Loading...
HomeMy WebLinkAboutPermit Building 2002-7-12 , . " 225 Fifth Street Springfield, OR 97477 . ti/ . I Job# 02-00779-01 I Page 1 of 5 TRANS#:01-0009914 DATE: JUl, 12 2002 AMT RECD:2 $ 6161.21 CHANGE: CASHIER:061 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00779-01 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 747 Old Orchard Ln Spr Assessors Map#: 17032343 Lot: 106 Block: Addition: 3rd Owner: Address: Tax Lot#: 07400 Subdivision: River Glen Future B Inc Po Box 7425 Phone Number~\O~ -744-2660 0'0 ura0 City/Sta!~~'e.(\6 Eugene, OR 97401-0017 New ..,,0 ",I' ~alue: $17~~,\ '\~~ S ~\) , \<-(~ ~~~~~~~~ ~\)'(\ Re.~~atio~~i~"~~~~~te Phone ~~~~\ ~~~~04 541-744-2660 ~'\~~ ~ 'i::J~1-~ ~'V ~ ~~\)'V. 9~~~~<:J'V~~/20/2004 ~(S ~ \ ro\) 102~~ 10/4/2002 ,,' 0,.....' ..{) ,.:.':-" .:..' _~J I ,," '.0" , (5j6/~.901:Y$:.~"''\ A 541-485-1146 ..c. !'\O~c.:) ~r:;, ~C(, r~ .,.~-.',' '" _c,1J'G~ A~f'.""f:J Scope Of Work: Single Family Residence Contractor Type General Contr Electrical Contr Mechanical Contr Plumbing Contr Contractor Future B Inc Po Box 7425, Eugene, OR 97401-0017 Deans Electric P,O, Box 2585, Eugene, OR Jung Enterprises Inc Po Box 66, Dexter, OR 97431 Chapin Enterprises Incorporated 3248 Kentwood Dr, Eugene, OR 97401 541-935-5303 541-937-2688 81994 Offi U j"'",...\~~_,Y>':"'O"','~) n~v'f'~o'\' Ice se :_ OV f.>~ ~' 0' "'!)'<"v'; .....' ....c.. ~o OV e..l'/:J .,~~ Quad Area: 2RNW Land Use: Single FamilyDwelling~ #;OfJ3uildlilgs: 1 ,...... ~c-" c" ,\.> cf"~ -" ',.,..,,,, ..."..' # Of Units: 1 Zoning Code: LDR,,;.' ,{e" ,~~ RJ~ '~ 9.9c'upal),cy Group: Dwelling C (VN)W F B d ." ~ CJ'~' ~tj'} ~H" ," ".. onstr. Type: ood rame e rooms: 4 :~,. ,.\"", 0"'!J<::l cYJ, r;\' Jlat ,Source: Forced Air Gas Water Heater: Gas Range: Ga~~\c,~ ""~'):. ~"'\f'"" dS9~'Footage: 2183 ...~P"'- ~ _~o~ :\S' ~ .;s""' :.C- . To request an inspection call the 24 hour recording at 726-3769;\CAII;inspectio~sJequested before 7:00 a,m, will be made the same working day, inspections requested' aiie'r<7~60;a~m,' will be made the following working day, ",-:S" Required Inspections I Buildinll I -Install ground rod at footing, and call for inspection in conjuction with footing and/or foundation ir -After trenches are excavated, -After forms are erected but prior to concrete placement. - Prior to floor insulation or decking, -Prior to decking, - Prior to cover. - Before covering sheathing with finish materials, - Prior to cover, - Prior to Cover Verify Ground Rod Footing Foundation Post and Beam Floor Insulation Ceiling Insulation Shear Wall Nailing Framing Wall Insulation Street Improvement: Fully Improved Curb Cut?D Improvement Agr.?D San Sewer Depth (Ft): 6 4 Storm Sewer Available? 