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Home My WebLink AboutPermit Electrical 1990-05-09INSPECTiON L 72e - -?7 59 Pri ma CITY OF SPRINGFIELD COHBI IIATI ON APPL I CATION/PERMIT 726-3 llater Heater Ranqe EIIERGY SOURCES Heat value of uofn ) Fto. l.la in-- Sq. Ftg. Access._ Sq. Ftg. 0ther l,lew Add Al ter F.eP. _ :1ence_Oefrb Change/Use 0ther \) !-egal Description Job Address n t Info:k .e., Build SinglePhone ,lnt"tR 5b 52 Construction Lender I J T Address Phone Structura I name El ectri cal Mechani cal nhonp no-addrpss lics. no.exDt resname Genera I s-7b/oElectrical BL Et-nc*lr & ' l'1echan i MECHAN I CALELECTR I CALPLUI,IB I NG FFF C HARGFFFF(.HARGF NOCHARGFNOFEE furnace/burner to BTU's Residence of FTSQEach single fixture )4n, Floor furnace and ventqNew circuits alts. or extensionr<, f ( Relocated building (new fix. additional) Recessed wal I Soace heater and ventSERV I C ESS. F. Residence(l bath)p5 ).3Duplex (1 bath) each Apol iance vent seDa rateTemporary ConstructionAdditional bath Stationary evap cool erChange in existing res i dence[.later servi ce Vent fan with sinole duct multifamily, comn. or IndustrialSewer Vent systern apart from heatino or A.C,0f s.Storm Sewer Mechani cal exhaust hood and ductCOMI{./IND. FEEDERS Llood stove/heaterInstal I /a l ter/rel ocate distrib. feeders 0f amps. ISSUANCE OF PFRI1IT TOTAL CHARGESTOTAL CHARGES OITOTAL CHARGES WHERE STATE LAN REQUIRES that the Electrical work be done by shall not be valiC until the label has been signed by an Electri an Electrical Contractor, the electrical portion of this permit ca1 Supervisor and returned to the Building Division F 0*L lGIIA's wi th ORS 7only subcontractors and employees -;p;ff';n t'lAt'lE( please pri nt) Ci ty made xempt 5 r'li l tru ethaIa'II forman 'It he0n reon standodhertcereb.y thewlht0rdthenance'I ofssIhabeI'Idone accordan enc th ta OCCUPAI,ICYNC 'Iwl beIhedworkcesbedr1nhere i a nd I'I ttra 0'I vnn thth Bui deI r sfuherrtcertitthasIreqmyfy s hereonnoted tha tandI0n'Iba1sfoSrthet1fexempe n 1th 5005usedbe1 Dermi t rformedny of 0regon ,he Bu ithe permi nd effect etedI I1 atc 0ntIEFULL'r)apcomp a 'II kworndacertfurther'I ttha a peIandandco rrec t fy ttoart'I n1f'|f d theof teSta ngoeortIandLawstheSpng 'I 1d Di Svl 0n1'Is ofon +f ngsoasctutruunrehotutny ORS 055701 tha trdBoas'I n'I Ifu force1 a s redarequi by w-;'/q,/qo proj ect. g/oa€'b/'/tz Ftg Ftg Ftg ToTAL VALUATI0N_Flood Plain S tori es . Access x Va lue Units SFire Zone Bedrooms 0ccy Load 5qGro l'la i n Va iueZoneType/ Con st. Value0ther opment rge Plan Ck. Cornm/Ind 65%/B1do Per Fee Plan Ck. Res 30%/Bldq Per Fee BUILDING PERI'IIT Charges and Surcharges on.\c.Fence D6mo Si dewal k Total Comb tA/C Paving PLUI4BING PERMIT Charges and Surcha rges ELECTRICAL PERI1IT Charges and Surcharges Curb Cut o\A,L\, I TOTAL I,IECHANICAL PERMIT Charges and Surc harges Addres s )o n4-.338 / Jocn\k foo COMBINATION APPLICATION/PERMIT (CAP) I. App'licant to furnish A. Job Address B. Legal DescriPtion l. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, Znd Addition to Springfield Estates C. Name, etc. of owner and construction lender PERMIT VALIDATION D. Energy Sources 1. exampl e-2. exampl e- E. Square footag air gas 1 exampl e- examp I e- check add 1250 sq.if new p foot house, 500 sq. foot garage ?roject, check new - if addition, , etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. exahple - convert single family residence into iltaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adiacent to the appropriate item(s) to be 'installed B. Full P'lumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2.'