HomeMy WebLinkAboutPermit Demolition 2006-03-09CITY OF SPRINGFIELD
Status: Issued
225 Fifth Street, Springfield, OR
541:726-3753 Phone
541-726-3676Fax
541 :7 26-37 69 Ins pe ction Line
Buildin g/Co mbination Permit
PERMIT NO: COM2006-00285ISSUED: 0310912006APPLIED: 0310912006E)GIRES: 09/0912006
VALUE:
SITE ADDRESS: 624 36TH ST
ASSESSOR'S PARCEL NO.: 1702312402100
PROJECT DESCRIPTION: Demolition
Springfield TYPE OF Single Family Residence
+tO
,\iLY Residential
i iiih
Owner:
Address:
Owner:
Address:
RECREATION DISTRICT
2OO S MILL ST
SPRINGFIELD OR 97477
WILLAMALANE PARK &
2OO S MILL ST
SPRINGFIELD OR 97477
nufl
Contractor Type Contractor License Expiration Date Phone
CONTRACTOR INFORMATION
# of Uni6:
Primary Occupancy Group:
Secondary Occupancy
Ptimary Construction Type
Secondary Construction
# of Bedrooms:
Fron{ard SetbrcIc
Side l Setback:
Side 2 Setback:
Rearyard Setback:
* Solar Setbacks:
Street
Storm SewerAvailable:
Special Inshuction:
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled
Overlay Dist:
# Street Trees
Paved Drive Rqd:
Yo ofLot Coverage:
NOTICE:
THIS PERMIT SH
AUTHORIZED UN
Lot Size:
Sq Ft lst Floor:
COM MEN CED ORq6 NED
i so6nv pEnggpant Load:
HE WORK
NOT
REQUIRED PARIilNG
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutMDrains
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Notes:
lof2
TYPE
lru I I .l-rl1\(, rNI UI(rVIA. llllNl
Building/Co mbination Permit
Status: Issued
225 Fifth Street, Springfield, OR
541:726-3753 Phone
541-726-3676Fax
541:7 26-37 69 I nspection Line
PERMIT NO: COM2006-00285ISSUED: 0310912006APPLIED: 03/0912006E)PIRES: 09/0912006
VALUE:
Description Type of Construction
Fee Description
+ lOoh Administrative Fee
+ 8%o State Surcharge
Demolition
Sanitary or Storm Sewer Cap
Total Amount
Total Value of Project
Date Paid
319106
3t9t06
3t9t06
3t9t06
Value Date Calculated
Receipt Number
1200600000000000281
1200600000000000281
r200600000000000281
120060000000000028r
$ Per Sq Ft
ormuhip[er
Square Footage
orBful Amount
!
.t
Amount Paid
$9.00
$7.20
$4s.00
$45.00
$106.20
Fees Pa
Plan Reviews
' To Request an inspection call the 24 hour recording at72G3769. All inspection requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
Final Building: After all required inspections have been requested and approved and the building is complete.
Sanitary Sewer Cap: Capped within five (5) feet of the property line and capped with an approved material as
required by the code.
By signaturer l state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance
with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the work described herein,
and that NO OCCT PAI\ICY will be made of any structure without permission of the Community Servhes Division,
Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used
on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from
the the permit card is located at flte front of the property, and the approved set of plans will remain on the site
at all
A- q- ob
Owner or Contractors Signature
2of2
Date
--Il
___r
Valuation Description I
Keourred InsDectrons I
225 Fifth Street
Springfield, Ore gon 97 477
541-726-3759 Phone
6'i1y of Springfield Official Receipt
velopment Services Department
Public Works Department
it RECEIPT#: 1200600000000000281 Date: 0310912006 1:38:43PM
Job/Journal Number
coM2006-0028s
coM2006-0028s
coM2006-0028s
coM2006-00285
Description
Demolition
Sanitary or Storm Sewer Cap
+ 8% State Surcharge
+ l0% Administrative Fee
Amunt Due
45.00
45.00
7.20
9.00
Item Total:$r06.20
Payments:
T;rpe of Payment Paid By
CheckNumber Authorization
Received By Bdch Number Number How Received Amount Paid
Check WILLAMALANE dlm 61704 In Person $106.20
Payment Totat:
-5Td6.iii-j'[,
:
1
'l
i
"t
:J
319/2006 lofl
glaa
CitY of SPringfield
225 Fifth Street, Springfield, OR 97477
541-726-3759 Phone
541-726-3676 Fax
August 21,2006
WILLAMALANE PARK &
2OO S MILL ST
SPRINGFIELD OR
Job Number:
Location:
97 477
coM2006-0028s
624 36TH ST
The Springfield Building Safety code Administrative code provides that in order for a permit to
remain ,ulid, the work *fri"t lras been authorized by the permit must begin within 180 days of the date
of issuance, and an inspection must be requested at least every 180 days.