0 Special Req.: Security Required: Bond Begin DateTime: 00/00/0000 00:00:00 ' Special Instructions: Other Utilities: Project Supervisor: Drywall Hold Downs Installed Vapor Barrier/Insulation Final Building Temporary Power Rough Electrical Electrical Service Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Perimeter Foundation Drains Final Plumbing Underfloor Mechanical Rough Gas Rough Mechanical Gas Service Final Gas Final Mechanical SW-Setback CC-Standard . . I Job# 02-00779-01 I Required Inspections Building Page 2 of 5 - Prior to taping, - To be made after insulation and required vapor barriers are in place, but prior to any wall coverir - When all required inspections have been approved and the building is complete, I Electrical I -Approval required prior to SUB energizing pole, - Prior to cover, - Must be approved to obtain permanent power. -When all electrical work is complete, I Plumbing -Prior to insulation or decking, - Prior to cover or placement of concrete, - Prior to cover, -Prior to filling trench, - Prior to filling trench, - Prior to filling trench, -After gravel and filter cloth is installed, but prior to backfill. - When all plumbing work is complete, I Mechanical - Prior to insulation or decking, -After line is installed and capped if not attached to an appliance, - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance, Pressure tes -When all gas work is complete, - When all mechanical work is complete. I Public Works I -After forms are erected but prior to placement of concrete -After forms are erected but prior to placement of concrete Sidewalk Type: Additional ROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: Setback - 5' o 8 To Curb and Gutter 6 00/00/000000:00:00 . Types Of Warning Devices Reqd. . Zoning: LDR FloodPlain? D Wetlands? D Journal numbers 1: 2002-06-0187 2: Comments:Over Counter LDAP I Job# 02-00779-01 I Overlay District: # of Street Trees: 2 . 3: Additional Requirements: Required Attachments: Source Locn: Material: Planner: Urban Growth Boundary?D Glenwood Area? D Quantity Of Fill: Supplier: Drainage: Floodway FEMA: Zone X White Construction Types:(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 4 Handicap Access? D [Area (Sq. F, ,:) Main: 2183 Accessory:592 Fee Residential Plan Check Total Plan Check Building Permit State Surcharge For Building Permit 8% Building Administrative Fee Total Building Minimum Electrical Permit Fee Wiring Footage 1,000 Sq Ft or Less Wiring Footage Each Add'l 500 Sq Ft Temporary: 200 Amps or Less State Surcharge - Electrical 8% Admin Fee - Electrical Total Electrical Minimum Plumbing Permit Fee Three Bathrooms State Surcharge - Plumbing 8% Administrative Fee - Plumbing Total Plumbing Hood and Exhaust One to Four Outlets Minimum Mechanical Permit 8% Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct Page 3 of 5 Land Use: Single Family Dwelling Pave Driveway? 