HomeMy WebLinkAboutPermit Building 1994-09-13BES'DENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce: 726-3759
LOCATION OF
ASSESSORS
LOT:
SPRIl\lGFIELE
R
225 Flfth Street
Sprlngfleld, Orego
TAX LOT:
BLOCK:SUBDIVIS
OWN
ADDR
CITY:STATE:
ONE:
ZIP:
OTHERSHY_DDITION DEM
DESCRIBE WOBK:
NEW
CONSTNAM EXPIBESiADDRESS H E
ELECTRICA
CONT
GENERA
PLUMBING:
MECHAN
SE-
\
(-\\
?-l%WATER HEATEB:
FLOOD PLAIN
ZONING CODE:
r OF BDRMS:
LAND USE:
, OF UNI:TS:
CONSTR, TYPE:
HEAT SOURCE:
BANGE:
SECONDARY HEAT:
SOUABE FOOTAGE:
OCCY GROUP:
r OF STORIES:
QUAD AREA:
r OF BLDGS:
To req
made
uost an lnspectlon, you must call 726'3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7;00 a.m, wlll bethe same worklng day, lnspectlons requested after 7:0p a.m, wlll be made the followlng work day.
REOUIBED INSPECTIONS
R
x
Bfl
x
tr]-
Temporary Electrlc
Slte lnspectlon - To be made
after excavatlon, but prlor tosettlng forms.
Underslab Ptumblngl Electrlcal/
Mechanlcat - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erectod but prlor to concrete
placoment,
Underf loor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulatlon - Prlor to
decklng.
Sanltary Sewer - Prlor to llillng
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to fllllng
trench.
Rough Plumblng - Prlor to
cover.
Rough Mechanlcal - prlor to
cover.
Rough Electrlcal - Prlor to
cover.
Eleclrlcal Servlce - Must be
ffi flnat Ptumblng - When alt
---plumblng
work ls complete.
E-
E
Flnal Eloctrlcal - When allelectrlcal work ls complete.
Flnal Mechanlcal - When allmechanlcal work ls complete.
Other
approved
oloctrlcal
to obtaln permanent
power.
[-l Underground Ptumblng - prloru to fllllng trench.
E
E
x
tr
B
X.
E
l-l Flreptaco - prtor to faclng
-
materlals and lramlng lnsp.
ffi tt"-tng - Prlor to cover.
ffiWalllCenlng tneutatlon - prtor to
-
cover.
[RorVwall - prtor ro taptng.
l--l Wood Stove - Afrer tnstaflatton.
l-l lnsert - Aftpr ftreplace approval
-
and lnstallatlon of unlt.
ffl Curbcut & Approach - After
-
forms are erected but prlor toplacement of concrete.
ffi sto"*rlk & Drlveway - Afrer
-excavatlon
ls completo, forms
and sub.base materlal ln place.
n Fence - When completed.
fTlElnat Buttdtns - When ail.4 fegulred lnspectlons have beenapproved and bulldlng lscomploted.
MOBILE HOME INSPE TIONS
l-l Blocklng and Set.Up - When ail
-
blocklng ls complete.
Plumblng Connectlons - Whenhomo has been connected to
water and sewer,
Slreet Tieee - When all requlred
trees aro planted.
Electrlcal Connecllon - Whenblocklng, set-up, and plumblng
lnspections have been approved
and the home ls connected tothe servlce panel.
Flnal - After all requlred
lnspectlons are approved andporchos, sklrtlng, decks, andventlng have been lnstalled.
JOB NUMBER
a
- OFFICE
r
l,i ,l ,'r,'ri,r .r if.ri th
l,
Lot faces
Lot sq. ftg.
Lot cov€rage
, Topography
Total hel
Lot TYpe
*. ,nr.no,
-.X "orn",
-
Panhandle
-
Cul-de-sac
HE PROPOSED WORK TN THE.
HISTOB]CAL DISTBIGT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved bY the Hlstorlcal
Coordlnator prlor to permlt lssuance,
APPROVED:
PL.HSE GAB ACC'
N
S
W
E
lD*7+
(A)
BUILDING PERMIT
Total Value
Bulldlng Permit Fee
State Surcharge
Total Fee
ITEM
Maln
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express condltlon that the sald
constructlon shall, ln all respectg, conform to the Ordlnanceadopted by the City of Sprlngfleld, lncludlng the
Development Code, regulatlng the construcilon and use ofbulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provlslons of sald ordlnances.
