HomeMy WebLinkAboutPermit Building 1985-02-28I IISPECT I r
7 26-37 69
L
COHBI iIATION APPL ICATIONIPERMIT 7
Job Address
Legal Oescription
Ranoe
tlater Heater
ElIERGY SOURCES
Hea t
0wner S?aaql C-t,.-(drr^l err?
varue or *"\,uDr
Sq. Ftg. Access._
Sq. Ftg. 0ther
_llew_Add AtIffiE.-
_Fence Demo Change/Use
0ther
. Ftg n
Address Phone 0e
i
nq
Re s diFamI e
l^lork
Ga
.e., Build Single,\
Construction Lender \\I
Addres s Phone \
\^N
I
$
name adr ress 'I CS , nO.exDI res ohone no.
Pri ma ry
Structura I
El ectri ca I
l,lechani ca I
ACTORS name rpqq Iics- no-exDt res (ohone no-
o
El ectri cal
itechanical
PLUI.IBI NG ELECTR I CAL HECHANICAL
FEE CHARGE NO FFF CHARGF N0-FFF CHARGF
Each single fixture Residence of
FTSQ
furnace/burner to
BTU' S
Relocated buildino
(new fix. additional)New circuits alts.
or extensions
Floor furnace
and vent
S. F. Residence(l bath)SERVICES *a/ /Recessed wal l
Soace heatpr and vcnt
Dupl ex ('l bath ) each
Additional bath structi on Apol iance vent
seDa ra tP
tlater service 0 exi sti ng Stati onary evap.
cool er
Sewer i fami y, corm. or Vent fan with
sinole duct
Storm Sewer 0f Vent systern apart from
heatinq or A.C.
coMl.t./IND. FEEDERS Mechanical exhaust
hood and drrri
I n s ta l 'l /a I ter/ rel ocatedistnib. feeders l'Jood stove/heater
0f amp s.
ISSUANCE OF PFRI,IIT
TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES
},HERE STATE LAI,I REQUI
shall not be valii until
RES that the Electricai work be done by an Electrical Contractor, the electrical portion of this permitthe Iabel has been signed by an Electrical Supervisor and returned to the Building Division
llAl.lE(please print)(/),
' 0regon
the Buiof any
Board
NED the e ted c ta 0n d nc0mpapherertce,f tha atdoant n rmatfo 0n true!')b.y vndarreccotandcertfu rther hat t a workand oerfo srmed ha be done accn WI tthfyordance he nances0rdi o f cthe ty
e anddsof
any
ofethofLawsStheteta nng fipri thandrtathet0descriworkherebedn wl madebeOCCUPAHCYNCatngDEtructswluretthouethSSofndivlpermiDisonhefurtcerrtthattrastonthvrltheulderSfym.y reg
s ful fo rce and ef asfect red 0Rs fng
701requ i tha t bathe s forS t 0n s055byexempt hereonnoted and thatexemp
on ubcontracto rs a nd who rea nlyempoyee ance wl th 0t1s 70t 055 wl be used thn tcomDnroj ec
Lzonelf{-Jvoelconst. E -l( units so Ftg.
Ftg.
Ftg.
l'la i n
ToTAL VALUATIoil_
xFlood Plain Stori es Group Sl-l SO
Fi re Bed
rVa lue
rooms 0ccy Load lue
a
Accesr
0ther
Plan Ck. Conrn/Ind
651,/B1do Ppr Fce
Svsterxs Deve
Charqe fI.51
opmentEUILDING PERI'IIT
Charges and
Su rcharges Plan Ck. Res
30%/Bldq Per Fee
FencePLUT,IBING PERMIT
Charges and
Surcha rges DEsro
SldewalkELECTRICAL PERIlIT
Charges and
Surcha rges A/C Paving Total Comb. Fermit
Curb CutI,IECHANICAL PERHIT
Charges and
Surcharqes /o -pTOTAL
;+
COMBINATION APPLICATION/PERHIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Descriptionl. glaTplg: Tax Lot 100, Lane County ilap Reference17 03 432. gxaTp'lq: Lot l. Btock 3, Znd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
example- heat/
Exi6il e-- wa terre footage or
PERMIT VALIDATION
CITY OF SPRINGFIELD
tk
Clty Hall
Spdngffeld, Oregon
Department ol Publlc Workr
OFFICIAL RECEIPT
No. B G4-?0t
19
I
el ectri ca I forced air garteror solaFvaluation, etcq. foot house,500 sq. foot garageproject, check new -if addition, (Rec'd From
LJ
li
F
2
E. Squa
I
?