|f the item(s) to be installed are not covered on the abbreviated schedules you should consult the fulI schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the labei must be delivered to the electnical contractor for signature by his electrical supervisor. The general contractor is not authorized to sign the electrical label. Appiicant to sign and date Whenever possible, the initial application wil I be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gnature. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. II 5q# lbffi+ III. IV V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Perm'it applicant exempt from registration with the Builder's Board because: Add'iti onal Proiect Informati on : PLANS REVIEWED BY: ) name sig nature date c CITY OF SPRiNGFIE,LD COMBI I.IATI OII APPL I CATIOI,I/PERMiT 7?6-3753 Job Addres:00 sf si Lega1 Description D3 EIIERGY SOURCES Hea t l,later Heater Ran Ftq. l''lain--- Sq. Ftg. Access._ Sq. Ftg. Other-- _l{ewJd d_A l te r_P.e p . _Fence_Demo_C hange,/ U se 0ther -sooI 11 Value of l,lork 0wner *{. Address Phone tI o: Des'I .e., Build Single 323. Az?.2 Constructicn Lender Fno e)n,,,..,jt-crt L -1 )*\,-o.)a 'tW \/ ,^^,{.o L V.'t} c,ln-o^,^.- t{ocrols Address Phone I u e)n v ^,.,)* (P\ DESIGN TEAI4 name addre s s tcs. no-exD I res ohone no. Pri ma ry Structura I El ectri cal n Mechan i ca I name addres s t aq nr)exo r res nhnnp no- ) Genera I Pl umb i no El ectri cai l.lechani cal PLUI.IB I NG ELECTR I CAL MECHAN I CAL FEF CHARGE Nn_F'F F I]HARGF NO FFF CHARGF Each single fixture Residence of sQ FT furnace/burner to BTU' s Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S. F. Residence(l bath)SERV ICES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent seDarat-e [,later servi ce Change in existing rcs i dence Stati onar.v evap cool er Sewer multifamily, comm. or Industria l la Vent fan with sinole duct 2r@ ,5;, Storm Sewer 0f .amps. Vent systenn apart from heatinq or A.C. c0Mr.1./IND. FEEDERS i7.Mechanical exhaust hood and duct €g+e Instal I /al terlrel ocate dictrih- feeders l,Jood stove/heater 0f amps. ISSUANCF OF PFRIlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAtl REQUIRES that the Electrical work shall not be valiC until the label has been signed by be done by an Electrical Contractor, the electrical portion of this permit an Electrical Supervisor and returned to the Building Division I HAVE L c0mp 1 ted ap p I 'I ca ti 0n Dermit, an 'formed sha d do he reb.y cert 1 fy t ha t a I 'I n forma t 'I on hereon 'I s true and correct, aof Springfieldof any structu Board is in fu nd I fu rthe r ce rt ,l fy t ha t any te ofnof and I I work per I I be done I n accorda nc e wl t h the 0rd I n an ces o f the C 1 ty a nd the Laws of the St the permiss and effect as Ld ' Oregon oe the Buildi rta 'l n 1 ng to the WO rk de SC rl bed here i n and th at N c OCCUP ,ANCY wl I I be made re wl thou 'I ng Di vl s I 0n I furtherf exempt .055 wi l I cert'i fy th at my reg I s tra +I on t/ll th t he u 1 I de r s I I force req u 1 red by 0Rs 701 0 55 th at '|the ba s '|s for exemp t 1 0n 1 s noted hereon and tha t on 1y s ubcontracto rs and emp I oyee s who are I n comp I 1 an ce w1 th nDc 7 0 1 be used 0n th 'I s proj t t'lAl'lE ( p1 ease pri nt)IGNA pL-f- {e FOI1 r)FFI Tone st its Sq. Ftg. l'lain Val ue Fire Zone Load Sq. Ftg. Access Val ue Flood Plain Stories 0c c.y Cror/p----------- :Sq. Ftg. 0ther Val TorAL VALUATI0N-- BUILDING PERMIT Charges and Surc harges Plan Ck. Comm/Ind 65%/B1dq Per Fee Svstems Deve' charqe (1.s2 opment Plan Ck. Res 30%/Bldq Per Fee PLUMBING PERMIT Charges and Surcha rges Fence Demo ELECTRICAL PERI1IT Charges and Surcha rges Sidewal k A/C Paving Total Comb. Permit 14ECHANICAL PERI'4IT Charoes and ..