Date
Plan Check Fee:
Date Pald:
Recelpt Num
Recelved By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
23a7.7? (B) @
Systems Development Charge ls due on all undeveloped
propertles wlthln the Clty llmlts which are being lmproved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
g
(c)
48C +
N9
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
\\
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent 50
SOt
(D)
MECHANICAL PERMIT
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
By slgnature, I state and agree, that I have caref ully examlned
the completed appilcailon and do hereby certlfy that alt
lnformatlon hereon ls true and correct, and I f urther cerilfy
that any and all work performed shall be done ln accordance
wlth the Ordlnances of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCy wlll be made of any
structure wlthout permission of the Bulldlng Safety Dlvlslon.
I further certlfy that only contractors and employees who
are ln compllance wtth ORS 701.OSS wlll be used on thls
prolect.
I further agroe to ensure that all requlred lnspectlons are
requested at the proper ilme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plan
Date
will remaln
on the
.K"",ure
slte at all mes durlng construct
MISCELLANEOUS PERMTTS
Moblle Home
State issuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
Total Mlscellaneous Permlts (E)
4C'eU
TOTAL AMOUNT DUE (exctudlng electrlcat) _
(A, B, C, Q and E Comblned)
DATE PAIO
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
BECEIPT NUMBER
E
ffiffiw
I
I
I
N"3
Furnace
Exhaust Hood
Vent Fan
ffi ,n
AI IACHMTNI E I JoB N0. g4/o€f
CITY OF SPRINtI IELD. SYSIFITS DEVELOPMENT U''\RGE
I^IORKSHEET
(COMMERCIAL & RESIDENTIAL)
NA}4E OR COMPANY:
LOCATION:
./
DEVELOPMENT TYPE:
Ft
BUILDING SIZE:
1. STQBtrDMyAGE
IHPERVIOUS SQ. FT.27
SANITARY SFWER.CITY
NO. OF PFU'S /T
(Sed Reverse)
SI
4+X $0.209 PER SQ. FT.
X $43.26 PER PFU
$
SUBTOTAL (ADD ITEMS i,2, & 3)V/3-63
2
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
v /,0/ X $436.19
x
-
x s436.19
x
-
x $436.19
4. SANITARY SFI^IFR-M\^,MC
s/
NO. OF PFU'S
(Use PFU Total From Item 2
$17.19 PER PFU + $10 M\^I|'4C ADMIN.FIE
Above)
s3 /?. l2
Ob
S zo? t, f{
5
}4l^lMC CREDIT IF APPLICABLE (SEE REVERSE); iotnL-uwuc snc
SUBTOTAL (AOD ITEMS 1.2.3 & 4)
APMINISTATIVT FFFS
(SUBTflNL ABOVE) X .05
-7-
"/
Ha
SDC
ig. P
82 . SDC
rdi nator
Date:7
TOTAL SDC
q
FIXTURE UNIT CALCULATION TABLE: ruumuer of New Fixturec X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only tt :f additional fixturesl
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub.....2
z
1
TOTAL FIXTURE UNITS
4
Z
4 T
/t
Z
z-
/Head
2
1
2
3
6
2
6
6
1
3
2
1
2
2
1
6
Drinking Fountain.........
Floor Drain.
lnterceptors For Grease/Oil/Solids/Etc
lnterceptors For SandiAuto Wash/Etc
Laundry Tub/Clotheswasher......
Clotheswasher - 3 Or More.....
Mobile Home Park Trap (1 Per Trailer)......
Receptor For RefrigeratorMater Station/Etc
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Sta1l..........
Shower, Gang......... ................
Sink: Bar, Commercial, Residential Kitchen..
Urinal, Stall^Vall.
Wash Basin/Lavatory, Single.
Toilet, Public lnstallation
Toilet , Private
MiscellaneOus: tT'tlt roR's g,lk 2
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $ 1,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1 985
1 986
1 987
1 988
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o.97
o.61
o.44
o.15
Credit for Parcel or Land Or*/ lf Applicable
lmprovement (if after annexation date)
x$/o. tzz t4.eo
(Rate X Assessed Value)x s_
(Rate X Assessed Value)
7.a e
CREDIT TOTAL - $3464
I
SPFINGFIELD
Il:, 10]
I o$/i rlS, projecl as s u brn itred hss th ezonrng, and does not require,p"iiii"-l"nJapproval.'Et gcaRrcat, PERI{rr APPIJcarroN225 PITTE STREET
SPRTNGFIELD, OREGON 97477
MSPBCTION REQUEST z 72
OFPICE: 726-3759
1.