1250 s,It new, etc.
exampl e-
examD I e-
check add
exampl e
a ttac hed
examole -
examole -
res ta u ran
Bu i lding permit informati on:- construct single family house with an Addressgarage
remodel existing gara ge into family roon (
convert si ngle fami ly res idence intot(c use )Received For:G. Value of work as
hange of
defined i n Section 303 (a) of the
H.
Structural Specia I ty Code
DESIGN TEAM AND CONTRACTORS
Amount Received
Permit Clerk
I:..:::19 !::lg, or construction delays, Buildinsulvlslon Staff must be abie to contact appropriitepersons.regarding design information or jbU iite--corrections, etc.
lbb.:yj1!:o plumb.ing,. Mechanicat, & Electricat SchedutesA. Lxcept where blank spaces occur in the description--portion of the Mechan.ical and Electriiat Sctreluiel,the applicant need fi|t_in only the G. Boxaa-;;jiient_ to the appropriate item(s) to 6e instal.ledB. Full ptumbing, Mechanicii, i.a-if.iirical Schedulesare available at the Building Division1. To conserve space on the"permit iorm the scheduleshave been abbreviated2. ff the item(s) to be instal.led are not covered onthe abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES ANDCHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be delivered to thelectrical contractor ror signaiur. [v r,i, eteci"iiaisupervisor. The generai conlractor ii not authorized- to sign the electiical labelApplicant to sign and datellhenever possibie, the .initial application will be used as
.a-.worksheet only. Where possibt!, euilding Division Stafiwrrr.prepare a type written copy and return it to theapplicant at the time the actui'i fermit-is"issueo for hiss i gna ture.
Fees and Charges
Plan.check fees are due and payable at the time of theapplication, and no plans wiit-ue proieiiid until thesefees are paid. All other rees ano'cii.s.i-.". due andPayable when the permit is issued.
FOR OFFICE USE ONLY
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IV.
SIGNATUHE
fubr ", ","rc< EoFMs ,to. rsorruz.ar.q{
v
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
rmPe t'l a 1I anc tpp fromt 'l tras 'ltexemp w'ton htreg Bthe 'lu dI er S rdBoa cbe ua SE
Additional Project Information :
name G.s't gnature dat
PLANS REVIEWED BY: Na PQ*Is
DATE:
JOB ADDRESS: 5-l ,
o!trNER: -4., -so C-L,'//.e-
"
Cu, /".rzQ
OT,,INERS ADDRESS:/,iSn s s/r."e/(( .t
APPLICANT: ./o, on .. o C ,^U en 's Ce, /r.
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY-.P E INCLUDE TELEPUONE NIIMBER : 7 4
(( /.q/
)o - zl :(rn
CITY OF SPRINGFIELD ,
Department of Publ i c ll, ..sBuilding Safety Division
?25 North 5th StreetSpringfield
726- 3753 ( Bus .
0regon 97 477
726-3769 (Insp. )i
OCCUPANCY IIJSPECTTON
APPLICATION
SPRINGFIELD
,14,
?,"4
>: o0
PROPOSED USE 0
A $:O.OO INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY TI{E OI.'NER OF THE PROPERTY TO
BE INSPECTED.
SIGNATUPS OF PRO OWNERT"/ ts'o/z J-FOR OFFICE USE ONLY
DATE OF I}ISPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF CO}{PLIANCE:
COMMENTS:
SU I {o lt
RECEIPT NI]MBER:2b3
DATE PAID:
4/
daru424
*/tq /8r-
.. RESIb..NTIAL..' APPLICATION/PERI[?
225 North Sth Street
SprLngfield' 1tegon 97477
BuLLdlng DLU'| s1,on
7 26-37 53
SPFINGFTET.D
Date
3C.
