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13832 SW ALPINE VIEW
i
MAS"FER PERMIT
CITY OF TIGARD DaTLIISSUED: ' 12/04/9�J
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171 E-'ARCGL: 7'S 11Z19f3A—HS247
ITL (IDDRES)S. . . : 13832 SW faLP I Nr U I I W 7 CIN I NG:
iUlaO I V I S I ON. . . . :
CAL.-(ICK. . . . . . . . . . L.01 . . . . . . .
. :X47: -
Remarks: path i ,, J
BUILDING ��-c,!'t�.C�Le._t�GC..Y►�t�yY�•�5��.-----z==-----
FEISR E: STORIES.......: 2 FLOOR AREAS----------- BASEMEN 0 if REQLIRED SETBACKS---- REWIRED------------
-LASS OF WORK.-NEW HEIGHT,....... : 33 FIRST....: 1308 sf GARAGE.....: 792 if LEFT........... 7 SMOKE DETECTRSt Y
TYPE OF USE...,SF FLOOR LOAD..... 40 SECOND...: 1658 if FRONT....... .: 48 PARKING SPACES: 1
tYPE OF CONST.:SN DWELLING UNITS: 1 FINDSMENT: 0 sf RIGH..,....... 7
OCCLIPANCY GRP.-'R3 BDRM: 4 BATH: 2 TOTAL-------: 0 if VALUE 004668 REAR.......... . 40
--------------------------------------------------
INKS.. 1 WATER CLOSETS„ C WASHING MACH..: 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 0 TRAPS.........: k
ASEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS..: a
VATDRIES....: 5 DISHWASHERS...: l FLOOR DRAINS..: 0
'UB/SHCWRS...: 3 GARBAGE D1SP..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW GREVNTR; 1 GREASE TRAPS..:
------- OTHER FIXTURES:
-- ----�'
-------- ------------------ - --
IECHANICX ---- ----------------------------
DUEL TYPES----------- FURN f 100K ..: 0 BOIL/CMG ( 3HP: 0 VENT FANS.....: 4 CLOTHES DRYERS: 1
iGAS/ ! / FURN )=100K ..: 1 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: 1
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES...... 8 GAS OUTLETS...: I
----------- --- ELECTRICAL --------------------------------..-------------.....----------
—RESIDENTIAL. UNIT--- ---SERVICE/FEEDER----- --TENP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPELTION --
1x00 SF OR LESS: 1 0 - 200 alp,.: 0 0 - 200 alp..: 0 W/SVC OR FDA 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5005F. : 4 201 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR,..... : 0
LIMITED ENERGY,: 0 401 - 600 ago..: 0 401 - 600 amp.-: 0 FA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT,.....: 0
MANF HM/SVC/FDR: 0 601 - 1000 age.: 0 601+a1ps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp volt, 0 -------------------------------------- PLAN REVIEW ''ECTION -----------•----------------------
:
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR-225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC;
----------------------------- ELECTRICAL - RESTRICTED ENERGY ----------------------------------------.---------
A. SF RESIDENTIAL---------------------------- B, COMMERCIAL----------------------'---'-
-------------------------------------------------
',IO & STEREO. : VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM,PAGING: OUTDOOR LNDSC LT:
":,RGLAR ALARM„: OTH: X BOILER......... , HVAC..........,: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK.......... . INSTRUMENTATION: MEDICAL......... OTHR: :•
HVAC. DATA/TELE COMM. : NURSE CALLS.... : TOTP'- A SYSTEMS: 0
Owner: ----------------- Contractor: ----- -------------------- 'OTAL FEES:$ 2664.81
LHI. CONSTRUCTION INC LHL CONSTRUCTION INC
.0 SW FIR LOU '7110 5W FIR LOOP
:TE 160
i6ARD OR 97223 TIGARD OR 97223
Phone N: 624-7714 Phone t: 624-7714
Rea N..: 53769
This permit is issued subiect to the regulations contained in the Tiga-d Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work wtil be done :n accordance with approved plans. This permit will expire if week is not started within 180
days of issua-ce, or if work is suspended for more than 180 days,
------------------------------------------------------------ REOIUIRED INSPECTIONS ------------ -----------------------•-----------------
Foot:ng Insp Ple/undslab Insp Electrical Rough Insulation Inso Appr/Sdwlk Inso Erosion Control
Foundation Inso PLM/Underfloor Framing Insp Gyp Board Insp Electrical Final
Post/Beam Struct Mechanical Inso Low Voltage Rai;. drain Insp Mechanical Final
Pos:/Beam Meehan Plumb Too Out Fireplace lnsc Water Line Insp Plumb Final
Crawl Drain Electrical Servi Inso Water Service In Buildino Final
t,e mittee aignatrar e: 00.
