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--- 121-Q26 SW ASCENSION DRIVE --
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., 'lgard,OR 97223 (°03)639-4171
CERTIFICATE 017
OCCUPANCY
PERMIT 0. . . . . . . t
",TE ISSUED t 04/13/r4-1
PARCEL.a c G 104BC--05-;Q10
S I TE ADDRESS. . . t 18926 SW ASCEND I UN DR
3UB1 I!I'.S I ON. . . . a H I LLSH I RE WLJODL1 Z ON I NG t R.-7 PI)
LOT. . . . . . . . . . . . . Oi",4 JURIa171[:TION:TIG
CLASS OF WORK. tNEW
TYPE OF USE. . . i9F
TYPE OF COtaG'f R t"_iN i
OCCUPANCY GRP. i R3
!]CCUPANCY LOAD t
Remmirkst 9F - Path I
Rbd r.ULLE'RTON CO
64;1'.6 SW 19VRTN- lil_5111.. '1WY
PCIRTI.AND OP 9' c.:81
Phune *, ..:93-4433
FUI_t_FRTUN COMPANY
64e6 SW REAVh RTON H I L.L_SDAI_C HWY
4OR"CLANU OR 9*72.21-13.if+
Phone 01 ?97--44.3,3
Rey V. . . 000406
This Certificate pr—'--into oCc'upa►ncv of the abovra reflorenced bui ldivy or portion
+:her eof and confirms that the bl.ril.ding has been insper_.ted for compItance vrith
rhe State of Oregon Specialty Cedes fnr• ttv�� yr alar, OCr.�.rpn�*tC:", snd use Unuer
,4hich therifFerenrrcd permit was issued.
HU I L.D I NG IN i i!_. ' 1 N.�f�EC:7 I SUC'r^"t'"rtin
POST 114 CONSPICUOUS PLACE
i
I
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 6394175 Business Phone: 639-4171m L�
4,, _
Date RequeEted _ .�!�-Y - '7�(�' Y�. M. - 1'.M.%��, (-- MST:9 7-t/i)
Location:_ ( _���� �� , _f _--- BUR
Tenant:- Suite: Bldg NEC:
Contractor: i := Phone: 4-1, PLM:
Owner: =- �,�� Phone: ELC: -
ELR:
SIT:
BUILhiNG $LmIrnn't) PLUMBING ( E"' 1 CHANIf_'A7. ELECTRICAL' SITE
Site Post/Beam Post/Beam I'ost/f3cam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slnb Framing 'fop out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Dict Reconnect Vault
Bsmt Dmnp Drywall Storm Furnace Temp Service MISC
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire SpIWIm Crawl/Foun r 1lent P I-a,)w Volt
pprove r roved Approved Approved
App/Sdwlk raved OKI proved 1 of Approved Not Approved Not Approved '[ ��-
NAL FINALOK- FINALOA FINAL
j
CI Call for reinspection Reinspection fee of S�- - re uired before next' tion O Unable to inspect
Inspector:.- Y�L DO 3 _ _ Page of--
_ It
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-11our Inspection Linc: 633944175 Business/Phone: 6394171
Date Requested: I�C 7 `�� /O I A.M. n VM. MST:
Location: BOP:
Tenant: Suite:: — Bldg: _ NEC:
Contractor: , Phone: PLM
132
Owner: _` Phone: — ELC:
ELR:
_ SIT:
bITILDING BLDG(con't) LUMBIN MECHANICAL ELECTRICAL SITE
Site Post/Beam Po s eam Post/13eam Cover/Service. Sewer/Storm
Fooling Roof Undl'I/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In Uta Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace 'Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Fbnnd Dr Heat Pump I.ow Volt
Approved Approved Approved Approved uv
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved roved
l FINAL / FINAL FINAL
0 Cell for reins 1 � inspection fee of S irecf arc inspection O Unable to inspect
i
tngmtor: _ �� Date: _ Page_ of _
ATY OF TIG.,\RD Plumbing Application Recd e
3125 SW HAIL BLVD. Commercial and Residential Date Recc'dd
GARD, UR 97223 Date to P E-
50) 639-4171 Date to DST
Permit s
Print or ,ype Related SWR 0
incomplete or illegible applications will not be accepted Called n117-C
Name Day
elyipment/Pmject _ FIXTURES (Individua,) QTY PRICE ANT
30h _ l ( ' Sink 9.00
Address Street A� �� Suite Lavatory __ g.00
' Tub or Tub/Shower Comb
'�!•:Z. S i� fn v 9.00
Ids S City/State Zip Shower Only 9.00
Narrilirl e, r Water Closet 9.00
/I Dishwaor 9.00
Garbage Disposal
Owner Mailing Address Tulic — 9.00
Washing Machine _9.00
Cdy/Slate Zip Phone Floor Drain 2" 9.00
---
Name 3' 9.00
— —
4' 9.00
�
Occupant
Mailing Address Swte Water Heater 9.00_ _
Laundry Room Tray 9.00
City/state Zip Phone Unnal 9.00 �—