GeneraL
Conajrucfron_lendet
Reati-rad Tn
I^t ie the tespona-ibi-Lily of the permit hold* to aee tlnt alt itapectiota are nade at the propet tine, tl,at eceh addtess ,l,s vsaCab'.2f.yl-tlp stlegt, and tlut the_pernrtt-eatd. ia Located, at the frcni of the property.*Euilding Dioiciott appro"*ed pLan shall rema'in on tlp Building site Zt aLL' tiines.-
PR2jEDUPEa FoR. IySPEcTI2ttt
=E!-37ES?;CALL 726-3769 (recorder) state you" City designated job tnm,bet,, job aCiress, tgpe of inspec=icnreQuested atd ahen gou uiLL be ready foz, inspection, Contya.eto*s i, a,tners runneLrra pnoin rutnber. -p.equests rccetxZd bb1cre'Z:00 an'*YLL be nade the sane dcy, ?equests made after ?:00 @n trLLL be nal.e the nert cotking dag-
8(o/ 7-{IdLt? CitA Desigr,ated Job Nutnber Is
rob Iacaticn, 5d / 5 CQ-J/
Assessots Map #Ic,x lat #
Svbdit;ision:
/J"Asner://
otu:::'-1i,2 / -S-4 Ph'ri 242:- S7r? ?)frA;_az;/il 0k zip: ? z,/ > >cifu:
Desa4be Wotk:
4//r))
/
t--t
TI
ValueDate of App Lieation
Additicn
RemoCel
l,lechan:ieaL
Page 1 of 2
SITE INSPECTION:?o be nade after
pt ior tc set up of
lnCntttltCll: fo be ffiiEefote-anyratk is eotset,ed.
eceansation, but
fonne.
UNDERSLAB PLUMBING, ELSCTRICAL &
FOOffNc & F)UNDAIICN: ?o be tmCeafter trenches aie -escatsated and.
forms ate erected, but priot, to
pout'Lng ecncrete.
FTUAL PLUVBIIIG
PTNAL MECHANICAL
FINAL ELECTRICAL
INSULA?TON/VAPOR BARRTER IIISP.ECTION :
To be made after aLL insulaticn ed.
required oapor barie?s @e in pl,ace
but before ory Lath, gqpswn bcatC or
tnLL cotteying is appli.ed, and. before
oty itoulation is eoncealed.
DETlOLrurc!] OR
Sani:atg saser eapped et p,operfi; Lire
Septic totk punped and filled ttith gra;,;el
I u N DIRCP)U\Lp PLUMB IN G z_EEilEBL_ n'ATt&
Lirq trenchzs.
UTIDEPTLOOR PLUMBTNG & MECHANTCAL:
o7
floor ineuT,ation or decking.
IOS! AND BEAI4: To be nade priot, to
ffiTilTat-lon o7 floor ircul)tion or
deeking.
R)ucH PLUIBIL:|1. ELECIRTCAL e !,IJCH-
w:til these irnpections tnue beer,
made and approoed.
FIPEPLICE: PrLon to plccirq facingna-tet"ials and. before franing inspeb-tion.
FRALIING: l4ust be reqtested after
apptoual of rough plutr,bing, electri-u.L 8 meclwnical. AL! roofing
btactng & ehinmegs, etc. rmtst be
. eonpleted. llo ucrk is to be cotl-. eealed until this inspectton lus'been nade anC approoed.
CURB & APPRCACH APPAN,
d,e e"ectA-ffiVio"
Hcnes
Blocking od. Set-up
Plwbing connections -- sate? sd. aaler
ElectrLcal Cc*nection - Bloeking, set-u,
and plwnbing conneetions mist be apprcxeC
before requeeting eleclrical inspection
Aecessory BuilCnng
Pinal - After pcrches, skirting, d,ecks,etc. ate cotnpleted.
DRYWALL INSPECII)N: ?c be made
;1tet -aA@;aITis in p't aee,
but prior to any taping.
ILAS1NRI: Steel Location, bond
beans, gtouting ot oerticals in
accordance LrLth A,B.C. Section
2415,
WOODS?O'/E:
empTetud.
After installation ie
Final - Wen abctse itens ate canoleted
and uhen Cqtclition is eorrplete bt sAuc-
tuye nooed and pt,ewLses cleaneC up.
: After fornsto pouting
ancyete.
SIDWALK & DRfWWAI: Eor aLL eon-
ct eteVa,rfuAffi stteet night-of-rny, to be made after aLL esca-
oating canplete & forrn wrk & sub-
base natertal in place.