J.rrihc;l:ecJ
LOCATION OP INSTALI,ATION1 S. lQtu {^:r-nctr-
IAGAL DESCRIPTIONa
JOB DESCRTFIION
SEC )Qr-rl St trM
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI.ATION ONLY
Electrical Contracto (=
Address -L\Z d, <7d s7.
City Qor=e nl€-Phone Aa<++St
Superviso r License Number t32SJLE
Expiration oate fOf t lq6
Constr Contr. Number oq q 45R
Expiration Date u /r /qr
Signa ising Electrician
Ovners Name
Add ress <6f q6ru N,)l =L
Ci ty QA( E IV\phone Z1o- )1{b
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
's
DATE:
City Job Nunber
Signatuio.Lry17*r;OHPLRTB FEE SCEEDUIJ BELOII
A. Nev Residential-Single or
Mu1ti-FamilY Per dvelling unit.
Service Included:
B
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
20L amps to 400 amPS
-
401 amps to 600 amps
-
601 amps to 1000 amPs-
0ver L000 amps/volts
-
Reconnect OnlY
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
Items Cost Sum
$ 8s.00
s r.s.00
s 40.00
r\
$ s0.00
$ 60.00
$100.00
s130. 00
s300.00s 40.00
D.
c
one circuit $ 35'00
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2'00
E. Miscellaneous (Service/feeder not included)
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
over 4b1 to 6oo amps
-
S 8o.oo
Over 600 amps or ibOOETts see nBu aE6lE
Branch Circuits ; .-
Nev, Alteration or Extension Per Panel
-Each i.ns tallation
Pump or irrigation
-
Sign/0utline Lighting-
l,iili ted Energy/Re s -7
Limited EnergY/Comm
22,4
--f .:ry-
2,.,.
40.00
40.00
20.00
35.00
s
$
$
$
5
CITY OF OREGON
,n.A
RECEIVED zl,bo
CITY OF SPR OREGO'V
zj:,rring, and
epprL\val.
not requiro spocillc land use
225 FTVTH STREET
SPRfNGFIELD, OREGON 97477 sa6 .13-1
INSPECTT oN RBOUBST: 726-376
OFFICE: 726-3759 Authorized Slgnatu re nr*
1. LOCATION OF
LEGAL DESCRIPTION I 8
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 da,ys.
2. COIiITRACTOR INSTALLATION ONLY
Electrical Contracto r All nt)trlz-4e tC
t) sP 5r
SPRIi.GFIELO
ELE TRICAL PERHTT APPLICATIONq4
3
A
City Job Nunber
COUPLETB FEE SCMDULE BELOS
Nev Residential-Single or
1ti-Family per dvelling unit.
rvice Ineluded:Items Cost Sum/5
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf 'd llome or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
-l-A
-85s$ 8s.00
$ 40.00
200 amps or
201 amps to
401 amps to
less
600 amps
1000 amps
Phone q>{ -Jl 3?
/f-Kr
Ci ty /L'l s
Exp iration Date
Constr Contr. Number
Expiration Date
S
0vners
Address
Ci ty
B
601 amps
Over 1000
to
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00supervisor License Number ,/C '' Zaf
of Supervis Electrician
one
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 1q.00201 amps to 400 amps
-
$ SS.99
Over 40L to 600 amps
-
$ 80.00
Over 600 amps or 1000 voTts see *B" a6ive
D. Branch Circuits
Nev, Alteration or Extension Per Panel
amps/volts _
Reconnect 0n1y
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
OVNER TION
The installation is being made on
property I ovn vhich is not intended
for sale, ]ease or rent.
Ovners Signature:
One Circuit S 35.00
Each Additional-
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscell-aneous (Service/feeder not included)
-Each instalLation
Pump or irrigation
-
S
Sign/Outline Lighting- $
t imited Energy/Res
-
$
Limited Energy/Comm
-
$
40.00
40.00
20.00
36.00
DATE;
RECETVED
5 d)
zonins-ilDL
$ 1s.00
RESIDENTIAL - COIIIIERCIAL
gIDEIUALK / CURBCUT
APPL ICATIOI.I / PERI-IIT
SPFlINGFIELO
225 NORTH FFTH gTREET
9PRlh&3'FlELD, oREGohl 314'11
El.l6 INEERING D lvl9lohlffilcE No. 12b-31>3
IN9PECTiON LINF-, 126 - )1b3
ioB ADDRE99'
AggEggoRg HAP NO.l6 L gIAx LoT No.