| Surcfiarges O\t oo____ 5O--Qe ' Curb Cut TOTAL nq]a lui :am )e Work (I Garaop COMBINATION APPLICATION/PERMIT (CAP)PERMIT VAL IDATION I Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, Znd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat,/electrical ceiling/or forced air gas 2. exampJe- waterheater/electrical/or solar E. Square footage or valuation, etc. 1. examp'le- 1250 sq. foot house, 500 sq. foot garage 2. exihpie: if new proiect, check new - if addition, check add, etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. eiample - convert single family residence into restElFant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avojd design or construction delays, Build'ing ?,)- CA X q ooo OPfrV (t" ') Division Staff must be able to contact a persons regarding design information or corrections, etc. pj propni ate ob site #{'><} II. Abbreviated Piumbing, Mechanica'1, & Electrica'l Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adiacent to the appropriate item(s) to be instailed B. Fu'll Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1, To conserve space on the permit form the schedules . have bee.,n abbrevi ated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult thefull schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the'labe'l must be delivered to the electrical contractor for si supervisor. The general con to sign the electrical label Applicant to sign and date gna tra ture by his electrical ctor is not authorized III. l,lhenever possibie, the initial application wilI be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gnature. IV. Fees and Charges P'lan check fees are due and payab'le at the time of the application, and no plans wil) be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information PLANS REVIEWED BY: name Si g nature date ON LINE CIIY OF SPRINGFIELD CCMBI NATI ON APPL I CATI ON/PERMIT 7?6 Job Address EIIERGY SOURCES Heat I'later Heater Ran l.1a i n_ Sq Sq Ftg 0 'I rLegal 0escription A'J Value of 0wner scr :€. r ng en Fami'lAddressflPhone )no CIHo L'r {\\ -tvY n Lender I c \- I I Addres s Phone (7 t&\s =l.X: DESIGN TEAI,{name addres s 1CS. nO.ex0lr nhone no- Pri ma Structura l El ectri cal Mec han i ca I name addres s lics. no.exolres (nhone no. I 'I E l.'lec PLUI,lBI NG ELECTRI CAL MECHAN I CAL FFF CHARGF N0-FFF .HA PGF NO FFF NHARGF Each single fixture r)5)Jho[Y' Residence of SQ FT furnace/burner to BTU'S Relocated building (new fix. additional) New circuits alts. or extensions Floor furnace and vent S. F. Residence ( I bath)SERVICES Recessed wal I Soace heater and vent Duplex (l bath) each Additional bath Temporary Constructi on Apol iance vent separate tlater service Chan ge in existing dpncercq 1 Stati onar"v evap. coo l er Sewer multifamily, corm. or Industria l Vent fan with si no le duct Storm Sewer 0f amPs Vent system apart from heatino or A.C, COMI.I./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocate dictrih. feeders tlood stove/heater 0f amPs" ISSUANCE 0F pFRtlIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE LAl,l REQUIRES that shall not be vali'l until the label the Electrical work be done by an Elect has been signed by an Electrical Super rical Contractor, the electrical portion of this permit visor and returned to the Building Division L Y E xAtl t compl eted that any State of ssion of ap r)I at 0n for oermit perfo rmed an do hereb.y certi fy tha i