According to our records, you obtained a permit for a project at 624 36TH ST which is set to expire on
91912006. Our records indicate that you have not requested an inspection within the past five (5)
months. This letter is written to notif,, you that your permit(s) wili be expiring shortly. If you are
ready to request an inspection for your project, pleasephone the inspection line at 541-726-3769. If
you do not iequest an inspection prior tb tne expiration date, your permit(s) will expire and additional
permit fees will be required in order to complete your project'
If you have any questions, please feel free to phone me at 541-726-3790.
Project:Ddmolition
Dear Permit Holder:
Sincerely,
Lisa Hopper
Building Safety Management Analyst
CITY OF SP INGFIELD, OREGON
225 FIFTH STREET . SPRINGFIELD, OR97477 o PHz(541)72t5-3753 o FAX: (541)7?5-3689
DEMOLITION PERMIT APPLICATIONS
Your demolition permit is currentlybeing processed. There maybe a slight delay, of
up to z working days for small structures, due to the time required to review the
history of the structure to determine if it needs to be documented before demolition.
This documentation is for archival purposes only and will not affect the granting of
the demolition permit. If the structure is verylarge or complicated the
documentation process maytake up to a maximum of 4 working days.
Documentation will consist of photographing the building, taking measurements and
making scaled drawings. The documentation will be undertaken by the City at no cost
to you. Documentation is being done on all structures dated prior to 1940 that may
have historic importance to the Ci!y's development.
THIS DOCI]MENTATION VYILL NOT IMPEDE THE DEMOLITION PROCESS.
An age cut-off of tg4o was chosen because this is the date that the National Parks
Service and The Springfield Development Code use to determine potential historic
significance.
If you would prefer to complete this documentation yourself you must provide the
City with the following information: r) black and white photographs of each
elevation, a floor plan with measurements, and z) a set of elevation drawings with
measurements.
Thank you for your patience.
I grant the City of Springfield permission to enter my property to complete
documentation prior to the requested demolition of the structure located at:
Address:
I <:9-^)
Property Owner kr><-
- '.4,<t:.-
Job Number:Date:
SPF.INGFIELD
%,
1:7
clTY oF *TNGFTELD, oREGoN
225 FTFTH STREET r SPRINGFIELD, OR97477 e PH:(541)7?6-3753 o FAX: (541)726-3689 ,
DEMOLITION PERMIT APPLICATION
Address:
Structure to be Demolished:
Job Number: fl,Wt 2-H1o ODZ .'
The applicant js hereby notified that any redevelopment of the subject site must
comply with all of the applicable laws, codes, ordinances, polices and plans in
effect at the time the redevelopment proposal is accepted is complete for City
review. This would include correction of substandard conditionJassociated with
the present development. Examples of such corrections may include
modification of inadequate drainage facilities; compliance with building set- .
backs from property lines; correction of substandard sidewalks and strJet
improvements, including driveway width and placement; and other corrections
which maybe necessary to comply with existing development standards.
Furthermore, if an existing use is demolished or otherwise removed prior to the
development of the proposed use, then the system development charge credit for
the previously existing use shall expire two years after the date of issriance of the
$gmglition permit or other removal of the previously existing use. (springfield
Municipal Code S.+16(r)).
My signature below indicates that I have read and understand the above
conditions relating to the demolition of the above mentioned structure.