� Issi.ted Py :
La 11 for inspection -- Cb39--41•/5
Community Development ELECTRICAL_ PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # —
Permit #
Phone (503) 639-4171 Date Issued
FAX (503) 684-7297 Issued by
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
�,l�frt ( Number of Inspections per permit allowed
Name of Development / l r rr,, N L _
Address 13 i C r /,),. . \�1 T�.. Service included Items uost(ea) Sum
City/State/Zip /Cyrz IZ `�7 i-)_ 3
4a. Residential. par unit 4
1000 aq It or lose $11000
_ Each Additional 500 sal h or
Name (or name of business) JL�� 't %I r-'t 1 portion thereof $2500 '
^
L'mood Energy $25 00
Commercial LJ Residential Each Manuld Home or Modular 2
Owellrng Service or resoer S66 00
2a. Contractor Installation only: 4b.Services or Feeders
- Installation.alteration at relocation 2
Electrical Contractor F' 200 amps or less $6000 2
� - - 201 amps to 400 amps $8000 2
Address S L i1"c?n /�7�/�5 401 amps to 800 amps $12000 2
City_ "i State 0K ZIP 601 amps to 1000 amps $18000
Phone No. 9.,Z) 5U,^ r F �Ci - S 3 Over 1000 amps or volts $34000 _ 2
~• �`'�'— RFw.onnpcf only $5000
Contractor's License No.-- .3 il !� C
Contractor's Board Reg. No. ` 53`/ 'Z Z r/6' 4c.Temporary Services or Feeders
/) /1 f Installation alteration or relocation 2
I J 200 amps or less $50 00 2
Signature of Su r. Elec'naUl'. 0 � 2
_ Phone No. �} 201 amps to 400 amps $7500
License No. •Sy .__ �,y � 401 amps to 800 amps $10000
Over 600 amps to 1000 volts
2b. For owner Installations: see•b•above
4d. Branch Circuits
Print Owner's Narr a New altpretior oi eKlension per panel
Address __ a)The fps for nrarch clrrtllls With
purchase of service or Aueder W. 2
City __. State ZIP _ Each branch circuit $1,00
Phone No. b)The fee for branch circuits without
purchase of ssrvirs or Aseder Am. 2
The installation is being made on property i own which is First brarrh o,ri t $3500 2
not intended for sale, lease or rent. Each additional branch circuit $500
Owner's Signature _ 4e. Miscellaneous
(Service or feeder not Included) 2
[]
Each pump or irrigation circle $40 00 2
3. Plan Review Section (if required: Each sign or outline lighting 54000
Signal cvruAls)or a limded erargy 2
Please check appropriate item and enter fee in section 58. nanpl a"Pral on or et4ensron $4000 _
4 or more residential units in one structure Minn,I abwls(101 $10000
Service and feeder 225 amps or more 4f. Each additional inspection over
System over 600 volts nominal
Classified area or structure containing special occupancy the allowable in any of the shove
._ Per rroprhon $3500
as described In WE C Chapter 5 Per hour $5500
In Plant $55 00 _
Submit 2 sets of plans with application where any of life above
apply. Not required for temporary construction services. 5. Fees:
5s. Enter total of above fees $ _
NOTICE 5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $Enter 25%of tine A for _—
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Plan Review if required(Sec 3) $
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED 0 Trust Account r $
Balance Due $
SEWER CUNNEC ! TOM
F'L RM I T
CITY OF TIGARD DATEI ISSUED:. 12/04/05 , 047:
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223.8100 (503)630-4171 F'ARC:EL_: 2S 1 a9BFa HSi 47
'5 I T1= ADDRESS. . . : 13832 SW AL F'I NE VIEW
3UBD I V I S I ON. . . . : Z ON T NG:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
i ENAN T NAME. . . . . :
USA NO. . . . . . . . . . . F 1 X7URE UNI-rS. . . . 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYf='F OF USE. . . . . :GF NO. OF BUILDINGS: 1
INSTALL TYPIE. . . . :RL.ISWR I M1='F RV SURFACE., 0 f
Remarks : P-:1ATH I
Owner: ____.______._______._____.________.______. . —_.___.__-____—._._ FEES
l_.HL. CONSTRUCTION INC type amol-int by date recpt
7110 SW FIR LOOP' F'RMT 7 RLOO. 00 JSD 12'/01/95 95-273zft�,:,
`:SUITE 160 INaF' $ ;,.5. 00 JSD 12/01/95 `35—`7:34'1
IIUARU OR 97223
Phone #: 62`4-7714
Contract or : _._._._.___-----______-----•--•—____—•
CONTRACTOR NOT' ON FILE
----------------------
1 (hone #: S 2235. 00 TOTAL.