__ — Otri cNlures(Specify) 9,00
Name
111 < L dr l C ( 1 „ � ' r V 9.00
Contractorailing Address Sud 9.00
M I�f ( a 900
City/Stale Zip Phone
Or 'i7di§'I 1, `1 318 '1 9.00
Oregon Const.Cont.Board Uc.0 Exp.Date 900
Attach Copy of ii, ) `j-7 I r e-, •f1)� 9.00
Current Plumbing Lic,9n Exp Date Sewer-1st 100' 30.00
Licenses ) (, -3 1, 013 1 3 t-, rr Sewer-each additional 100' 2500
COT Business Tax or Metro s Exp.Date - -
/ S r Water 5eroce-lit 100' -_—__ 3000
—- Name Water Servioe-each additional 200' 25.00
Storm 3 Rain Drain-lit 100' 30.00
Architect
Marling Address Suite Storm&Rain Dra+n-each addibonal 100' 25.00 I
Qf Mobile Home Space 25 00
Engineer City/Stale Zip Phone Commercial Back Flow Prevention Devux or Ant)- 2500
Poll ion Device
�ascnbe wort( New O Addition O Alteration O Repair O Residential Backflow Prevention Device' i 15.00 j S
to be done Residential O Non-residential O Any Trap or Waste Not ConneGed to a Fixture 900
7ddi0onal description of work Catch Basin 900
� Insp of Existing Plumbing 40.00
J S l n 4
Specialty Requested Inspections 40.00
,usting use of
w .-
lding Or property_ —�IPS I(A F rt�� � --- - - — ,- per
Rain Drain,single family dwelling 30.00DO
reposed use of Grease Traps 900
budding or property
QUANTITY TOTAL
Aro you capping. moving or replacing any fWures7 Yes p No Isometric«n+w dugram o reay.ea 1 Our rty Truer is >9
(if yes soo back of form; 'SUBTOTAL
! I hereby acknowledge that I have read this application that the information -
given is correct.teat I am the owner or authorized agent of the Owner.and 5%SURCHARGE 7S`
that plans subnxtted are in compliance with O on State Laws
Signature of tTwner/Ayont Data
PLAN REVIEW 25% OF SUBTOTAL
Reoured 1 fbm,ro My taw a�.9
__ TOTAL /S y-31
Contact Person Name Phone
'Minimum permit foe is S25+5%surcharge.except Residenbal Backflow
4il C,, r L 3', �`I Prevention Device.which is 315+5%surcharge
l:ldstMpirnapp doc 8/96
CITY OF TIGARD MA5TCR F,ERMT1-
DEVE!OPMENT SERVICES PERMIT #. . . . . . . : MST97-032'
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 r)ATE" I SSUED: 10/2,2/97
r'ARCEL-: 2 S 104BC-05300
";TTE ADDRESS. . . : 12926 SW ASCENSION DR
>tJBDI.VIrTOhd. . . . :HIL-L ;HIRE: WOODO ZONING: R•--7 F,T"
lL-OCK. . . . . . . . . . LOT. . . . . . . . . . . . . :064 JUR T SD I CT I Oh,a URB
nemarMs: SF - Path 1
--------------------------------------------------------------- BUILDING ---—--------------------------------------
PEISSUE: STORIES........ 2 FLOOR AREAS --------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-------
CLRSS OF WORK.08 HEIGH'........ ; 25 FIRST....: 1213 sf GARAGE.....: 650 sf LEFT..........: 13 SMOKE DEiECTRS. Y
TYPE OF USE....-SF FLOOD LOAD....: 40 SECOND...: 1127 sf FRONT.........: 20 PARKING SPACES:
TYPE OF CONST.-5N DWEL'.ING UNITS: 1 FINBSMENT: 0 sf RIGHT.........: 6
OCCUPANCY GRP.:R3 BDRM: 4 BATH: 3 TOTAL------: 2340 sf VALUE..1: 168038 REAR..........: 44
-------------------------------------------------------- ------ PLUMBING ---- —--------------------------------------------------
SINKS.........: 1 WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 100 TRAPS.........: 0
-AVATORIES....: 5 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 1 CATCH BASINS.,: 0
TUB/SHOWERS... : 3 GARBAGE DISP..: 1 WATER HEATERS,: 1 WATER LINE ft: 100 BCKFLW PREVNTR: 1 GREASE TRAPS..: 0
OTHER FIXTURE5: 0
-- -- ----- -- --------------------------------------- MECHANICAL ----------------------------------------------------------------
;7UEL TYPES-----.--.---- FURN ( 100K ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....; 4 CLOTHES DRYERS: 1
JAS FURN )=100K ..; 1 UNIT HEATEPS..: 0 HOODS.........: 1 OTHER UNITS...: 1
'"AX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: I