0 Flood Plain FEMA: Panel 1134 of 2975 Private Garage/Carp/Stor # Of Stories: 2 Height (feet): 21 Current Units: Proposed Units:1 Census Code: New SF - detached Total:2775 Paid On Receipt# Plan Check 06/28/2002 9776 Buildin!l 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 Electrical 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 Plumbin!l 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 Mechanical 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 Value/Quantity Fee Amount 174,454 $526,11 $526.11 174,454 $809.40 $56,66 $64,75 $930.81 1 4 1 $,00 $106,00 $76,00 $50,00 $16,24 $18,56 $266.80 1 $,00 $306,00 $21.42 $24.48 $351.90 1 1 $9,00 $4,00 $,00 $5,12 $12,00 $24,00 1 4 , . . Fee Gas Fireplace Dryer Vent Mechanical Issuance State Surcharge - Mechanical Total Mechanical New Sidewalk New Curbcut Multiple Permit Discount - 2nd Permit Total Public Works Residential- Single Family - Storm Residential Improvement MWMC MWMC Administrative Fee SDC Administrative Fee Residential Sanitary MWMC Residential - Improvement Residential - Reimbursement Sanitary Sewer SDC Reimbursement Sanitary Sewer SDC Improvement Total System Development S,F, Residence - Willamalane Total Willamalane SDC Planning Plan Review Total Planning Address Assignment Total Permits w/o Srchg Grand Total Plan Check Type Checked By Initial Review-Res Lisa Hopper Virginia Jurasevich Liz Miller Bob Barnhart Engineering-Res Planning-Res Structural-Res Page 4 of5 Value/Quantity Fee Amount Job# 02-00779-01 . Paid On Receipt# Mechanical 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 1 1 Public Works 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 55 1 1 Svstem Development 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 07/12/2002 9914 3,306 1 1 1 1 1 29 29 Willamalane SDC 07/12/2002 9914 1 Planning 07/12/2002 9914 1 Permits w/o Srchg 07/12/2002 9914 1 Date Completed Comment 07/01/2002 07/10/2002 07/05/2002 07/03/2002 By signature, I 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 Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety, I further certify that only contractors and employees who are in compliance with ORS 701,055 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 street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction, $9,00 $6,00 $10,00 $4.48 $83.60 $75,00 $75,00 $-30,00 $120.00 $902,54 $34,83 $10,00 $159,29 $332,86 $659,76 $155,13 $619,73 $470,96 $3,345.10 $1,000,00 $1,000,00 $55,00 $55.00 $8,00 $8.00 $6,687.32 ". ,', . \~ ~~ I Job#02-00779-01 s~ature ~ ~ . Page 5 of!' I 1./ f 2--/ () '? Dale / e e e 7L17 (1L;~"0Ar..A.4A',d ~@LF~CIDD[)l)U~@~ [IJ Builders Statement ~ InsulSafe@4 Fiber Glass Blowing Insulation InsulSafe.4 has been installed in accordance with the manufacturer's . res;wmen:~~ns to provide a value of R...5..!using bags of insulation to . cover~ _ square f~e~ .