Req_ #. . .
---- --- REQUIRED INSPE'A"T IONS
,his Aoolicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The oermit exo;r•es 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the acc-u•acv of the
side sewer laterals. If the sewer is not located at the measurement
given. the installer mall prospect 3 feet in all directions from
the distance given. It not so located, th installer sna'l rchase
a ''Tap and Side Sewer" Permit and the AV cy will stall lateral.
O
4
I
Call for inspec-tion — 639--•4175
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 [�
Jobsite Address: / 6 .i)- ILAJ / ,4l'�D
r _� (_ Office Use Only
Subdivision: I Uw- 'µ Lot#
Valuation: �x1U c�' 7< Contact Date _ / ! _Initials —
Result //-- c
New Construction Only: (Square Footage) Planck/Rec # —tP, F
Permit #
House: Garage: Rei- ie of
Corner Lot? Y �"N Fla Lot? Y mb,, u TL# 5%�' ,- 5�—
g Zone
^lat #
Owner: CJ.-A jF Lt�' 17(AA fit. c
Approvals Reguired
Address: 7/1 V
►2✓� C Ifs ���j Planning Setbacks _ Solar
y Engineering
Other
Phone: � 1 �� �� 1�/ L/
Items Required
Contractor:
Subcontractors -IRF
Address: _ Truss Details _
Other
Phone: Notes _
�— )
Contractor's License # J 1)4 --
. (atta copy of current Oregon license)
Contact Name. Ul c!< <'17/ ,
Contact Phone:
Subcontractors: 1 1 Architect/Engineer:
Plumbing i� _✓/ ,� ;rV+� l"�1CiT� Address
Mecnanical
(attach copy of currenit OR Contractor's License)
13VYAWOC, k1�CtYtG ;��� \(��i.T/1C^�_ Phone I� - --- —�
JOB DESCRIPTION:
Applicant Signature �— Applicant Phone number
�- . (Yl,u_���.r,._.-
Received by: _ �- _ Date Received
M U0QWdIteveeep0
Permit# Account Description Amount Amt. Pd. Bal. Due
��� 4�• Bldg. Permit. (BUILD) 5 7
Plumb. Permit (PLUMB) ;22 )f _ IV2i
Mech. Permit (MECH) 4.1 U j✓'
[, tate Tax (TAX) l
Bldg: 3 4V/
Plumb: �� Z
Mech: L t
Plan Check (PLANCK)
Bldg: S z• 4 J
Plumb:
Mech:
5cuk4 L,Lqj3 Sewer Connection (SWUSA) 2 2 v 11
3 �
Sewer Inspection (SWINSP) •
Parks Dev Charge (PKSDC) Sc d
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FL.S) _
Erosion Cntrl Permit (ERPRMT) _
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN) 0 4 U U
TOTALS: r Z-�
LffJ
SIERRA PACIFIC
nqD DFVELOPNFNT, Irj( Jb�.J 7
P.O. Box 1754 LAKE OSWEGO, OR 97035 15031 684-3175 FAX 15031 684-3176
TIF CREDIT VOUCHER
PROJECT NAME: HILLS111RE SUMMIT #2, HILLSHIRE ESTATES,
PILLSHIRE ESTATES 12
THIS VOUCHER ENTITLESGur, ►L�c;rzor)
TO ONE ( 1 ) TIF CREDIT FOR LOT 4 -7- IN THE Ili Ugh Lit,
" `�►�� SUBDIVISION.
THIS TIF CREDIT SHALL BE APPLIED BY THE CITY OF TIGARD AGAINST
THE APPROVED TOTAL TIF CREDITS FOR SIERRA PACIFIC DEVELOPMENT, INC.
L'-kj't't tw�t- i
AUTHORIZED SIGNATURE,
OREGON TITLE COMPANY
Credit No.: _
CITY CSF TIGARD Date Issued: /YIAy 215`1195'
Engineering
Authorization
TRAFFIC IMPACT FEE Date:
CREDIT
Land Use
Casefile No.: SUB 91-0013
In accordance with Ordinance 379 Sierra Pacific Development, Iric.