----------------------------------------------- ------ ELECTRICX --------------------------- ----------------------- --
--RESIDENTIAL UNIT--- ---SERVICE/FEFDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD�L INSPECTIONr
1000 SF OR LE55: 1 0 - 200 amp..: 0 0 200 amp..: 0 W/SVC OR FDR..: 0 Ptn/IRRIGATION: 0 PER INSPECTION;
EIA ADD'L 500SF,: 201 - 400 alp.. : 0 201 - 400 amp.. : 0 1st W/0 SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......;
'.IMI'ED ENERGY. : 0 401 - 600 amp..: 0 401 - 600 amp.. : 0 EA ADDL BR CIR: 0 SIGNAL/PANEL"' : 0 IN PLANT......:
'4ANF HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABFL -10: 0
10004 amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ---------------------------------
Reconnect
-------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
---------------------------- -- --- ELECTPICAL - RESTRICTED ENERGY --------------------------------------------------
1. SF RESIDENTIAL------------------ --- B. COMMERCIAL-------------------------------------------------------------------------
AUDIO I STEREO.: VACUUM SYSTEM,. : AUDIO G STEREO.: FIRE ALARM...... INTERCOM/PAGING: DUTDOOR LNDSC L':
BURGLAR ALARM..: 0TH: :: X BOILER,,.......: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGlk:
GARAGE OPENER..: CLOCK,.......... : INSTRLIMENTATIDN: MEDICAL........: OTHR: ::
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL 0 SYSTEMS: 0
.4ner-- -..--------------------------------Contractor; ----------------------------- TOTPL FEES:( 4516.61
RW FULLERTON CO FULLERTON COMPANY This permit is subject to the regulations contained in the
,426 5W BVRTN-HLSDI HWY 6426 SW BEAVERTON HILLSDALE HWY Tigard Municipal Cede, State of Ore. Specialty Codes and all
clORTLAND OR 97221 PORTLAND OR 97221-1128 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone #: 293-4433 Phone #: 297-4433 not started within 180 days of issuance, or if the worth i-
Reg C.: 000406 suspended for more than 180 days. ATTENTION: Oregon law
----- -------------------------------- requires you to follow rules adopted by the Oregon Utility
`lotification Center. Those rules are set forth in OAR 952-001-0010 through OAP, 952-001-0080. You may obtain copies of these rules or
direct questions to DUMC by calling (583)246-1987.
---------I-------------------------------- REQUIRED INSPECTIONS ------------------------------------------------------
Erosion Contol Crawl Drain Electrical Rough Gas Lire Insp Water Line Insp Plumb Final
rooting Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service In Building Final
roundation Insp Mechanical Insp Shear Wall Insp Insulation Insp App /Sdwlk Insp
Post/Beam Struct Plumb Top Out Low Voltage Gyp Board Insp Electrical Final
cost/Beam Mechan Electrical Ser __- Fir•eplare Insp Rain drain Insp Mechanical Frnat� _
_ (� ry
I s r>j.r e d By �-•--'- � `", .� � P e r m i t t e e S i g n a t l_i r �, ,V.�4r
bpi+4I4-4+144i�F 41i++1it�+•t+� a.{.i..}�.�.4.�..{++ 1 ,_.4.4.++4 t4 + h41 .1..+a4 +1..4411i11 � .+
c---
Call 639-4175 by :'. O p. m. for- an inspection needed the next bl-rsiness day
CITY OF TIGARD SEWER CONNECTION
DEVELOPMENT SERVICES F'ERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : SWR'37-0,"?rrl
DATE TSSIJED- 1.0/222/97
PARCEL. 2S104RC--05300
`926 ASCENSION DR
.,rm ADDRESS. . . : 1'L� r-
MBDIVISION. . . . :HILLSHIRE WOODS ZONING: R--7 PD
nLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :064 JURISDICTION: URR
I-ENANT NAME. . . . . : RW FULLEPION CO FIXTURE UNITS. . . 0
I)SA NO. . . . . . . . . . :
f-LASS OF WORK. . . ;NEW DWELLING UNITS. t
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
f NS)TALL TYPE. . . . :SUSWR IMPERV SURFACE: 0 a-F
Remai [<,.; : SF — Path I
rRW FULLERTON CO typir-, amoi.int by date v-ecpt
.790. 00 JSD 10/22/97 97-300-29r5'
C,42r-, SW SVRTN—HLSDL. HWY DUN $ �1.