S,UBDlVl9lON,
oil,h.lER'
ADDRE99'CITY:
PHOl.lE NO.
i],,FK DE9CRIPTICI.I,
gtDElUALK: x cURts SIDE
-
9ETBACK
-
CUR3-CUT: REglDEl'iTlAL
-
cOHl'lERlCA
-
g=COND DRIVEU]AY ( gEE TRr'.i+IC )
R=AUIR=9 APPLICATIoNI FOR A *coND DRI\€[JAY(T-4.1a)
OR A CO'JNTY AFPI-ICATION FOR FACILITY PER-1IT (C W-2@3)
IF IN THE UG.ts.
DATE G AFFLICATIOI.I
TIJORK TO BE FEFFORIIED BY:ou.r\l=R,, ! coNTFaAc'ioR
**CONTRACTOR REGISTRATiON NO.
&
EXPIRE9'
cr-rEcK A cll# ?/7
*
CHECKED FOR DEL INAJENCIES
alQa Qre-+rI# z*os{
7zJr
SIGNED,
DAE,
RECEIPT NO'
CAgl
ADDE55 P|IONE:
PROCEDURE FoR IN9FECTION REAUE9T:
C4J-L 12b-316A (re,CO@ER ) STATE YOUR CITY D=9IGNATED JO3 NIjY3=R, JO? !^DDE.59,TYPE 4
INSPECTICT.{ REAUEgTED A}{D IIJ|.{EN YOU UJILL B= READY FOR IN9PECiIOII, CONTR.ACTORS OR OUN=R5 NAI..1E A\lD
Pi'loNE Nl'Jl1tsER REaU=9Tg R=CEI\ED B=FOE lzoo Al1 llJlLL B= l'1AD= TH= SAIE DAY, REAUE9TS 4F]ic'R ltoo
AJ'1 IUILL BE HADE TI]E NEXT IIJORKING DAY
EXI9T ING BLJILDING PEFA-IIT NO. ( IF APPLICABLE
*YOUR CITY DESIGNATED JOts NO. I9TgEE BOOK
REaUIRED INgPECTlctt lg SID=UJALK / DRI\EI!,AYrcR ALL CONCRETE PAVING I,UITi..IIN
THE STREET RIGI]T OF IUAY, TO BErAD= AFTER ALL EXCAVATING
15 CO|.1PI-ETE AND FOB1 I,UOF'<
AID 5UB-BA5E I1ATERIAL 19
IN PLACE
CU@ / APPROACFI APRO'l.l'
AFTER FORI1g ARE ERECTED
BUT PRIOR TO POURINC
C'oNCRETE.
FEE9: glDEl,UALKg
rlO.OO + tO.ib/LF.( X )
OF LUALK
TOTA FENHIT FEE,3V.tu
r1O.OO+iO.ib/LF.(X)
CO|.1rIERICAL DRI\€IIJAYg gHALL
HAVE 5' TO 8'FLAIRg
3'- A'STADARD
CURts-CUT ruAL< x'T
*
I IA\G. c4REFULLY EXAI.IINED T=lE CONPLETED APPLICATION FOR PER-1 IT, A\D DO HEREBY CERTIFY THAT ALL:N, B1ATION I-]EREON I9 T,q]E A\D CORRECT , A\D I FURTHER CERTIFY :-HAT ANY AND ALL LI]OR< PERFoR.IED5i]ALL tsE DONE IN ACCORDANCE Ij,JITH T}.{E ORDTNA\CES oF T+.{E CITY 6 SFRING,FIELD , alD Tl-.tE LALl.!3 c Tt-tEgTATE OF OREGON FERTAINING TO DESCRIBED I.,{EREIN, AND Ti-.]AT NO OCCUPANCY I,UILL tsE I-1ADEG ANY STRLJCTURE II]ITIJOJT OF Tl-{E BUILDING DlVIglotl I FuRTr..lER CERTIFY T1{AT oNL:r
IUITI{ OR3 1O|@'> IjJILL BE USED ON THI9 PROJECTANDOYEE9Af<tr,
DATE
CONTR,ACTOF?g
*
?<-
t"/5o REgIPENTIAL - COHHERCIAL
SIDEIUAK / CURBCUT
APPLICATIOhI / PER|IIT
SPR!NGFIELE,
?25 NORTH FIFTH STREET
5PRll.!3FlELD, OREGOhI 3'141'l
Eh&3 lNEERlhlG D lvlg lol.l
ffitcE No. 126-V1>3
IN9PECTION LINE'']26-3169
h,
toa /Elolg:*, *,f7 ,\ " 34 $X t" 1:
A95E990R5 tlAP NO.*1 *
S{IBDlVl9lON;
ouhlER:
ADDRE99;
5TAiE,ZIP,
,1 TAX LOT NO.