6az
jI ti OGr--J
Date
'?"^. V- St-.s-v , .e > Rr.) oo -^O.rn,.\*,'
SPFlINGFIELI)
afr,
ACORL GERTIFICATE OF LIABILITY INSURANCE oATE (Mi{/DD/YYrY)
3/2/2o06
PRooucER (54L)342_444L
Wilsoa-Heirgood Asaociates
ru (541) 342-3786
2930 Chad Dri.ve
PO Box 1421
Eugene oR 97440-L421
THIS GERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED
Will.mlane Park & RecreaEion District
200 Soutb Mi1I St,reet
Sprinqfield oR 97477
TNSURERA: SPec Dist Assoc. of OR
INSURER g:
Ii.ISURER C:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
LTR TYPE OF INSURANCE POUCY NUMAER
POLICY EFFECTIVE
OATE (MM/DDTTY)
POLICY EXPIRATION
DATE (MM/OO/.YY)UMITS
A
GENERAT LIABILITY
x COMMERCIAL GENERAL LIABILITY
CLAIMS MADE x OCCUR
GENL AGGREGATE LIMIT APPLIES PER]
x POLICY
ztPL2267 t/t/2006 L/L/2O07
EACH OCCURRENCE $s00, 000
RENTED
$
MED EXP (Any ore pe6m)s
PERSONAL & ADV IN.ITJRY $
GENERAL AGGREGAIE No Liroit
PRODUCTS COMP/OP AGG $
A
AUTOTTOSILE UABILIrY
ANY AUTO
ALL OW{EO AUTOS
SCHEDTJLEO AUTOS
HIREO AUTOS
NON€WNED AUTOS
x
x
x
2LPL2267 L/t/20o6 L/7/2007
COMBINED SINGLE LIMIT
(Ea ecident)S s00, 000
BODILY lt'IJURY
(Pe. pe66)$
BOOILY INJURY
(Per a@ident)$
PROPERry DAMAGE
(Per aGideot)s
GAMGE UABILITY
ANYAUTO
AUTO ONLY . EA ACCIDENT $
OTHER TFIAN
AUTO ONLY:
EA ACC $
$
A
E(CESgI'MBRELLA UAAIL|TY
x O@UR CLAIMS MADE
OEOLrcTIBLE zLP72267 L/L/20o6 t/L/2007
EACH OCCURRENCE $ 2,000,000
AGGREGATE $
$
$
$
Y\,oRXERS COilPEfl SATIO'{ ANO
ETIPLO\ERS UAAIUTY
Ai,IY PROPRIETOFYPARTNEFYEXECUTIVE
OFFICER/MEi,BER EXCLUDEO?
lf )€s. desobe uder
SPECI.AL PROVISIONS below
\4rc STATU.
TORY LIMITS
OTH.
ER
E.L. EACH ACCIOENT $
E.L, DISEASE. EA EMPLOYEE $
E.L. DISEASE. POLICY LIMIT $
OIHER
DESCRIPnoII OF OPERATIONIi/IOCATIONSA/EHICLES|/EXCLUSIONS ADDED BY ENOORSEMENT/ISPECIAL PROVISIONS
Lllbility coverags for property locatad at 624 Nortb 36tb, Sprlugfield, OR
CERTIFICATE
ACORD 25 (2001/08)@ ACORD CORPORATION 1988
city
Mark
225 Fifrh st,Springfield, OR 97477
of Springfield Fire Department,
WaIker
SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED SEFORE THE
E)(PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO i/IiAIL
30 oavs wntrrEN NoncE To rHE cERTTFTCATE HoLDER NAMEo ro rHE LEFT, BUT
FAILURE TO DO SO SI{ALL IMPqSE NO OBUGATIOT,I OR UABIUTY OF ANY KINO UPON THE
INSURE& ITS AGENTS OR REPRESEilTATIVES.
AUTHORIZEO REPRESENTATIVE
Jeffrey Griffin/DMH
a lts \/frg lI^i^.^. $l.ii^^. l^. /Ann\117-nq(
(timited)
Environmental Site Assessment
For Asbestos Containing Materials
At:
62436th Street
Springfield, Oregon
October 261 2005
Prepared for:
Willamalane Parks and Recreation
Attn: Ken Long
By:
Pacific Environmental Group Inc.
Douglas J. Moore
\
624 36th Street
$ptingfield, Oregon
PACIFIC
Ervinuunenbl
Gotry Irrc P 0. Box 22306 Eugene, 0R 97402
OHD #1m5 CCB #66i70 DE0#FSC-560
(s41) 461-9115
PH. (541) 767-3710 FX (s41)767-3775
October 26,2005
Willarnalane Parks and Recreation
Attn: Ken Long
Re: Pre-dernolition Asbestos survey, bulk rnaterial sarnpling,624 36tl' Street
Springfield OR.
On October 19, 2005, at your request a building site was investigated at the
address identified above. The purpose being to attempt to identifu building
materials for asbestos. 13 bulk rnaterial sarnples were collected fiom the
identified locations arrd subrnitted to ECS / Wagner Envirorunental for
analysis for asbestos content.
The results from the lab (attached) indicate that there was asbestos found in
the flooring materials collected and sarnpled.
These materials will need be properly abated by an asbestos abatement
confactor prior to demolition of the struchre.