IENCE: When conplete -- ProoiCe
gates o" mouable sections through
P.U.E.
ALL pnoiect conditions, such as the installation of street trees, conpletion of tie
required Landsccping, atc., tmtst be satisfied before the BULLDLNC EfNAL can be z,equested.
n FrNAL B.urLDrNc: The Final Build.ing rnspection mtst be requested after the Final plunbing
\J Electrical, anC Meclnnieal fnspections haue been made atd apptoueC.
r
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tr l
ez/li - a///-tr r7q-,&
*ALL I,IANHCLES AND CLEANOUTS MUS? BE ACCESSTBLE, ADJASTITEID ?O BE I,L4DE !.T NO CCST T0 Cr?y
JOB No. )JV / 7 SOLAR t )ESS REQ.-
Total
Page 2
L-co d
Bedtoons
Date Pald
Reeeipt #:
Signed
Electricol Permit
Where State Lan requires tlat the electrical uork be done by an Electrical
Cont"actor, the electrLcal portion of this permit slnll not be oalil until
the Lobel hns been signed by the Electrical Contracto?.
PLan EcanrLnez,Date
I HAW CAfrEfULLy ExAl,ffNED the cornpleted application fot permit, and do
hereby eertify that aLL information heteon is tmte and correet, anC f
futtker eettify that any ard aLL aork perforned alnll be dote in aecor-
dance trith the 1rdinances of the City of Spningfield, and the Lasa of the
State of 2regon pertaining to the wtk Cescribed herein, cnd tlat N0 OCCU-
PANCY trill be nad.e of arry structute tytthout permission of the Building N-tision. f further eertify that otly eont?actot,6 ad. e:nplcyees Dho are in
eonpliance uith ORS 70L.055 uiLL be used on thie project
,(
*
Lot Faees -Enerqu Sources TiPe
Setbaeks Ileat
Df House Ca"aqe Access.Hate? lleatet,North Rarlge
East Fiz,eplace
South lloodstote
# of Stories
Total Height
?opographg
LCT TWE
_ Interior
_ Corne"
_ Panlwnlle
CUL-de-sac
rot Sq. Ftg.
7 cf Lct Cooetage
Vest
-- Fees --
ITEM 5q. FrG Va Building Volue & Permit
This pernrLt is granted on the ec?"ess eond.ition tlnt the s,i,id constmtctiottstnll-, in aLL z,-espects, conforn to the Ordirwnce adopted 6:y the City of
Spz"ingfield, ino|uding the Zoning C'rdinance, r,egulating the ccnstructicn
and, use of buildLngs, utd may be suspended or reuokeC at cny tine upon oic-'La,tion of @tA prcu'isione of said 2rdirances.
TOTAL VALUE
S.D.C. 7.5 c
Building PemrLt
State
?otal Charyea
N0.FEE CHARGE Plumbing Permit
No pe?eon slnll construct, install., alter ot ehange anA neD cr existing
plwnbing or drainage systan in uhole or in part, unlees such person is the
Legal poseessor of a oalid plurnbet's License, etcept that a pe?son nag do
plutnbing uork to prope?t! uhich is ormed, Leased or operated by the 6ppli-
ednt.
Fi.chses
Residenti^a.L (1 bath)
Seuer
Plunbing Penrit
9tate
Res. So. fto.
Neu/Ectend I /0ry
Tanpo"@A Seroice
/or
4c
0
NC Fq?CIIARCE Mechqnicol Permit
bhanet Hood
IJcodstore
V€nt Fdt
PermLt rssuance
Mec?nnical Permit
-- ENCROACEMENT --
Seatritu Deposit
Stora4e
Llainterwnce
Permit
Curbeu!
Sil.a,salk
Pence
Eleettical Label
Nobile Honte
t-9{
TOTAL ITMOUN? DUE: */o qJ Signed
SP]lINGFIELD
CIIY OF SPRINGFIELD
Department of Public Works 1 885- 1 985 Sprinslield Centennial year
March 18, 1985
Mr. AIvin Miller
Hosanna Childrenrs Center
1550 S Street
Springfield, Oregon 97477
RE: 0ccupancy Inspection for 521 North 5th Street, Springfield, 0regon
STRUCTURAL SPECIALTY CODE AND FIRE AIID LIF E SAFETY CODE (s S.C. )
t Install an approved electrical'ly supervisedfire alarm and detectlon system with aux-
iliary power in accordance with S.S.C, Section 1313, and arrange for a Fire Depart-
ment acceptance test.
provide two fire extinguishers with a minimum 2A rating (AgC type is recommended)
and coordinate p'lacement with the Springfield Fjre Department.