a 'I 1 'I nfo rma t I o n hereo n i s true the City'I be made ilder's and that and correct, and I further certifY and I I work s ha I I be do ne 1 n a ordance wl th the 0rd 'I n ances n f f Springfield and the Laws of the 0reqon oe the Bui I di rta 1 n I s to the wo r k de SC r '|bed here I n an d tha t r.lc OCCUPANCY 'I I of any str Board is i only subco uc tu re wt thout the permi ng Di vl s ,l on I furtherf exempt .055 wilI ce rt 'I fy tha t m.y reg i s t ra t 'I on vJ1 th the Bu noted hen full force and effect as requ 'I red by 0Rs 7 01 0s5 tha +'|the s I S for exempt I o n 1 S reon ntr actors and emp I oyee s who are 'I n c0mD I 'I ance w1 th 0l?S 701 th 'I s p ro,,l ect tlAt'tE(please print)S I GNATURE Zone______Tyoe/ Con s t.Units Ftq. l,la Val ue Fire Zone Bedrooms ; Occy Load Sq. FtS. Access x Va 'I ue. Flood Plain Sto ri es Group Sq. FtS x Val ue ToTAL VALUATI0N_ 0the r BUILDING PERI'IIT Charges and Surcharges Plan Ck. Conm/Ind 65/,/B1dq Per Fee Svstems Deve charqe (1.s2 opment Plan Ck. Res 30%/81dq Per Fee PLUt4BING PERMIT Charges and Surcha rges \c{-) -L,_-_ _)SO Fence Demo ELECTRICAL PERiIIT Charges and Surcharges Si dewa l k A/C Paving Curb Cut Total Cornb. Permit I/IECHANICAL PERMIT Charges and Surc harges TOTAL 41r- so COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal DescriPtion l. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceil'ing/or forced air gas 2. example- waterheater/electrical/or solar E. Square footage or valuation, etc.1. example- 1250 sq. foot house, 500 sq. foot garage 2. exampie- if new proiect, check new - if addition, check add, etc. F. Building permit information: l. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Special ty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or iob site corrections, etc. II. Abbreviated Plumbing, Mechanica'1, & Electrical SchedulesA. Except where blank spaces occulin the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. FuIl Plumbing, Mechanical, and E)ectrical Schedules are available at the Bui lding Division1. To conserve space on the permit form the schedules . have been abbreviated?. If the item(s) to be installed are not covered on the abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractolis not authorized to sign the electrical label.III. Applicant to sign and date !'lhenever possible, the initial appfication will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actuai permit is issued for his s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. Al l other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION 5r \l {D wk floz4 Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Bu.ilder's Board because: Additional Project Information: PLANS REVIEWED BY: name s'l g nature da te COHBI TI AP ICAT IT EIlERGY SOURCES Hea l,Jater Heater Ran -3 Job Address l-ega1 Descri ption Ftq. Access._ Sq. Ftg. 0ther_'llew "Add Alterm. - -Fence DEfr-o Cha-nge/Use -0ther- Sq Sq Ftg. l4a Value of l,Jork )0wn ui ld Single residence l,li th Attached Garaqe) U F ti 'IAddressPhonea+ +tin fYtrrlLC \o (:Cons truc deronL dAddre s s Phone ohone no,'ICS. nO.exrrt resaddre s snameDES I GN TEAI.I Pri ma ry Struc tura l E I ectri ca I Mechanical ohone no-I i cs. no.exoi res )add res sIACTOBInameCONI PI umbi nq El ectri ca l ['lec ha n i ca I MECHAN I CALELECTR I CALP LUI{B I NG FFF CHARGFFFFI^HARG F NONHARGFNOFEE furnace/burner to BTU' s Residence of FTSQEach single fixture Floor furnace and ventRelocated building (new fix. additional) Recessed wal I Soace heater and veniSERV I CESS. F. Residence(l bath) Duplex (1 bath) each Apol iance vent s eDa ra teTemporary Constructi onAdditional bath Stationary evap cool erChange in existing res i dencel^later servi ce Vent fan with sinole duct multifamily, comm. or TndrrstrialSewer apart from .c. Vent systern heatino or A0f amPs.Storm Sewer Mechanicai exhaust hood and ductCOMI'1./IND. FEEDERS [,,lood stove/heaterI nsta 1 i /a I ter/re1 ocate di stri h- feeders 0f : amPs ISSUANCF OF PFRI1IT TOTAL CHARGESiorol ,*n*rtt U.t!"ol .