PORTI-AND OR 97221. PRMT $ 2200- ally JSD 1.0/L2/97 97-300295
TNSP $ 35. 00 JSD 10/22/97 971 -3002295
r1flone #: EROS $ 64. V.!0 j'SD 10/22'/97 97-300?99
ERPU $ 20. 80 JSD 10/212/97 97-3002295
BQt JSD 10/22/97 97 --312VCq�,
Contractor : -ERPC
OWNER
4. 2630. 60 TOTAL
R(�y #. REQUIRED INSPECTIONS
"his Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. Thq total amount paid will be forfeited if the
pe,,sit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. if the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agercy will install a lateral,
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAA
952-001-0010 through DAR 952-MI-M?, Yo j may obtain copies of
these rules or direct questions tq/ by nailing (503)246-1387,
%
LIssi-ted by - Z Pei-mittee G)i gnat Ut'e
...........4.....4•......4-+4................+++++4......4.......... .............
Call 639--4175 by 7-00 p. m. for- an j.nspec-tion needed tfir, nexthj_kS4ne,;s day
+i-+++++4•+i+i ++4 4+++++4+++4................4........4...............4-4 ++4-++++4 4
Plan Chedt 117'J
TY OF TIGARD Residential Building Permit Application Recd By
1125 SW HALL_ BLVD. New Construction Additions or Alterations au.Recd
;GARD. OR 97223 Single Family Detu:hed or Attached (Duplex) Date to PAL -r
503-639--1171 Oat*to OST
X03-6F4-T 297 P,e.mmdt� T �' ` s Q /
Print or Type called I G
-Incomplete or illegible ap lications will not be acct bd
Name of Prolect Name
Job
Architect IuatIMtOAddtttiaa
Address 3L �' r!.
__------ i?_'-. ;� t�, �• „- � � sire
tells,
ZIP
Nai��. r„ N 4 LAR Z.5
Owner AWN" , ,�
( ,r 7 (I A-1
C. rstaaEngineer umll0Adill"m
�.i a° a 1 T _.r
Nam. Citylstate p ZO am
�( ^� _ !ti JOEY,:,
General ' t rd —Desrnbe worts Newt Addition o Alteration o Repair O
Contractor Malw7 Address to Do done:_
) &t v, k'Xi 1, 14(/'jV1 AdditnM DeMption of Work:
ayiState Phone
Ov - t'
Oon Const Coto ata LiaM
Attach Copy of (
current COTjjusiness Tax or Metro ri PROJECT
Ucenses a 7 I VALUATION
Nair,.
I
NEW CONSTRUCTION ONLY:
Mechanical A q �-�P�./Iti., ¢ (, --
Sub- Marling Address I Sq. Ft_ House: Sq. Ft_ garage
:ontractor _ �Lk, �-, A Corner Lot YES Flag Lot YES ,NQ
C+ryrstaa Zip hone (qi�one) _ (check one)
ix I- 7 ),
Oregon Cotat.Cont. Board t.,c.N Exo,,Igo Restnct'ed Audio/ tereo Burglar
.ttach copy of (�,r�-,< <_I'1 I / Energy System Alarm
Current CPT Business Tax or Metro a.- EX0,Date Installation Garage Door HVAC
Uconses Name - _ I Opener Systems
(+:heck ad that Other
Plumbingr'-fix,, ( Pi, apply)
Sub- Maiung AddressWill the elecmcal subcontractor wire for all {ES NO
Contractor I I restricted energy installations? �•r
ltate Zia , one Has the Subdivision Plat recorded? N/A NO
l
i %r i_-170
Oregon Const.Cann. Boom L cat Exo Dao Reissue of MST#7. Solar Compliance
Attach Copy of
(Calculation Attached)
Current Plumbing LIQ 0ono•tit I hearby acknowledge that I have read this application• that the
COT Business Tax orMetro tea Date
Licenses - it„ormation given is correct. that I am the owner or authorized
i n
�}_;r• I agent of the owner,and that plans submitted are in c;impliance
_ Name with Oregon State laws.