Remove non-approved double keyed deadbolt locks from a'lI exit doors.
proivde a secondary means of emergency egress from s'leeping.rooms on the second floor
the use of whjch ii rvithin the caiabiiity of persons it is intended to serve. Install
piitio"*i una." windows used for iuch puipose,-where the sill height above the ad-
jacent floor exceeds 44r'. S.S.C., Section 1204.
provide an approved handrail at the top section of stairs in accordance with S.S.C.
b..tion SjO6'iil. The handrail shall be located 30"-34" above the stair nosings
and shall exteni at least 6" beyond the top step. Ends of the handrail shall ter-
minate in newel posts or safety terminals.
provide steps at exter:ior exit doors at the north and west sides of the bui'ldi1S
ii;;irJt.g-lt ine front-entry aeir) in accordance with S.S.C., Section 3306 (c).
ifre rise 6t each step shall 6e between 4" and 74tt and the tread_run of each step
snitt be not less-thhn 10". The greatest difference between all risers or all
treads jn each set of steps shall not exceed 3/8". Handrails shall be provided
where each set of steps cbntains more than three risers. Provide a 30"-36" landing
at the top of the steps. The tanJing sha'll not be lower than %" below the threshold
of the door.
2
3.
4.
5
6.
225 North Sth Street. Sprinsfield, Oregon97477 o 503/726-3753
Dear l4r. Mi I l er:
At your request as agent for the owner, the Springfietg Puilding Safety Division conducted
an insp..tion of the-building(s) located at 521 North 5th Street. The purpose of this
inspection was to determine the suitability-of.the main building for the proposed use as
frouiing for unwed mothers, which ls categorized as an SR-3 0ccupancy.
In the interest of bui'lding safety, the following items shall be installed, replaced, or
repaired in order to confoim to applicable codes for the proposed occupancy:
I'lr. Al vi n l,li I I er
0ccupancy Inspection
521 North 5th Street
March 18, 1985
Page 2.
7. It is advised that the finished attic room adjacent to the staircase is not suitablefor habitation because of its low ceiling height and inadequate light and ventila-r tion.
ELECTRICAL SPECIALTY SAFETY CODE
I Install covers on a'll electrical devices or junction boxes in the attic and'in the
unfinished N.W. room on the first floor.
2
3. Install a light at the exterior of the front entry door.
4. Correct the reversed po'larity of the out'lets on the second floor which are marked
wi th tags.
5. Repair wiring in the garage as fol'lows: (a) Install box covers. (b) Insta'l'l
running boards across the joist and secure the cable properly to the boards andstuds. (c) Correct the reversed polarity of receptacles.
6. Remove receptacle out'lets from over baseboard heaters or re'locate them to the
side of the heaters.
7. Provide an approved grounding means fon the range hood in the apartment.
The foregoing items are requirements only for the existing bu'i1dings. Additiona'l require-
ments to conform to the approved Conditional Use Permit must also be met.
All necessary permits for the required work shall be obtained and required inspections
approved before a certificate of occupancy wi1'l be issued. All electrical ylork shall be
performed by an electrical contractor licensed in 0regon.
Please direct all inquiries to the Springfie'ld Building Safety Division at 726-3753.
Install a junction box with a cover at the splice on the furnace feed line (minimum
size - 4 LL/16" x 2l-." square). Five (5) cubic inches of space is required for each
conductor entering the box.
'il;?//,,-
rely,
Don Moore
Bui lding Inspector
,fr'rry*'*-/ l;* Matteson
Electrical Inspector
DM/r h
February 7, 1985
P.O. Box 26Springfield, Oregon 97477 ' ',
Subject: Hqne for unred mothers
Dear Mr. Miller,
1.
on February 6, 1995, the springfierd planning coxrmission approveda request made bv Hosanna tnirdi.n;; A;;tr;^'io, . conditionar usePermit to operate i rrorne ro.-o"u=a mothers-"t iir North 5th street.
