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Home My WebLink AboutPermit Plumbing 1988-06-03.. RESID"NTIAL.. APPLICATNN/PERMIT 225 North |th Street Spn'LrqfieLd, )r,egon 97477 Building Diuision 7 26- 37 53 Rece"j Siqned, # SPTINGFIELD GenepaL ELeetricaL t4echonieaL Conatruetion Ledet Reati-no,1 I^t ia tla tespono'ibi-Lill of -tle petwit 4U* to aee tlnt alt inspectiotts ore nade at the ptope" tine, that each ad4ress is reaCabietyl-tly atree.t'.and tlat the-penrtt-eatd ie Lxated at the front'of tlte gopenty*Building Nuicion appro,*ed pl.an shcll remain on tte ounlding- sile Zt aLL' trlnes.' I ll)cEDUP\F1R. IysPEcrI)N,W7EST.'CALL726-3769(recoz,der) state your Citg desigrnted. job ntmber, job aCCress, type of .Lnspee=icn ::f"i!"1_1y-uhen gou uiLL be z'eady for inspection, cont?acto?s ir a,mers"nc.rnn"""i puTn nunbit,.' p.nq";;; reL.li;La bLlcre'7:00 an'-'LLL be nade the sone dcy' ?equeste made after, ?:00 an tiLL be nwde the nest aorki$ d.a.y. 9?o tqb S<s 4' E{@Job Loeaticn: Aesessors Map #Ta, IDt # Sttbdioision: A,mer: Address:Phone: Deserlbe llotk: Qlt"'^t ValueDate of App Lieation Additicn RemoCel SI?E INSPEC?TON: etcauation, but ?o be made afterprior tc set up of forns. AUDERFLOOR PLUI.ETNG & IiECHANTCAL : PTilAL PLUMBING FIIIAL I,IECEANTCAL FIt:lAL ELECTRICAL INSALA?TON/VAPOR BARRTER ITISPECTION : To be made aftez, aLL insulattcn a"d. t equired oapot burie?s @e in place but before any Lath, Wptun bcarC or tnLL couez,ing is applied, ad. befone ay ir*ulation is concealed. DRYWALL INSPEC?f)N: ?c be made aftet aLL dtguall is in pl,ace, but prior to any tapin4. DEI,DLTTIA!] OR Sanitatg saset, eapped at propercg- Line Septic totk put=ped ard. filled tith gra:tel UNDERSLAB PLUMBTNG. ELECTRICAL 8, WCHIIIICAL: To be made befoz,e anywrk ie cooered. FO@LNC & FOUNDATICN: To be ttaCe;Fer t-Wes ate ezcaoated. and fotns are erected, but pz,ioz, topouring ccncrete, UND9RGPOU!]D PLUMETNG, SEWR. II,4TER. DRAINACE: To be maCe pr"ioz, to fil-Lirq trenchee. Final - I{hen obctse'ltens are ccrnoleted and uhen Cq,tclition is comp;Lete br sfuue- tu.te noued ard. pz,errises cleaneC up. Ioben@of floor ineulation or decking. P)S? AND BEAM: To be nade prior toffiffiDiof floor insulZtion or deckittg. R)UGH PLWIBIIIG, ELECTRICAL & I,IECH- ta:til theee inspeetions haue been nad,e and, approoeC. EIPEPTTAC.!: Prton to plaeirq facing ma-tet ials and befote franring inspee-tion. FRA|.IING: l4ust be requested after apptoual of rough plwrbing, electni-cal & nechanieal. ALL roofittg btactng & chinmegs, ete. rrust be corryLeted. lto ucrk is to be con- . cecled unttl this inspection \as'been mod,e anC approoed. MAS2NRI: Steel Location, bond beans, gz,outing ot oez,ticals in aceord.@tce Lrith U.B.C. Section 241s. WOODST)ItE: After installation is attrpleted. CURB & APPRCACE APPON: After fornsee erecteC but prior to pourLn4 corterete. StDEWALK & DRIr'E'tlAI: For aLL con- c"ete pAfrAtffi st?eet right-of-tny, to be maCe after aLL ezea- uating canplete & forn tsork & sub- base material in place. e Hcnes Blocking od. Set-up Plwnbing connectione -- aaie? otd. ualet Electrical Connection - Blocking, set-up. and plutnbing eonnections rrust be dpprcted befote requesting eleelrtcal inspeetiot Aecessory BuilCnrq Firal - After pcnckes, skirting, decla, etc. @e contpleted. ALL pnoj, requined !!!!l: hhen complete -- Pz,otsiCe gatee or notsable sectians thtough P.a.E. ect eonditions, such as the i.nstallation of street trees, co:pletion of the Landseeping, ete., mtst be satisfied before the BUfLDING FINAL can be requested. n ilNAL B.urLDrNG: The Final Building. rnspection mtet be requested after the Final plunbing \J Electrical, attd Meclnnical