CITY;
PHOI.IE NO.
oul\lER
r!oR<t6l:
gtDErllALK, ++ CURB srDE
-
sErBAcK _
CURS-CUT, RESIDEhiTIAL
-
CO]-IIIERICAL
-
S=COND DRI\EIJAY ( 5EE TRAFFIC )
EAUIR=S APPLICATIOII FOR A 9ECOND DRI\€I!AY(T-4,IA)
OR A COIJNTY AFPT.ICATION FOR FACILITY PER-IIT (C AA.2@3)
IF IN THE I.JGg,
DA]E. G APFLICATIOI.I
II}()R( TO BE FERFRIIED BY:
CONTRACTOR *.a,
=4- coNTRAc-ioR
*REGISTRATION NO.EXF'IRE5'
cHEcK A cH# 7/7
*
CI.{ECKED FOR DELNAJENCIEg
? 2-6
5I6NED:
DATE,
RECEIPT NO.
cA9+]
ADDE55 Fi-{ONE:
PRoCEDUFE FoR INgPEcTlc,t l REa]IEST'
CALL 12b-31bA (re.CO@ER ) STATE YOUR CITY DE9IGNATED JOg NIJ,-13=R, JOz ADDre.S9,TYPE 4
INgPEcTIoN FEaUE9TED AND tl,HEN YoU IUILL BE READY FoR INgPEcTloll, CoNT.RACTOR5 oR ouJ.lERg NAI.1E AND
PiioNE Nl'Jl'ltsER reaUEgTg R=CEI\€D BEFoF= ltoo /,11 IUILL BE IIADE Tl-.i= 94J'1E DAY, REaUESTS #1:.-? ltoo
A}.,I TUILL BE IIADE THE NEXT UJORKING DAY
EXISTI}.IG BUILDINC PEB1IT NO. (IF APPLICABLE )
*YOUR CITY DESICNA TED JOB NO. Isf5EE B'oOK
gID=IUALK / DRI\GIUAYrcR ALL CONCRETE PAVING IUITI..IIN
THE gTREET RIGI]T OF IUAY, TO BE
l1AD= AFTER AL EXCAV.A.TNG
19 COi.IPLETE AI.ID FORI1 IUORK
AND 5UE-BAgE HATERIAL 15
IN PLACE
cU@ / APPROACH APROII'
AFTER FORI19 ARE ERECTED
tsUT PRIOR TO PC/JRING
CONCRETE.
FEE9' gIDEtUALKg
rlO.OO + tO.l>/LF.( X )
OF IUALK
TOTA FEFI'1IT FEE'*i?.tCI
rlO.OO + uO.I9/LF.( X )
COIIIIERICAL DRIYETUAYS SHALL
HA\.E 5' TO A'FLAlRg
3,- O'5TA\DARD
cUBg3-691 IUALK X,
I AA. G. CAREF1JLLY EXAYINED T}J= COI1PLETED APPLICATION FOR PER1IT, A\D DO |-.IEREBY CERTIFY TI-.{I.T ALLINrcBIATION HEREON 15 TR-]E AX{D CORRECT,, AND I FURTI-.I=R CERTIFY ]'I.1AT A\Y AND ALL LUOR< PEtrOSlED5}..IALL BE DONE IN ACCORDANCE IUITH THE ORDINA\CE5 OF THE CITY 4 9PRINC,FIELD , AND T}-.IE LAI.IJ5 G TI..IEgTATE ff OREGON PERTATNINC TO IIJORK DEgCRIEED HERE IN, AND TI-{AT NO OCCUPANCY IUILL BE HADEG ANY STRL,ICTURE TUITHOJT PE OF THE BUILDING DIVISION. I FURTT-.IER CERTIFY T}IAT ONLYA}.ID IUITH ORS 1O1O5> UJILL tsE USED ON THIS PROJECT
5
ARE
i,A iE
CoNTFACToRS
V-7-v-
REAU IRED INgPECT ICt.{g