~~ area at a minimum thickness of~ches. . /f &-"-'~ . InsJa~er Contractor (~) . .:J ~ h"o/VJe~'A/<;O~,(J.);~,r,/ . Com~any N3J}le / /- /-0 -0.:1.. Date Builder (sign) Company Name Date Batts and Blankets I R-Value Insulation Thickness (in) I 38 10,12 I 30 81/~, 10 I n 8 I 22 6112 I 21 51h I 19 61/~ I 15 3112 I 13 31/2 I 11 31/2 Fiber glass balts or rolls have been installed in accordance with the manufacturer's recommendations to provide an R-value of _ in the ceiling, _ in the exterior walls, _ in the floor or crawl space perimeter. Installer Contractor (sign) Company Name Date Builder (sign) Company Name Date .....ode No. 30-24-233 THERMAL PERFORMANCE-ATTIC BLOWING APPLICATION In accordance with the chart below, you must install the minimum number of bags per 1,000 sq, h, of net area for each R-Value listed, The maximum net coverage must not exceed that specified for each R-Value. The installed insulation must be at or above the specified minimum thickness for each R-Value, Failure to install the required minimum weight per sq. ft. of insulation at or above the minimum thickness will result in reduced R-Value. This product should not be mixed with other blown insulations or the thermal claims will become invalid. BAGS PER MAXIMUM MINIMUM WEIGHT. MINIMUM R-VALUE 1000 sQ. FT. SQ. FT. PER BAG POUNDS PER SQ. FT. THICKNESS To obtain a Bagspcr Contents of hag W~ht per sq. ft. of Should not be Thermal Resistance 1000 sq. ft. should not cover install insulation should less than: (R) of: of net area: more than: (sq. ft.) not be less Ihan:(Ibs.) (in.) 60 36.5 27 0.986 22 ,. 29.6 J4 0.800 18Vl 44 26.4 38 0.712 16lf~ 38 22.8 44 0.615 14lf~ 30 18.0 S6 0.485 12 '6 15.5 6S 0.418 10Vl 22 13.1 77 0.353 . " 11.1 .0 0.301 7l/, 13 7.7 12. 0.209 5Vl 11 6,6 1S1 0.179 41J. R-values are determined in accordance with ASTM C 687 and 518, Complies with ASTM C 764 as Type 1 insulation. "R" means resistance to heat flow, The higher the R-Value, the greater the insulating power. To get the marked R-Value, it is essential that the insulation is installed properly, DANGER: RECESSED LIGHT FIXTURES-TO PREVENT OVERHEATING, DO NOT INSULATE ON TOP OR WITHIN 3" OF SUCH DEVICES, DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR TO FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS, FRAMING ADJUSTMENT To compensate for framing members the number of bags per 1000 sq, ft. of net area should be reduced as follows, loistSize (in.) ", ,,6 "8 2 X 10 Bags 10 deducVl 000 sq. fl. Joists 16" O.c. o,s 0,8 1.0 1.3 Bags to deducV1000 sq. (t. loists 24"0.C. 0.3 D,S 0.7 0,' 2000 Certaineed Corporation 2/00 ) . Manufacturer Insulation Fact Sheet This is CertainTeed Corporation InsulSafe@4 Fiber Glass Blowing Insulation . CertainTeed II e CertainTeed Corporation P,O, Box 860 Valley Forge, PA 19482 THERMAL PERFORMANCE-HORIZONTAL OPEN