fnspections late been mad.e atd'appt,otsed. *ALL I'IANHCLES AND CLEANOUTS tlUS? BE ACCESSTBLE, ADJUST\\EIIT ?O BE M4DE t1.? lto CCST fO CEy Pesel"fzl your City Desigr,ated Job Nurnber fs: Contractors Ad.dress L1-AC-D^ tr r !!eat PLan Erorlner Date f HAW CAREEULLY EXAt'fiNED tle eontpleted appli,cation for permit, and. do het'eby certify that aLL ilfomation het'eon is trwe and carrect, attd f futtker eertifg that any ard aLL dotk pe"fot".ned elnll be dote in accot- dance tlth the ordinances of the City of Springfield, and. the La:,;e of the* State of 1regon pertaining to the uork Cesct'ibed here;-n, qrtd. tlnt N0 )CCU- PANCY LrLLL be nade of any st?uct1/re vithout permission of the Building N- oision. f fu.rther certifE that only cont?acto?s ord anplcyees uho are in eanpliance uith 1RS 701.055 ui-LL be uaed on thie pz,oject # ?otal Qa alzl*, SOLAR ACCESS REQ.-d Grc JOB NO L-CO Bedrools: z of Lot Cooerage_ # of Stories Total Eeight LOT TWE _ Interiot _ Corne? _ Panhardle _ CUl-de-sac Iot Sq. Ftg. Topogrqhy Sourees t P. L.House Lot Faees - -- Eees -- Building Volue & Permit This pertntt is granted on the erptess eond.ition tlat the said,construction slwll, in aLL z,espects, eonfonn to the Crdinance adopted by the City gf Springfield, incT.uding the Zoning Crdinance, regzlating the ecnsttwcticn and use of buiLdings, and may be suspended or reuokeC at cnA tine upon o'ic- lation of otA prcuisione of said 1rdir,ances. TOTAL VALUE Date Paid: ITEM FTG x Signed: s.D.c. 1,5 0 Euilding PermLt Iotal Clwrges State Plumbing Perrnit No person slnll consttaet, instal1-, alter ot clwnge anA nea cr etisting plunbing or drainage syetan in uhole or in patt, unless such person is the legal possessor of a oalid plutnber's L'Lcense, ezcept that a pe?son nag do pltnbing uork to property uhich is otmed, Leased or operated bg the dPPLi- cant. N0.FEE CHARGE \1 rTEM Ficttl,es Resil.enti.al (1 bath) Seuer Plunbing Permit State Electricql Permit ' Were State Lan requires tl".at the eleetrical uork be done by an Eleetr-ieal Cont?acto", the electv"ical portion of this permit shall not be ualil until the lobel lns been signed by the Electu'ical Cont?acto!. ?otal Neu/Eotend Citcuits Seroiee fLL C!IARCE * Mechonicol Permit bhanst Hood llcodstoite Vent Eot PermLt fssuanee Mectnnical Per,tntt -- EIICROACHI4ENT -- Sec,t-ttg Depoeit Storage I'bintenaree Permtt Cvtbcut Silasalk ?ence ELeet?LcdL La.beL Plobile Horne TATAL AIAOUN? DUE: *lSrf Signed tute I'laf en hm.c P?ll'S Total Chanaes State Swchanqe , _/ .- - .. RESID-NTIAL.. APPLTCATmN/PERMTT 225 North 5th Street Spr"tngfield, 0regon 97477 Butlding Diuision 7 26-37 53 # SPFtINGFIEL.D tl,/60t , Consj@on_ted."_ It ia ttte rcepons.ibility of tte permit ltolder to see that aLL inspections aye nade at the propet time, that each adlress is rea'C.abie fiont tlu at?eet, and tllat the penrit eatd ia Loeated at the frcnt of the property.*Building Nticiot appto"*ed plan shcll vemain on tlp Building Site at aLL times. PROCEDUPE FoR INSPECTION RI1UEST:CALL726-3769(yecordet,) state Aouy City Cesignated job nwtiber, iob aCircss, lUne-of inspec)icn eadyfot,inspection,cont"acta?sol,a,mersrwnecndplonenunbet,.Requestsreceixedbefcre7:00an ,vLLL be made the sane dcy" Tequests made aftet, 7:00 onurLLL be made the nect aorking day. Reauired fnsoeetions Iout, City Desigr,ated Job Number fs .986/76 u\ 4 rob Locaticn' .E4, /Y< q=n> 57 Aasessore uap # i/)^o"-=/^ 7 / r6a Lot # a1<oa Subdiuision: )tmer: Phone: cifu:zip DescrLbe l{ork: Brfzrm.> 7> 5a,6ri-7> ^*vz fiarea-.F- VaLue n Ned .*Date of 7*2-a= Add.ition RemoCel Lisc. #D^Contracto?s Address GeneraL Page 1 of 2 fotme. UNDERSLAB PLUMBTNG, ELECTRICAL & !