �v-'S `k: (��' x 8,s'itit Y:.��J `�1":...�P,„.. e� ,�'5,.. �,C± u��i�.+ �k" �:" '�+�, ' 7tir� ` ��Al' 7Gjb7a. Street Setback 20 ft. n&i -tU 2 -floor: 'l10 srE (Circle Yor N) l"Side Setback S ft. -E143`"Fl^or: /II J stit2, l> Shoreline/Wetlands Y 2nd Side Setback: 10 ft. Basement: - -sf. Water on/Adj.To Property Y• 6 - n Rear Setback 20 ft. 0cc. Group: rc..3•A,zn 0-4 Soils Report Yy : `.= Use Zone: R•y Carport Area: ---s Sensitive Area y � m Type of Construction: be ..apt-RAtkr) Garage Area: to64---lip i Latecomers Agreement Y I� -n t Lot Area: S $14-7 sf. No.of Stories: Tki-tsueL Fire Hydrant(250 Feet) ® N ;x o No. of Dwellin I Building Height Z.Si JP Variance i j c u g �- sf Covenant • ■ n o Lot Coverage: j¢6 �gp„p °�o) Deck Area: o, 1-Hoer s84— sf.53,7api FloodZoi X A VE o := Caw-LfrkL E �a Y..t�v l "a` { µ o Project Valuation(Labor and Material Cost): -f I a-) , 1 I � j, 914J rL�J � u o THIS APPLICATION IS RECEIVEDEY THE BUILDING OFFICIAL UNDER.THE PROVISIONS QF HIE UNIFORM BUlWg1 O •Pe4iNEWatil:EkpIRESTI 51TATION `-_ 'F AND BECOME NULL AND VOID IF PERMIT IS NOT OBTAINED WITHIN ISO DAYS OF THIS APPLICATION. BY AFFIXING MY SIGNATURE I HEREBY CERTIFY THAT I 8 AMTHE I P13At OWNER OF THE PROPERTY FOR WHICH THIS APPLICATION IS ISSUED OR AN AUTHORIZED AGENT OF THE OWNER. ALL PROVISIONS OF LAWS t'3 AND ORDINANCES OOVERNINOTHIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT,INCLINING CALLS FOR INSPECTIONS. 4. SCGNATURE: 5 _ 1F . DATE: 11 9 e¢ QEd ass dB ©y r alp° <.:3::,nr a," r+:.A....rasiY>`.[/:n...y..n.w.ri<fni...!:r.in.:of':.ni,"..:. c)>.:�i)^!::..::' ..,...i t./%n.:ii�<.v o,.v:'/ , .<�1..;,,... ,..:.i<T%:Y••:�<:>•f>:Al�</ii:P ,:.y fn.:3' .T r,w>. nr , F,d tr �t� > .h[ .... r...,. f ,q Tr.c.y F.n...v,. ,.x_«.✓,.m n..r... .....r.:::.n.Y...::>.r.:::,p..r. ,. .n... ..........A::,_: ..., .., . , .. ..,.r:3-:. . .._:... .n.:„ fc:,,,, .. a<.,• n<'..3: i:'%.<.R;i:.a:. t;::.:'�T.3i?au.�::.aY.i: :f,.c., •:cn,:....,::,. ,. ^.<nn.....�[:,tlyof,%.., ,yL.. s<'/+ic....u: .p...... r ./,r«y A.'i'.._ef2.., :•%.:.. ..lA' ..!%'. ... . . : . . . .. .. . . .. ._.,.... .,.., .rrri<t.. _.:d:$:n_rr:<cs,,;,.2<:'gi;%,:`.�.:.:n._`:;,.:.jr :rY):'«n:�: ;;�, ,,. .r?' v. . : < A;.«, rxt .a : ':. t•. •<. .. . . 3.:v.0 r<n. > .. .: . •% - ii"'r3::t-<: n Pizo982. SITE ADDRESS: 34/2 `&DAL £lw/ (IazT ASSESSOR'S NO .: 4.$zs-oq,_DU- WOO LOT: /8 Wart- ate#4 PinsE tBLOCK: ADDITION: a- :o'>.y....<y. .� 'H�'":rsY<.a.a'.,:r..mnt�:v�uq"r'yir!=:';� :'v •>r . . .ilk;;g{•r::,.�S,.Yr.:,.3 s:..>.: :»:rr'a r;..o.f%sos < , ..A,:�/v„nrtti�<s6>s .,i,n,r � .f..,r.,n...n..x. .:/...� . ./,:r,! a.rf .a1• .;11I��.�L�.'A i!>'•,., .x;<:f'z':G%. { ' <. ...:._i..rn... .vS..,!>}'�Y" ' Lt4�:!Y".'.nfi£�'. >./<r ii �;5�?�: �;Ll. �iy`: ' ':'i�":ill Name: IRUInNG Co 0ST2ocTiotA Coe?ulPTiod Name: IZ.vWG 4;4TRue'Acta CGRPb RATion4 1 Mailing Address: 8[R CeMMEncIAt- Ave. , Surre. "G" Mailing Address: SKI tom/4414clat_ kuE. ,SutTc. 