Following completion of abatement of the identified materials, the structure
is considered ready for disposition.
Whomever completes the abatement should provide evidence of such about
the activities performed to both you and the local fire deparhnent prior to
burning
All samples collected were done so by individuals with current EPA
AHERA / ASHARA asbestos inspection credentials. Copies of these
credentials are on file at the Veneta office of Pacific Environmental Group
lnc.
I
t
If we can be of any furttrer assistance please call me at the following
nunbers; Office 541935 9656' Mobile 541954 4369
Fax 541935 6270
E:mail dirnourkigaia.nel
Thanks again for the opportunity to assist you at this facility.
) ''/v1 __-. *.-.,,'-_,__=-_-_D
Douglas J. Moore
Pacific Environmental Group fnc.
PO Box 1524 Venet4 Oregon 97487 (541) 935 9656 (541) 935 6270 fur
Asbestos Sampling lnventory List
October 13,2005
Client: PEG Inc.
Conducted for
Willamalane Parks and Recreation
Property located at :
A2q 36* Street Springfield, Oregon
All samples were collected by D. J. Moore
#
wPR 62436 0l
wPR 62436 02
wPR 62436 03
wPR 62436 04
wPR 62436 05
wPR 62436 06
wPR 62436 07
wPR 62436 08
wPR 62436 09
3 tab roofing (bottom layer) roof NE corner
3 tab roofing (middle layer) roof NE corner
3 tab roofing (top layer) roof NE corner
l" X l" ceiling tile (nailed) living room SE corner
Wall composite (sheetrock) living room E wall
9" )t9" Floor tile (offwhite) living room East entry
9" X 9" Floor tile (brown) living room East entry
Sheet vinyl flooring (layer 1) living room East entry
Sheet vinyl flooring (layer 2) living room East entry
Sheet vinyl flooring (layer 3) living room East entrywPR 62436 010
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Sent By: sCHNEIOER LABS;
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DATE rcLLECTED:
DATE REGEIVEO:
DATEAIIATYZED:
DATE REPOf,TED;
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Page 1 tZ
10/132m5
1012512005
r0a5/2005
10/292005
SCHNEIDER LABORATORIES
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ACCOUNT: 2gS&0$224JCUINT: EcsM€nrEnvironmentalADDRESS: 371 vtCsJSfi Avonue
- -
EuEerE, OR 9r40t
PO NO.:
PROJecrH.Ue: padfic Env. Group
PROJECT NO.:
JOB IOCAT|ON: 624 36rh sr
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!n9I ll -Roofitu No Gray{tsleck, Eitumirrcus
1ffi70 Non-Aebertoo MINERAUGLASS woo[ 12%. NcN Henous I\TATERIAL 887,
WPR6243602 28200091 RoofNE Corner
!ll!f ]: Roofng No Gra]lgbclr. Bituminous
10016 Non'Arborror MlNERAuGl.AsS wooi 1o%, Not{ FtERous MATERTAL oo%
WPR024380S 28200092 RoofNECornar1: Roollng
tlmd.bostoD
2: Rooflng
Nm./t30{tor
WPR624lt604 28700693 Ltving Rm SE Comer
!!yg l, Ccllirp Tir ilo WhitdTrn Fbrous
tOO* ITONTAIbC*Or CEILUTOSE FIBER EO%, ilOri HBR9L'€ MATERIAL 10%
Laysr
100%
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ilo Gray/Bhck, Bi(umhoue
frllNERAUcl-AfISWOOL t0%, NON FIBROUS MATERTAL 90%
llo Bhct. Flbrous
CELLULOSE FIBER 7O%.TQN FIBROUS MATERIAL 30%
wPR6',243605 287m694 Uvtng Room E Wall
Layor 1: Shcclnoc* No Whltr, potrdery
100% llon.A.bector CELLULOSE FTBER tAB, NO,rr FIBROUS MATERIAL €8%
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Layer 2: Floor Titeglt Atb.rloe
967, t{orr-Arbrstor
Layr 3: MasUc
l0O% Non-Acbeetos
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l{o yellon, SoftNON FIBROUS MATERIAL TOO%
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NON F'BROUS MATERIAL O5%
l{o glack. BltuminorrsNON FIBROUS ilIATERIAL 1@'.