@C!t!j!ICa!: To be nade befoz,e any ffiAe-iotset,ed. FOO?ING & F)UNDATICN: ?o be rm.de after trenches a?e ard. forns ote etected, but prior to pow-Lng ccncret€. UNDIRGROUTID PLAMBING, SEWP,, W,ATER, DRAilIAGE: To be maCe prior to fil- @fiinehee. AIDERFLOOR PLUI,IBING & I|ECIIANTCAL: o1 floor insul,ation or decking. P1S! 4!L EE4!4: To be nade prtor to ZffiTTffi{of floor insulation ot' decking.u) r5 No these inspeetions haoe been made and approueC. ry3EE!$SE: Prior to plaeirg fceing ^atAld; and before f".ri"s Zn"pnb- tion. PRAI.,IING: litust be z.equested aftet, @piffal of rough plwr,bing, electri- cal & nechanical. ALL roofing btacirq & ehinmeys, etc. tntst be , completed. llo ucz,k is to be con- . cealed until this inspectLon lws 'been made anC apptooed. rNsuLArr)N/VA.P)R BAIRTE! !!E!!!!!pN :DEI.IOLTTIA!! OR :.:OW) BI,/ ILDI\ICS To be made aften aLL insulaticn ond required oapor batrie?s @e in pl,ace but before oty Lath, gApsl.tn boa.rC or tmLL couering is cppli-ed, and before oty insuLation is concealed. SITE INSPECTION: ezcao;tl;n,'but ?o be made aftez' pr"Lot, tc set up of l/) DRYWALL fNSPEC?f1N: Ic be made;F$;V@iitTis in pl-ace, but ptior to any taping. MASONRY: Steel location, bond beons, grouti-ng or oerticaLs in accordotce tnLth U.B.C. Section 2415. wooDST)I,/E: anpLeted. After installation is SarrLtaty seaer eapped at properfui Line Septic tutk y"nped and. filled rtith gratel Final - h1ten abctse itens ote catpleted and uhen Cqnclition is cornplete o! struc- tuye moued otd. prewLses cleaneC up. Hcnes Bl,ocking otd Set-up Plunbin7 connections -- sare? qtd. uater Eleetrical Ccnnection - Bloeking, set-up and pLwnbing connections m;st be apprcoed before tequesting eleetv"tcal inspection Accessory BuilCing Einal - After pcrekes, skirting, deeks, etc. at,e c.cnpleted. CURB & A?PROACH APPON: ee erecteC but prior to concyete. SIDEWALK & DRT',WAY: After .fornspou?L719 For aLL con- er. et;naorng-,rf il;fn s tt e et ri ght - 7f-txA, to be made after aLL erca- oating complete & fotn uork & sub- base material in pLace. tv IENCE: tt4ten complate -- ProuiCe gates or mooable sections through P,U.E, ALL pToject conditions, such as the installation of stpeet trees, conpletion-of tne requ.Ly,ed LanCseeping, etc., rmtst be satisfied before the BUILDING FINAL can be teqtested'FIilAL PLUAAING \)l PTNAL MECHANICAL -t c.\tt FINAL ELEC?RICAL /.\}\ FINAL BUILDING: The Final Building Inspection mnt be requested after the Final Plwnbing \a/ Electrtcal, otd Meelnnical rnspeetions hate been made ard approtsed.w Z *ALL MANHCLES AND CLEANOUTS I'IUS? BE ACCESSIBLE, ADJASTIIEI'IT TO BE MADE N? NO COS? IO CITY : tr Address: JOB NO.;0 (t soLAR ALCESS REQ.-d Gro t Sources Bedroons L-CO # of Stories lotal Height fopography LCT TWE _ Intericr _ Co?ner _ Panhan-d.Le CuL-de-sac bt Sq. Etg. % of Lct Cooenage Se Access Lace Df House Lot Faces - -- Eees -- ITEM FTG x Value Building Volue & Permit This pernrLt is granted on the erpress condition tLnt the said_construction s?nLL, in aLL respeets, conform to the Crdinance adopted by the City of Spr_ingfield, incT.uding- the Zoning Crdinance, r,egulciing th-e ccnstru-ctibn cnd -use of buildings, and nay be suspen^d.ed or reuokeC at enA time upon uic-Lation of cnA prcuisions of said Ordirances. TOTAL VALUE S.D.C. 1.5 t Bui.Lding Permit S> State ) Date Paid *I?otal Clnrges o Signed rTEM NO T LL CHARGE Eiotures Plumbing Permit Resid.ential (1 bath)N9 pereon stnll constntet, install., alter ot elnnge anA ne?n cr existing qlwnb_ing or dtainage sAsten in uhoI.e ot, in patt, inless such person is- the Legal.posseasoz, of a ualid plutnber,s Licensb, ercept that a pZrsonnag doplunbing uoz,k to property uhich is ouned, Leased or opet'ated by the "ppli.