Electrical I 0 Signature of Owner/Agent I Date
Sub- Mading T+dress Contar.1 Person Name
I, Phone M
Contractor 1 1"17”, y 4 4 - 79 0,
C rstate Zip Phone FOR OFFICE USE ONLY:
v( - Plat# _ Map,TL;r, �
0�on Const Cont.Boars L,c.a1 Exp gats l r z,j �
Attach Copy of '7-1 r _ (1 '' a Setbacks: e: solar
Licenses F-4c0 1 Lc.0 FSO.P ata _ �'� I � I P� i' �4 rA'l
Licenses
COT Business Tax or Metro t o -- Engineering Approval: Planning Approval: rIF:
I SFAPP COC (DST) 4d97
Permit* Acct. Descritpion COT WACO Amount Amt Pd. Bal. Due
MST. Permit (BUILD) (UBUILD) �D�, _y_
Plumb. Permit (PLUMB) (UPLUMB)
Mech. Permit (MECH) (UMECH)
ELC/ELR Permit (ELPRMT) (UELPMT)
State Tax (TAX) (UTAX) •s�, x� $
BLDG:
PLUMB:
MECH:
ELC/ELR:
Plan Check
MST: (BUPPLN) (UBUPLN)
Plumb: (PLUMB) (UPLUMB)
Mech:
(MECPLN) (UMEPLN)
COC Review(BUILD) (CDCBLD) (UCDC) e a o L
CDC Review (PLN) (CDCPLN) N/A r U U
n GU Pa77—
u
Sewer Connon (SWt!SA) (USWUSA)
Reimbur. District ( ) ( )
Sewer Inspection (SWINSP) (USWINS) 3.)
t9,0
Parks Dev Charge (PKSDC) N/A �J Gi �C�.s''>✓
i
Residential TIF MF-R) (UTIF-R) '� �G4;10
Mass Transit TIF (TIF-W) (UTIF-M) 3
Water Quality (WQUAL) (UWQUAL)
Water Quantity (WQUANT) (I IWQANT) j'
Erosion Control Prmt (ERPRMT) (UERPMT)
.. f1
Erosicn Planck/USA. (ERPLlq) (UERPLN) d�0' ��" _p�j• ''
Erosion Planck/COT (EROSN) (UEROSN) opt'
Fire L;fe Safety (FLS) (UFLS) oe
TOTALS: — _ ►�1.� ..,-SU "• '_ .Now
11PAPP DOC (DIM 4197
91 Jul 22 14 10 21 R`.LT'LT64HW ',At URN(MR R.I
22395
(MIRRORED)
(912 ROOF PITCH)
8Y
RW FULLERTON
1� PH 297.4433
CITY OF TIGARD
HILSHIRE WOODS
S 0'3b'38" W.,.— �p0 LOT 64
— _ _ — 75.00' _ � _ ___.
( 8,148 S0. FF)
p
"'1 Ili'I�o
N , MAIN FLOOR I C o
a,lo EL =337 0' Z ;•,
C? co
b+ N 29' 6
1 II II
h
Pu
,
L+ G3A ,EI i 1
lk
_ 13• ! 1
A' CGNC Sl1.7 FFMCf
o, DRIVEWAY o
13500 P.S LI
N '36'38" *-; �y9
PSL• t 75 00' \)JLJER --�
400fJ:(p —r— --- —
i5�w7"uT ---- METER " pl P �IATE12
17.9110 S W ASCENSION DRIVE
ORIUINA
07/22/97 MRR
ALAN LANCED DESIGN ASSOCIATES r
ig 40 LIABLE cOR 111E ACCLAtAGr OF
iME /
igVOWA kI Y Of 74 itON it A 0 SOLE
ALL Sit+S GOND D< 111E @MDMUDI R N vFILL
ALL ytE CONDITIONS INClUpNO ANY Flll
ANON t4 SITE AND INFORM OWNERS
Of Y
DL ANoq ipNflAL cFlO 11OOiICAt10N5
A L A n 11A / COPD D C f I I n Ail0CIAIC /
1305 N VV 18T1-1 AVENUE PORTLAND OREGON 97209 15031 225-9161 S C A L E 1 2 0 0