'G" City: ANAcxrz<ES State: WR Zip: gaZy l City: Dc coctre5 State: W A Zip: %zz l Phone No.: 3bo 2q3- b354- Phone No.: 3too 2'I3 6354- Contractors License No.: tRYIt4 ccc,44-K6 m'a ' .fs}:,�' �` q• r. r ....r..(it:. ... <"/''i.<nAw "ter,. . x��µ (, ..,.��,.�'.wr:�.,�•i!�tJf**5,..,:.n.�t .�«:,.s>t�3.�',.,<rx<"�i.. «.�.. «u"., ,f,«. a. 'p�( q .i^f`< ,...ts�;; r. :.«n:!..'.5.,..:...!J::n:,.y,!Y.. . 'Ai.3.�' /'..«n,::.t{T�MV'N.{NI�Tr�R�.<.'iY?.l:v NO: Type of Fixture _.. .... . .:...:,3...F.!.r.:�:� ;::� ,;=r> �:z%:<;,::-< NO: Type of Equipment 3 Water Closet 1.5 GPF Air Cond. Unit HP a Bathtub Refrigeration Unit HP 2 Shower 2.5 GPM Boiler BTU/HP / Dishwasher 2.5 GPM / Forced Air System mu 4_ Lavatory 2.5 GPM Floor Furnace Kitchen Sink 2.5 GPM Wall Heater I Clothes Washer I Clothes Dryer Urinal LO GPM 5 Ventilation Fan Drinking Fountain i Range Hood Floor Sink or Drain Air Handling Unit cm Slop Sink Pre-Manf. Stove or Fireplace I Water Piping I Gas Fireplace 3 Hose Bibs I Gas Water Heater Back Flow Prevention Device ✓ Gas Piping Other(Describe) Other(Describe) ' GAS: 7"-- ELEC: OTHER; • THIS APPLICATION IS RECEIVED BY THE BUILDING DEPARTMENT UNDER THE PROVISIONS OF THE UNIFORM PLUMBING AND MECHANICAL ' CODES AND SHALL EXPIRE BY LIMITATION AND BECOME NULL AND VOID IF PERMIT IS NOT OBTAINED WITHIN 180 DAYS OF THIS APPLICATION. BY AFFIXING MY SIGNATURE I HEREBY CERTIFY THAT I AM THE LEGAL OWNER OF THE PROPERTY FOR WHICH THIS APPLICATION IS ISSUED OR AN AUTHORIZED AGENT OF THE OWNER. ALLPROVISIONS OF LAWS AND ORDINANCE GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH,WHETHER SPECIFIED HEREIN OR NOT,INCLUDING CALLS FOR INSPECTION. SIGNATURE: Ut.. atikc DATE: II-q-D1- CEDAR GLEN COURT .. ' A CUL-DE-SAC . iihik,T • ti , w • 10' PUBLIC MIRY EASEMENT gag , ' <I s t • \ CURVE C31: ...• -- ,„ LOT its. .- ERSTING RESDEKE .. '. ..--•-'----.„.. — • --iiiik... IW = - / = VERIFY _ 1 / 9.,0,f,... • MZEITP..}' ..- _ , . •• '• t // X•••• ./C' ...---- Ht.i X/' . . ' :. r.r.cl•F`''.5---——— _-- . . //,/ „..-',,R.Ay 'I,' . . , .,. ,./ ...---- 1 UNDERGROUND • t t . -ff. 1 HI.... •rt` I —rz•• ...';'• ice, HI vt '47;11// \ “ m:P"'“ 1 '''''' lhal V la I Garage irr:::-• 6•• 41 7:-:, - 4... 1,..10'-8:-..... 'Ll ,„;.:7,LL' 11 i roc LOT 12 .- 4r UNDER casisurnoN 1,1 e. rtet co +// VI 12 a-"ye ... /,/ Lower-Level \ 49 / ...> .e_ / - 20 REM SETBACK m. la P I LOT 11 5, f.• . e itll li of 8,147 sf f2' •-. ——171 5' PUBUC UTIUTY EASEMENT n 0 11.1 }Pe frs • 75.001 1,. 55.00. ...... • liell".......... Nrrigiry 130.00' •,••• ii — • 1 levmuns.sTun.n: . . •______ —_ ..• . . 1 15' PUBLIC UUUTY EASEMENT I 1 . 