-cant. Seuer Planbing Pernit * ilo. Na,t,/Ectend Ci7cuits ?2-, Electricol Permit Wtet,e State La,t requires tVwt the electtical uork be done by an Eleetrieal Cont"acta?, the electrical poz,tion of thia permit slwll not be oalid untilthe Label \ns been signed by the Electrical Conttactor.Set uice Permii 2>-s> State -Ll Iotal 7€V NC.FEE fII A DfF pl> a?5 b Mechonicol Permit bhanst Hood llcodstotse Vent F@l Petttrtt fssuanee Meclnnical Penrntt -- ENCROACHME!']? -- Seeuz.ity Depqsit Storage Maintenance Permit C'utbcut Sida,salk Pence Electrical Inbel Mobile llorne Receipt #: ?otaL * f HAW CAREFULLy EXAI4fNED tle completed appLication for permit, and do herebg certify that aLL infonnation heyeon is true and ebw,ect, atC I furtker cettify that any ard aLL uork perforned s?nLL be done in accot- dznce urith the )rdinances of the City of Springfield, and the Laas of the State of Oregcn pertaining to the aork Cescribed het,ein, end tlnt N0 )CCA- PLNCy l,till be rnad.e of anA structut,e uithout permission of the Building DL-uision. f futther eertify that only contractors and e:ttplcyees uho arb in eonplianee uith ORS 707.055 ui.LL be used on thia ptoject TOTAL AI4OUII? DLIE: *fl gz,dT Signed Date 5^2-Aa - fi,r, SPRINGFIELD CIIY OF SPRINGFIELD Department of Public Works October 18, 1982 l.ls. Pamela D. I'Iest U.S. Department of Housing and Urban Development Area Office Cascade Building 520 S.W. 6th Avenue Portland, Oregon 97204 Dear [ts. West: At your request, the Building Division of the City of Springfield nade a Housing Inspection on October 8, L982 at 555 North 33rd Street, Springfield, Oregon. The following itens were found in need of repair or replacement to conforn to the Housing Code as adopted by the City of Springfield. A11 applicable pe::nits. rnus.t be obtained and all itens shall be installed in accor- dance wittr appticable Codes and inspected before a Certificate of Compliance will be issued Front door must be repaired and nust open, close and latch properly. Carpet prevents opening of the door. 1 2 Ceiling above front door is falling off. ing at this location causing the damage. it is not repaired. Ceiling must be repaired. Roof is leak- Carpet and floors will be damaged if 5. Floor grills for heat system need replacing in living room and front bedroom. 4. The bedroom windows are painted shut. They nust be openable. (No locks on windows. ) ; 5. Foundation vents nust be covered with corrosion-resistant wire mesh not less than L/4 inch, not more than l/2 inch in any dimension. 6. The drain line from the washer. must have an approved trap installed 7. Valves on the hot and cold water line to the washer must be replaced. 8. An approved (ANSI) pressure/temperature relief valve nust be installed on the water heater. 9. The shut off valve on the cold water line to the water heater must be accessable. 10. The gas furnace is installed in a closet that opens into a bedroom and utility room. The gas water heater is also installed at this location. Furnaces are not allowed in rooms designed as bedrooms, bathrooms, or a closet. A walI nust 225 North 5th Street . Springfield, Oregon 97477 a 503/726-3753. ',i'i:ir',..t= *i:'.r/'l{s. Pamel-a D.