The pranning cqnnission approved.this request based on the findingspresented at the nreeting ui,a "rui""t-to-ilI-ioil.o*ing conditi.ons:
The rnaximun residential capacl Qr for this facilier shall notexceedmothers
2' The proposed use sharl provide four off-street parkingspaces' No current open space area sharl be redr:ced in sizeto acconmodate Snrking requirsnents-
3
4
5
6.
+1, _
appropriare buildingshalI be met prior a;'ocrctipancy inspection .
safetlr code provisions
This shall incltde an
A one year review shalr be reguired which shalr includeIllff;;ttt"" or t*uruy--iesfrents -and eriecl& neisrroorhood
xi:,nJfr"T: .ffS."fii$:" will be permitted ro keep an
shaIl be limited to a total of one on_site
HiI HHrUl"t" and resident staff shall be arlorcd ro use
and fire
occupancy.
Resident staff
trnrking space.
7
--I
These conditions were assigned by the Planning Ccrnnission at apublic hearing on February 6, 1985. Failure to comply with theseconditions courd resurt in a review of your request with thepossibility of revocation. rf you wish to modify any of theseconditions you must complete a 'rModification of conditions,atrplication avairabre at our office, and appear before the eranning
Ccnrnission at a regularly scheduled public hearing.
If you have any questions concerning the Planning Ccmnission actionor conditions please contact nre at your convenience.
Sincerely,
Gregory S. Mott
Associate Planner
CITY
De pa rtme
Buildin
225 NSpringfi
726- 37s3 ( B
PRINGFIELDf Public Ifety Djvisron5th Street
0regon 97477
726-3769 (Insp.)
OF Snt og sa
o rth
eld,
us. )
SPRINGFIELD
DATE:Jmrftuv,r?/ fu4/
i ?e,v,yrs *ra/
DoDtt /aatR -
be /5{ec@*44 -',
JOB ADDRESS: 5X L/h,l/.2 Xb ./.5 <.*sccl
C-{,'//re. '' C /".
OI,INERS ADDPGSS:/5sb s/r."c/
APPLICANT: //o Seq-zQ C ,^//, e- I C-e o 4.7*6zarry.@-
OWNER:SCi 4 -?Q e4
((
(< /s/,-B/APPLICANTS ADDRESS: ./5-5-rr
APPLICATION
Er.ioN
>: o07*-u.
a
FOR ACCESS TO PROPERTY--SE INCLUDE TELEPTIONE NIMBER : 7 /-s
PROPOSED USE:/1
A $3O.OO INSPECTION FEE IS REQUIRED AT TIIE TI},IEOF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY T}IE OIINER OF THE PROPERTY TO
BE INSPECTED.
lo - 4:(fr
c
7
T./ ts'o/z J-SIGNATUPG OF PROPER
FOR OFFICE USE ONLY
Oi{NER
DATE OF I}ISPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF CO}{PLIANCE:
COMMENTS:
JO 8 {o /7
RECEIPT NUMBER:..)4 a6 7
DATE PAID:
4^/.
g - oz
a
FIRE DEPARTMENT INSPECTION
OCCUPANCY NAME CLASS
b SPRINGFTELD
ADDRESS 5A/ pwt 5 BUS. PHONE
OCCUP. NAME 4( /,t?,'rh -HOME PH.
BUILDING OWNER PHONE
ADDRESS
CODE SECTION VIOLATIONS
fl,* A//er*:;no *r1 L" n"-+ fi. p,["a^r, {e<<*^rcoJ
/^) -M,o.or"d 4 b rl-,'"^ll, s<-<tt< " v i*.d {,dLt:r<- q[qrm d
deJ"cJ"oro *.h* =/^*/f il wo, ,.1"d (u 8C s.c /3r5 )
,7 sJ-
-A a ,L
Plo*),n. ^+usr'% QZe
JArot.
?rl an - +O prpe<d r{ouLL - k,.i du"/ lo lL h.A
4 . P.oo;dz a. * c A-J4ru i/14-ca ^)s o€ u** rtL., cA ee r<.rs
b,sfI
;"(rS i-J+^cLd +. *ruL.
YOU ARE HEREBY NOTIFIED TO CORRECT THE ABOVE VIOLATIONS TYITHIN DAYS.
SIGNED: VIOLATIONS: Noted 4
ABATEDINSPECTOR,il co,oarc;2-kt-6
NUMBER
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