BLOW The following thermal performances are achieved at weights and coverages specified when insulation is installed with pneumatic equipment in a horizontal open blow application: BAGS PER MAXIMUM MINIMUM WEIGHT- MINIMUM R.VAlUE 1000 sQ. FT. sQ. FT. PER BAG POUNDS PER SQ, FT, THICKNESS To obtain a Bags per Contents of bag Weijht per sq. ft. of Should nolbe Thermal Resistance 1000 sq. ft. should nateover installe insulation should less than: (R}of: of net area: more tnan: {sq. (t.) not be less than: (lbs.) (in.) &0 3&.5 27 0,98& 22 49 29,& 34 0,800 18'h 44 2&.4 38 0.712 16]/4 38 22,8 44 0,&15 14lf4 30 18,0 5& 0.485 12 2& 15,5 &5 0.418 10112 22 13,1 77 0.353 9 19 11.1 90 0.301 7l/4 13 7.7 129 0,209 Slh 11 &.& 151 0,179 4lf4 e R-values are determined in accordance with ASTM C 687 and 518, Complies with ASTM C 764 as Type 1 insulation, THERMAL PERFORMANCE-SIDEWALL RETROFIT APPLICATION When installed with pneumatic equipment in sidewalls, the following thermal performances are achieved at the thicknesses, weights and coverages specified, BAGS PER MAXIMUM MINIMUM WEIGHT. MINIMUM R-VAlUE 1000 SQ. FT. SQ. FT. PER BAG POUNDS PER SQ. FT. THICKNESS looblal" a Bags per (ontents of bag W~hl per sq. fl. of Should not be Thermal Resistance 1000 sq. ft. should not cover install insulation should less than; (R)of: of net area: more than: (sq. ft.l not be less than; (Ibs.l (in.) 29 35.8 28 0.967 71/~ 22 27,2 37 0.733 51/2 1& 19,8 51 0.533 4 15 17.9 5& 0.483 3%1 14 17.3 58 0.4&7 31/2 READ THIS BEFORE YOU BUY What you should know about R-Values, The chart shows the R-Value of this insulation, R means resistance to heat flow, The higher the R- Value, the greater the insulating power, Compare insulation R-Values before you buy, There are other factors to consider, The amount of insulation you need depends mainly on the climate you live in, Also, your fuel savings from insulation will depend upon the climate, the type e and size of your house, the amount of insulation already in your house, and your fuel use patterns and family size, If you buy too much insulation, it will cost you more than what you'll save on fuel. To get the marked R-Value, it is essential that this insulation be installed properly, , ;;; <AQ~GPERMr:r'~PClCATION;''.'.'''''''' '. ./ ~ Efy~,>;t~":'i{^'f~,;n ~.\,:~~'~ ~ '~v ':'Ci\y,?ob N~p1~.crjJ'l1.~~:';\: }"'1 ~l' "'~~'~ f ~j r! ~,. "..' ",;,:'\,. , ,C<:." , ...,., , i:J JCOMF~EiE FEltsCiffibULE BEL"6W', . "r ;', ';": .;, ,:. t.~.~~~ b.ii :J f\- . ,:.tf .~" .~~:~; '~'t,~::~~:..:, :.c~. ;~~'-'~;.~ :~~. '_",,:~ )\:'.l'l'ew'Residential'Single v, ,'-'No", " -~- ~,,:"'f1 Multi-Family per dwelling unit. ~'.~(;:: . LEGAL DESCRIPTION .A ",..... Service Included: i'!!';:,.;: ~~~~~ (')\~ I Items Cost S~;: " R%~n+~ ~::~~;:;OO :-"0600 ~!~b ~~..'