- lrlest iy 555 North 33rd Street'y 10-15-82, Page 2 G be installed between the furnace and the bedroom closet. Access to the furnace may be from the utility room. A furnace room shal1 have an opening or door and Passage way thereto not less than 2 feet in width and large enough to pernit removal of the largest furnace in such roon. A warm air furnace sha1l not be installed in a closet or alcove less than 12 inches wider than the furnace in- stalled therein with a mininun clear working space less than 3 inches along the sides, back and top of the furnace. An unobstructed working space not less than 30 inches in depth and the height of the furnace, but not less than 30 inches, shall be provided along the entire front or firebox side of every warm-air fur- nace when the door of the furnace enclosure is open. Adequate combustion air must be provided as specified in Chapter 6 of the State Mechanical Code. The furnace roorn area must be remodeled, the square footage of the furnace room will determine the amount of combustion air requirements. 11. The ceiling above the furnace must be sealed to eliminate any opening into the attic. (Note: Heat ducts in crawl space and attic are not insulated) L2. A11 openings from the utility area into the attic area must be sealed or doors instal 1ed. 13. The gas piping frorn the meter is laying on the ground. A11 exposed gas piping shal1 be kept at least 6 inches above grade or structure. This applies to the sma11 building on rear of lot also. L4. The gas lines should be pressure tested in accordance with Section 2208 of the State Mechanical Code before use. 15. Electrical wire splices in utility roorn must be made in an approved manner in junction box with an approved cover. 16. Outside electrical receptacles should be replaced with weather approved type. L7. The loose electrical wiring in the small building at the rear of the lot nust be removed or terninated in an approved manner. 18. The small buitding on the rear of the property shall not be used as a residence. P1ease direct inquiries to the Springfield Building Division at 726-3753. : Sincerel Y, Dan Smith Building Inspector DS: ch (-' , illzr,*l Zf a''- ;- 4'/u/t/? CIIY OF SPR4NGFIELD, OR )N Department of Public l"iorlcs 225 I'trorth 5th Street BUII. \G INSPECTION DIVISIOII JOB NI]MBER: DATE:JOB ADDRESS , .rr{73 c1 aTO: NOTE; ,4r-*o** a{ Aa.t C^-4, INFOR},IATIO}I: CTION ECTOR: 7 26-37 53 7 26-37 69 U^fh -*t -ri.rlrtt r^ f #'W""*PECrroN,tH-<, lfu/h 2,,"2 - z:,,t *t - ftrL. *r^{ %erflib eaD .r 4z-z T/,4/"2^ a 4 ,$zd--. Oz? /z*zzz-raz ZezAaAz4r* d,, Vza*l *4 4n z?zx.:Q-'+ - l PUBLiC I^,ORKS GENERAL C OMPLAINT FORM TIME:7:'za DATE: V f #tli' , ,}I\, ,.lEf$i /( guilding ': 'Engi neeri n g Traffic _ Maintenance _ Bldg. Attendant ADDRESS OF COMPLAINT: VIOLATION/COMPLAI NT: COMPLAI NANT: ADDRESS OF COMPLAINANT: PHOI,IE: TAKEN BY: fJ:{ /.</? -=na <-'. SPRINGFIELD CIIY OF SPRINGFIELD Department of Public Works October 18, 1982 l.ls. Pamela D. lllest U.S. Departnent of Housing and Urban Development Area 0ffice Cascade Building 520 S.W. 6th Avenue Portland, Oregon 97204 Dear lrls. West At your request, the Building Division of the City of Springfield nade a Housing Inspection on 0ctober 8, 1982 at 555 North 33rd Street, Springfield, Oregon. Ihe foLlor.ring items were found in need of repair or replacement to conform to the Housing Code as adopted by the City of Springfield. A11 applicable peroits mus.t be obtained and all items shall be installed in accor- dance with applicable Codes and inspected before a Certificate of Corupliance will be issued. Front door must be repaired and nust open, close and latch properly. Carpet prevents opening of the door. 1 2 Ceiling above front door is falling off. ing at this location causing the danage. it is not repaired. Ceiling must be repaired. Roof is leak- Carpet and floors will be damaged if J 4 Floor grills for heat system need replacing in living roon and front bedroorn. The bedroom windows are painted shut. They must be openable. windows. ) (No locks on Foundation vents must be covered with corrosion-resistant wire mesh not less than L/4 inch, not more than l/2 inch in any dimension. The drain line from the washer must have an approved trap installed. Valves on the hot and cold water line to the washer must be replaced. An approved (ANSI) pressure/temperature relief valve must be instalLed on the water heater. 