1 —17111 \ ... —1/Jyr 23 LOT 22 ArIpcent La IMMO RESIDENCE DIMING RESIDENCE V E W SITE PLAN Residential Energy Code ,_' (Simple Form) 2003 Washington State Ventilation&Indoor Air Quality Code 2003 Washington State Energy Code This worksheet is intended to assist you in deciding which methods of construction will be used to meet the requirements of the WA ST VIAQ and WSEC Codes. After completing this form, please add all relevant information to your construction plans. PART*1 Whole-House Ventilation:select one of the following methods. A. Fresh air will be circulated by the central forced air furnace along with a whole house exhaust fan. A single whole- house exhaust fan,which usually does double duty as a room spot fan,is required and must be controlled by a timer set to operate fan a minimum of 8 hours per day. The CFM capacity of the fan must be measured at 0.25 w.g.and have a maximum sone(noise)rating of 1.5. Fresh air intake ports or ducts are required with this option. (WA VIAQ 303.4.1) The minimum size of the fan is based on the number of bedrooms and the size of the house. For houses up to 3,000 square feet,the following sizes are acceptable: 1 or 2 bedrooms—75 CFM 3 bedrooms—90 CFM _4 bedrooms—105 CFM For other options contact the Planning&Permit Center. ✓ B. Fresh air will be circulated by the central forced air furnace system. The furnace must have a fresh air intake duct and the blower must be activated by a timer to circulate air daily. An exhaust fan is not required with this system. (WA VIAQ 303.4.2) C. Fresh air will be supplied by wall or window vent ports in each bedroom,kitchen,living room and other habitable rooms along with a whole-house exhaust fan as described in Option A. (WA VIAQ 303.4.1) D. A heat-recovery ventilation system.(WA VIAQ 303.4.4) PART 2 Insulation and Windows:select one of the following methods. (WSEC Table 6-1) Glazing% U-factor Ceiling Vaulted Walls Floor Slab _1. (2x4 construction) up to 12% 0.35 R-38 R-30 R-15 R-30 R-10 ✓2. (2x6 construction) unlimited 0.40 R-38 R-30 R-21 R-30 R-10 if you intend to use 2x4 construction,compute the window glazing percentage of heated floor area to verify that the project falls below the 12%maximum allowed glazing: Total area of windows,skylights and patio doors: sq.ft. Total heated area: sq.ft. Total window area divided by total heated area=glazing Updated: August 24,2004 Page 1 of 2 . + - INSULATION CERTIFICATE I ! Address of Property I- I- - --- _ ICounty Job No. -:- _-__-- ---_ —__I____---�_---_.-._ — — - - EXTERIOR WALLS ill-I- I YP — — -- J� ti I R Value: .. - — R 7 eof Material FIBERGLASS Manufacturer: CT/KN/OC Thickness: L- --- — — LING BATTS ' I r t CT/KN/OC Thickness: 38 T eof rZ t- R Value: .. yp Material FIBERGLASS Manufacturer: 1 C UNDERFLOOR peof Material FIBERGLASS Manufacturer:I CT/KN/OC C Thickness: JC l f R Value: ,jlj CEILINGType i , — --- BLOW -[Type i 'Manufacturer:' KNAUF ThIckneas: RValue: Lia_____HS Ft Covered 1 T eof Material FIBERGLASS BLOW i No of Bags Wt./Bag WA$HINGTOi t - — — I N INSULATION'— — i i - _ 4 44_4_ L I CERTIFY UNDER THE PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF THAT THE FOREGOING IS TRUE AND CORRECT L- �_f-. ----- b gC8 (Builder) NG, au s C J General Contractor Buiidr — 7Nk Contractors Re . Number. WASHII 85 Licensed Architect/Engineer: T. I a By ITITLE_ j Cwl.� Date and Place I — 11 it t i 1