.. PerrnilsareJon ansferableaQexPire thereof ~ ~ $19,00 ~, ...."'ft'l if work is ndiistarted withia 180 days Each Manufd Home or I.!:~ [1(;"':,~ ~:.:."",~,;~.k.,~..,.,., of issuance I{iiifwork I'S suspended ~or Modular Dwelling --,,^,~ '1:-. ",....~ ~ ~ 'r",fi:r11r=r, ;D#;.~~t ~"i 180 days, ~ SelVice or Feeder )~".f;':~ $ 50,00 <r."~. ~~ ~~~, 'e'l'1~~;>~ g,f:~ ~ 2, CONTRA~OR~TALLATIONO~ B. ServicesorFeeders j' ''''.;,~;.1~'.;'.\ ~''i;~~J ~qc;i ~-'"' I \ I II' Al ;, ,.,~.' ~ j.\j '." ~.'l.'l~ i:-' ~' '.: \ 'l ~.. nsta atlOn, terations 01; , ...":;-- -,' ,J- .:" ,', 'iiJ"'~ Electrical'qo-Il.'r!aclor':-. -\ ~ ~ (..\~C. \ .l)"c.. Relocation: ;'.:+~~1J)~J~":~;Y';'~~"");j ~-:." ~I,",; ,CO< ~';-;') " ".:1-~~,... ". ..'ji ~" eo, ~~t;~ . ~'<ti"-;>?/ I} r"'"> J":r.t'~-;i:<t'~(~~~i;'." q~,..il!1t~~:e ~t:1~'1 t~~ Address t.:~~O:'f oJ'tl,- l.fiJ~ .":<~~ :";,:" 200 amps orle~~>.Jr,'J.":~."~"1 :~;.,~;~\,-;<~.~~~:,,;; , $1~3';OO L1~,i ',.~1 I' J'''r'd ri';;~\ -Z"r" ': ':;;,o( 201 amps to 400 amps' ,1,_ ,.,;;:~; ;,.."::$'75;06 -'~:',:" 'oJ \t.j~1 City Y .t.:,~e f'{~;~hOne q~,s';~S~3 '.:'"\~ 401 ampst~AQoa~ps,;,'_"f~L',",$ii5~O.o .."",1 y;~ '., t,'.X t <:1 /.. .'."~. ""',,-6QI amps~p.!?OQal!lpS",';:"}"';,-'----::,$,16~,OO---.::\ f,~,:; SupelVisor'.'L.iceuSeINumlier ~gli\)' _ :'-. ;,' 'GVer,!.o90 aIl1Psf.y,<l~ ,;'. ': ','t',-=--. $375~00 :: ,,-I ,;:g;< h ",,, .4J . .'~:.'-,.- , , .' ,:,..,ReconnectOnly,,' , ".' 'J':-..' - ~ . $,50,00 . ',:",,1\' ,.t,.-. i~/-OO ,.r...",u, '" ,~< '. ;; '. ";'.d."- r , ~, '4~'~ EXplf3tlOn Date '~I,. --:~_ <"~'io.'\V ~ !:.' h t, ,. ... . .,:>/:.\.'1 ~ \~\~ --:" \ f'~ , 'J:'" ... ,~'?,. ", . \ :", d c: ~" ,'~ :. > "' " : .'1" ",,0,>,: C, '(f","nporary ServiceS':or.J!eeders~-.~' ":, '; , ' " ',;'_ ,:: ". t~~' :,~'eonslr Co~tr~ ~u~ber', ~~.c::. 1 ~ :''ZD^I,;('fni~liation,ilte;:~ti'O'k~r\Woc~ion':, " ,I ',-: ' "~I ~'':'c..).. ~,-:,,-.-- /~::i~~"'~ f<. '(pl~ .'\;I.'~ ~~: '-.~. . ~~ :.:,'" ."....-..,,~.'~ ..~' ~ ":~', rW1t^''' "~!'\l' ~""';"~'f\""" .. f "', ........ " ,'.~ '.. ......" . lJl..' ~;..;.~1{;:;, ',,}~XpiralionDate ...~ .u:r--~-.:.: ~:'::':'.;r.,~OO~lie;p~tO!.~s' ~', ,:' .- -,_, ~"-1..,..:. J~O.oo" , ' ;' ~,~':?''\i,q "",~ ~, "n;&",201ampsto~~00<aml1s ,~: "!$6900' ,', ~;;.,..'f)"':v"~'''':i~ 1tL~!."'t"~I' \?-t ".{'~.." ."'... ,0,.",--:-- .",'~-; ~;m:1~; ,;,~ign.'!.t~!:~:of Supervising Electrician \~"'~Qyer 401,to,6qO ainps .,', :'{.~;: ," '-$100:00 ,c, : ',~ ..".;.<-!.- '" '":'. -~' ': 'f!'~~. '\.. \\)'? OY'ci-%0. crimps,Qr 1000 voltssee,-'i , '- ',:" 1 rd;"';~-'1,.', .-, c..,. .;:~ t1'.~. .:: _ r;'V"Bu,'lr~o'v-e':~' ~_~;'. ",,' "._'''' l,,,, .~ ." -. ;,., _~. .~, '. I< __ .,au^", , . . .~j,',,,,~ -4!'J .'''' j~;-- ~ ...... "\,} , ...... , '.0. -- ,( ;.~~-;ti~-, \{1l ~~~',~, -." ~:~'-;;'-_.~="-"~:~:':;";' . . ")""" ",cL,'.- " :'_',!,~..''->,'~:" ~ 1'1'''...' '.' d, . ....,."iJ.l,~L,f"i ~ ~\^^^_ _D. BranchCITCUlts "~"fA:.