9. The shut off valve on the cold water line to the water heater must be accessable. 10. The gas furnace is installed in a closet that opens into a bedroom and utility room. The gas water heater is also installed at this location. Furnaces are not allowed in rooms designed as bedrooms, bathrooms, or a closet. A wall rnust 5 6 7 8 225 North 5th Street a Springfield, Oregon 97477 503/726-3753. Itls. Pamela D. l{est 555 North 55rd Street 10- 1 5- 82 Page 2 be installed between the furnace and the bedroom closet. Access to the furnace may be from the utility room. A furnace room shall have an opening or door and passage way thereto not less than 2 feet in width and large enough to pernit removal of the largest furnace in such room. A warm air furnace shall not beinstalled in a closet or alcove less than 12 inches wider than the furnace in- stalled therein with a minimum clear working space less than 3 inches along the sides, back and top of the furnace. An unobstructed working space not less than 30 inches in depth and the height of the furnace, but not less than 30 inches, shal1 be provided along the entire front or firebox side of every warm-air fur- nace when the door of the furnace enclosure is open. Adequate combustion air must be provided as specified in Chapter 6 of the State Mechanical Code. The furnace room area must be renodeled, the square footage of the furnace room will determine the amount of combustion air requirenents. 11. The ceiling above the furnace must be sealed to eliminate any opening into the attic. (Note: Heat ducts in crawl space and attic are not insulated) 12. A11 openings from the utility area into the attic area must be sealed or doors installed. 13. The gas piping fron the neter is laying on the ground. A11 exposed gas piping shall be kept at least 6 inches above grade or structure. This applies to the sma1l building on rear of lot also. L4. The gas lines should be pressure tested in accordance with Section 2208 of the State Mechanical Code before use. 15 Electrical wire splices in utility room must be nade in an approved manner in junction box with an approved cover. Outside electrical receptacles should be replaced with weather approved type.16. L7.The loose electrical wiring in the snall building at the rear of the lot must be removed or terminated in an approved manner. 18. The small building on the rear of the property shall not be used as a residence. PIease direct inquiries to the Springfield Building Division at 726-3753. Sincerel Y, Dan Smith Building Inspector c DS: ch tzrsts3 alowlLng oc€uP*r+€Y INSPECTION APPLICATION EXISTING BUILDINGS CITY OF SPRINGFIELD BUILDING DEPARTMENT DATE: August 27, 1982 FHA Case ll43I-I50234-203 JOB ADDRESS:555 N. 33rd Street, Springfield, Oregon 97477 NUMBER OF 1INITS: OtrNER: T)enarfment of IIIID 1 0WNERS ADDRESS ! Cnennrte Brri'l rtino 520 S. W. 6th Ave.. Portland. Oreson 97 204 APPLICANT: Dennrrment of HUD APPLICANTS ADDRESS: crsr.rrie Brrilrtino 520 s- w- 6th .. Portland. Oreson 97204 FOR CESS TO PROPERTY - PLEASE INCLUDE TELE PHONE NIIMBERT pam West 2 t-267 | A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORi"l }ruST BE SIGNED BY INSPECTED. OWNER OF THE PROPERTY TO BE o PROP TY DATE OF INSPECTI ON, ,/2-7-;T>_ DATE OF CERT. OF COMPLIANCE : DATE OF REPORT: REI{ARKS: RECEIPT NI]MBER: c -1-8?-fi; - - __gqB_gEE-rqE_gEE- gNLv-