\TOTAL CHARGES WHERE STATE LAN REQU shall not be vali'l unti l IRES that the Electrica'l work be done the label has been signed by an Elec bytri ca1 Supervisor and returned to the Building Division an El ectri ca] Cont , the e'lectrical portion of this permit IGNATUREt'lAl.lE (pl ease pri nt)DATE ny of 0reg the B fy xempt 5 wil reon trs ueathatntformaoncertanddothereb.ytheDatconaYFULLINEEXAMpcompp s cfthewlcetth0rdhenance type ,fo ha be nedo n cca ordanrrmedndaaworktthaatDEcrrec0tndafucerrtherndafy wl madbendhatr.l0t CUPAN0c CYnwokrscderhbedanerearttotheonthetastepensJwsofLaethedndafosprngf de r ststraonhtthefuthe rr ertc th taonfudV1Dison reg im.yermsstu retruc thwl t0u het ngfo L thaandnnohereontedseforfpr ffr xemptredORS0i055athate any rd0a s n fu fo erc nda e ILec requ by ht s ect0projnceathwlDC070500nsntracubcorstondawhoreanempoyeescompv GroupFlood Plain Stories, TOTAL VALUATION n Bedrooms lln its SqCons t Val ue Val ue Fire Zone Zone 0ccy Load x Val u Fttt Ftg Ft9 Acce s s 0ther opmentSvsterirs Deve Charqe (1.57Plan Ck. Conm/Ind 65%/8ldo Per Fee Plan Ck. Res 30%/Bldq Per Fee BUILDING PERNIT Charges and Surcharges 5 Fence Domo PLUI4BING PERMIT Charges and Surc ha rges Si dewa I k Tota'l Comb. PermitA/C Paving ELECTRICAL PERI,IIT Charges and Surcharges Curb Cut 5q 33TOTAL MECHANICAL PERMIT Charges and Surc harges t vt X) n_-- New ci rcui ts al ts. or extensions I Buil COMBINATION APPLICATION/PERMIT (CAP)PERMIT VALIDATION Applicant to furnishA. Job AddressB. Legal DescriPtion1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, Znd Addition to Sprr-iETield EstatesC. Name, etc. of owner and construction Iender D. Energy Sources /electrical ceilinq/or forced air gas rheater/electrical /or so lar valuatioillTE- 1 examole- heat, EIdfrE-l-e- wate rre footage or 2 E. Squa 1 example- 1250 s example- if new check add, etc. q. foot house,500 sq. foot garage ,-n6w - if addition,2.project, check F. Building Permit information: l. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. AxamFIe - convert single family residence into E!taurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural SPecialtY Code H, DESIGN TEAM AND CONTRACTORS To avoid design or construction delays' Building Division Staff must be able to cohtact appropriate persons regarding design information or iob site corrections, etc. IL Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules' the applicant need fill-in only the No. Boxes adiacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful'l schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the e'lectrical contractor for signature by his electrical supervisor. The general contractor is.not authorized to sign the electrical label. III. Applicant to sign and date Whenever possible, the initial application will be used as a worksheet on1y. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gna ture.IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY )5uq> Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI'ICY: permjt applicant exempt from registration with the Builder's Board because: Addi t'ional Proiect Informati on : PLANS REVIEWED BY: name s1 g nature date