~ .'-- ..'~ " . ~;.~~f~',: "~wners,!'t~,~~;~, . :', ;~l\ ih(Q)J 1.AWU . Ne~iftC!~tion OJr'~tenSion peri~h;-'~~" .:;:; ',;" '''':' . ,~~~:;"':~~~~;~A~;~sr.',\ . O}e~~it\ ,,;..t ,~~ ,~; :'.::', ;:1 :5'-,,,'{ "(i ~-~..~, ,:'-:~'J\'~ -"'::.f..C.A . lit,:"" ~ :,;1 ~"~-' . ' z,,:~, .1 , ~~~~:~~~:':~ ~-:,qity ;r~:_~~f~.Jfi~rT~;.\~ ~ 11lllo 1~7~'<:~4di~OW{~~~_u~ . ,~5'~ ,',I:",:J::, ~_ ~~}::~ ~1 ~'~!F,~~' '.e~'~:":"1!o.7'-~':.'..jl~".".;(~j!l':it ,;:; Or!Fe"eder,Pernn~~ .' ~ _~ ",-",;.." $3. '.,00",\., ..., ;i;'J. ~~((~'~~;:~P~'~~~i~$,l~~;ti_~l!~;~t({~ . H l~~'l~' 9<t:'jl{i~a_ + ~~~. ~it~ ~ ..<~;t;!1.>~~~~f.;;~~'~, 1'k."1m."..i1>..,.,.; ,v :rlieiilStiiJlaticiniSibemg.ma.de.ork :';, E. Miscelra ~:~I! ~ncludeil)"):,'~J..,, 'f)... :%> eI:""'," ~,' ;" . "," '" _.V? - ,,,..; ,'., <10 I' .~. \- ,.,- '" ::r'J; . i ~?~~ ~ .~p.r~~~,lJY}ioo!~~~~lk~~ii.9t;i~~~~~~~\~ '. [:-. ,'.J ~ - . . . .'~. .;~ .~t" <~~~":.;{ :.(R~~~'~'-~~fqr.~ale;fl~~,~ .ofren~~~); ~<> .,~ .;;~:f'~~, . .~. ~" . j~_j ----=:'$~Q:99 ""~' ,0.) 'l"'-r. ~~r. .,., '>'. ,-..,;"'''-:;':..r:..u.<.J.~4..~~"...<; ,')" ' ;:} S' "1 'S50~OO>'" ""A~ ~t:~.... '~~~~()~Vi~rf~~J~j~.f€V:" ~ r;lfuit . s~ftf l~ - $25i.OO";;~"*;~~ ':ft!v'<;:' "~"('~~'""'~'~~'~'~--,Y':'~h"V\" ~ "f1~".." ~," " tr...,!j;Il!:' -""-"\:.1..,.,.It" t~{i~l;. ~:,;;..~...t,l:.,.?,\;vW';,~':.t'~',.i.:;,A1"'J:' .;,.~,;~ t~Llmite(r IComm':j $45.00....'-l,.; ,':"<'t..';. ;t,';:-~_" ~_:_'~ "F ~~''''''ii~\''.I~'''-''''';:::''~'..-,.~,'\,-t: _.'. ,,_,,' ~~Jh '!}~'-'~J '-...-Ii ~ -~; t;r;::o ;., - J;tF~:' .i'ti~~ -:',,,'i,,":I ",,,,,~,\:,..:.~. \'.:~" :;.f ij..~....~.. " ,..,~~,,' ~ l,'''l;' ~"""l\ r'. ~.>--'.~ t i' '''.~- l."'!=o~ .,: ,. 'tr'1'-~ '~'." ':J 190: ~~i~ ~;~. ,::;:~:~ ~:;- '~,~~,;.~~~;~:; .- '"" t~';'~~.>\ l\tlinimN~'Elt~tri,i~p~~iti:ris~~ction Fee is $45:00 + S~f~h~tg~s "3n ~;~-' ~~0:.~_-:t>/" ~c~::';'G.:-~''':f? ~:: "z-""i..J~~ '-.' ; 3,/."\ e,?i f:t.~.y~J':'~:;iif~~1 J ~('i~O",.tU'''; .:J , ~'-...~~.: ";:"''i~'' '_'1o:~;.(l. .. :'~"tl~'~'~&-- "-~~,t~~, ~";,\ .. 'f::1 f;.,";.'.'.J;.<:::','ls' 1J:-"'t,,~ '\~^~:',. , ' 1:(;''[ -' ~~" '",'li'!:1; "~."# ,!",,,,-~":,,:",i.'1"~ 4. SUBT.oTAh:OFiABOVE r N..""rI)~..':. -i ! ltil'f""~ ,~,.,"',- ~,,; "'",',,<- '~''''' '\ ,.' I"i"S'<r"(j"'>"""" r;;/;;,'. ~~.~' ZOO :1\' '.V~.tl : ,~",'i7 t'"!... )~t "--:.,, ..., "'7 ~f ';'i:."tt:. ;1(",,\ 70/0 State, ure arger Q' . l -:.;, --' +;16 ,', _~ ,~ i~iS~b~ ~~~~;:'tf':rf !~.~:7. /~~." ',~:.::;~, :[1~ : ':-:-~ 80/0 Actini~i~ra~~'Fief ---1 ." U:> ~\;,,-y " r ..-, ;,-,,~-', -~, ,.. 'i~" " " ," -c,,", /.-J ~ r#~",:, _ ~ ,._ _~..,.".I'" '~" ....;... .~ .:A.~::, " ~'l>_ ,. \, v.' ~~^ J~:"', _"J _I _ 0" <:-~;-.., ,~-,: -'-,";' ':t.;li,~! ' ';'#i~'. '~~'. ,:, ::"''l ,"";,\ TOTAL""" OILVU/ ~ .~-- v'\~\,. . "-- ~..-.,' .~'::'- /~;"~""'T>oy.:,.-';.!t :j~F:~<:~.ti - . ---"-