BluerBrown. Spongy. Ftbmus, &ido
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wPR0243609
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Page 2 (Contnueo)
CITY OF SPRINGFIELD, OREGON
DEPARTMENT OF FIRE & LIFE SAFETY
FIRE OPERATIONS
TRAINING
S[._- -cGFIELD
FD-1s8
225 FIFTH STBEET
SPRINGFIELD, OR 97477
(541) 726-3737
FAX 9541) 726-2297
TDD (541) 726-2247
www. ci. sp ri n gf i eld. o r. u s
TO: City of Springfield, a Municipal Corporation, acting by and through its Department of Fire and
Lile Safety
You are hereby authorized.and permitted to burn under supervision and for education and instruction
purposes that certain house or building located on:
Tax Lot #9/00 Addition to Springfield,
TRAINING BURN AUTHORIZATION
Date:3
,Itr
Oregon which is designated as +h Street, Springfield, Oregon.
I/We, expressly warrant and represent to you that I/We, the undersigned, are the owner(s) of said
property and that the same is free and clear of any and all liens, encumbrances, judgments, and any
interest, right, title or claim in any other person other than the undersigned, and that this consent is
freely and voluntarily given, and that we will save the City of Springfield harmless from any liability to
any person whomsoever by reason of any statement or warranty contained in this letter.
I/We, the undersigned, also agree to the following requirements imposed by the Department of Fire and
Life Safety to assure completion of all regulations.
1. The property owner(s) shall remove all debris on the lot(s) involved in this burn within sixty
(60) days after completion date of the burn by the Department of Fire and Life Safety.
2. The property owner(s) is to secure the required demolition and plumbing cap permits from the
Building Department when inside the City Limits.
3. Outside City Limits, County regulations apply.
4. The property owner(s) shall have the structure inspected for asbestos. This includes:
a. An internal and external inspection of the structure by an asbestos or environmental
consulting firm.
b. Removal of asbestos containing materials, as indicated by the inspecting firm.l. An Owner-occupant may perform asbestos removal.
a. The Waste Shipment Record (ASN-4)) must be filled out
b. setup an appointment with Short Mountain Landfill - 687-4120 for
disposal.
2. If not an owner-occupant, a removal company must perform asbestos removal
and disposal.
c. The property owner(s) shall submit a copy of the original asbestos inspection as written
by the inspecting firm and signed note stating that the asbestos has been removed.
\
oWNER(S)
ADDRESS
PHONE
2-,4 (-ha. r[ \ S'k .---F
1 9k *'t\D\
q--
V:LSPECIAL TRAINING\Training BurnsMesters\FD-l58 TRAINING B1RN AUTHORIZATION.doc
O-\-
CITY OF SPB'NGFIELD, OREGON
Sl _,rGFlELD
DEPARTMENT OF FIRE & LIFE SAFETY
FIRE OPERATIONS
TRAINING
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726_s737
FAX 9541) 726_2297
TDD (541) 726_2247
www. c i. sp ri n gf i e I d. o r. u s
2
1J
INSTRUCTIONS TO PROPERTY OWNERS (TRAINING BURNS)
The Owner will:
l. Complete the two (2) authorization forms (FD-158) - provide: date, property address,
tax lot number, signature of Owner(s), address of Owner, and phone number of Owner
Retain one copy of the authorization and return the other to the Departrnent of Fire and
Life Safety.
Complete the insurance "Notice of Cancellation or Nonrenewal" fonn. Retain one copy
and return the other to Springfield Depar-tment of Fire and Life Safety.
A demolition permit will be required from the city of Springfield. The permit costs
$45.00 (with fees) minimum. Please be sure to sign and date the pemrit. The City of
Springfield may require a septic/sewer permit to be obtained by the property Owner.
The cost of the sanitary septic/sewer permit is $45.00 (with fees) minimum. Fees include
Adrninistrative fee and State surcharge fee both totaling approximately $15.30. Please
contact the Springfield Development Services at126-3153 for both permits and fees, and
subrnit a copy of each to the Depaftment of Fire & Life Safety.
The Fire Department is required to run a title search. Please include a $80 check payable
to the City of Springfield to cover the title search fees to do the search.
Have the following disconnected:
Water
Electrical power and meter removed
Natural gas meters removed and line of supply capped at street
Telephone lines removed from building
Cable TV lines removed from building
Remove:
All closed vessel containers (water heaters, fuel tanks, etc.)
All asbestos containing materials, as indicated by the inspecting firm (a list of inspection
and abatement firms is enclosed). Documentation, signed by licensed removal or
inspection firm, veri$ing the asbestos was removed (or not present) needs to be
submitted to the fire department.
4
Thank you,
Mark C. Walker, Battalion Chief of Training
Springfield Fire and Life Safety
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