Inanof developer)
is entitled to $ 38,628.25 in Traffic Impact Fee Credits that car bu applied to TIF
charges for development on lot(s) as referenced in the attached Ifitter dated April 25,
1995, from Jeff Nelson, Sierra Pacific of the Hill hire Summl"#2, l-;illshire _states,
Hillshire Estates #2 Development. To use this credit, present this form at the time of
issuance of the building permit.
Dirador C E� ire
(Date Permit Numbers_ _Lot Numbers Credit Used Balance
Beginning Balance 38,628.25
Balance carried forward to TIF Credit No.
Ordinance 379 provides for an expiration 7 years from authorization.
laglnwlde!tIlOA 1 Use Additional pages if necessary.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
BUCKAROO ELECTRIC
16780 3 UNION MILLS RD
MULINO OR 97042
Electrical Signature Form
Kermit # • . • . : MST95-0414
Date Issued. : 12/04/95
Parcel . . . . . . : 2S109BA-HS247
Site Address : 13832 SW ALPINE VIEW .
Subdivision. :
Block . . . . . . . . Lot. :
Zoning. . . . . .
Remarks :
path i
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of wo-k. No electrical inspections will be authorizers until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
ELECTRICAL uONTRACTOR:
LHL CONSTRUCTION INC BUCKAROO ELECTRIC
7110 SW FIR LOOP 16780 S UNION MILLS RD
SUITE 160
TIGARD OR 97223 MULINO OR 97042
Phone # : 624-7714 Phone # : FAX-829-3853
Reg # . . : 89524
X Supervising
Si natuie of Su P ecu ician
9 P 9
Please return this completed form to the address above.
ATTN: Building Dept.
If You have any questions, please call 639-4171 , ext. #310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
BUCKAROO ELECTRIC
16780 S UNION MILLS RD
MULINO OR 97042
Electrical Signature Form
Permit # . . . . : MST95-0414
Date Issued. : 1/04/95
Parcel . . . . . . : 2S109BA-HS247
Site Address : 13832 SW ALPINE VIEW .
Subdivision. :
Block. . . . . . . . Lc�l
Zoning . . . . . .
Remarks :
path i
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER : ELECTRICAL CONTRACTOR:
LH5 CORSTRUCTION INC BUCKAROO ELECTRIC
71.10 SW FIR LOOP 16780 S UNION MILLS RD
SUITE 160
TIGARD OR 97223 MULINO OR 97042
Phone # : 624-7714 Phono # : FAX-829-3853
Reg # . . : ,89524
Signatu e o upervising _ ectrician
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
i
CITY OF TIGARD PLUMPING PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERM I T #. . . . . . . : IrIST95--0414
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 DATE? ISSUED: 12/04/95
PARCEL- t'S 109BA-H5247
SITE ADDRESS. . . : SW AI._P,111E VIEW
SUBDIVISION. . . . : ZONING:
BLOCK. . . . . . . . . . : L.O1.. . . . . . . . . . . . .
CLASS UF- WORK. . : GARBA(.-jE DISPOSALS. . 1
1-YPE OF USE. . . . -,NEW WASHING MACH. . . . . - - : 1 BACKFLOW F'REVNTNS. . : l
OCCUPANCY GRP". . :SF FLOOR DRAINS. . . . . . . : 0 TRA1 '5. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . : 0
F'IX'TLIRES -- -___ _ __ --_- 1-AUNDRY 'TROYS. . . . . . : 1 SF RAIN DRnINS. . . . . : 1
SINKS. . . . . . . . . . . 1 GREASE T"RAPS. . . . . . . :0
LAVATORIES. . . . . .. 5 OTHER FIxTURES. . . . . : it
TUB/SHOWERS. . . . : - SEWER LINE (ft ) . . : 0
WATI7-R CLOSE•T;,. . : 3 WATER L I NE (f t) . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . : 0
�_--mar^ks : path i
UWNE._R: - ---
1_HL CONSTRUCTION INC SWM $ 1130. 00 Y-31) 1c/01 /99 '?5--i�734'53
71 1121 514 F I tl L.OQF, SWM $ 100. 00 JSI? 12/01/95 9`,•-`7.',453
SUITE 160 F I..CF w 1.V1. 00 ,73D l r- -1/95 95-2:7345 .i
TIf3ARD OR 97C.i�w
•,- ; ELC5 $ 10. 50 JSD 12/01/95 97i-27345::,
Phone #: 624-7714 CL RF' 4 40. Oil) .JSD 12:/01/95 i--x::73453
E:LR5 $ 2:. 00 JSD 12/01/95/95 3.5'--273453
f"11 ,m mbang C;ontvactolr : _._.....___._._._....__.__.._._.-- BPRT 4 695. 50 JSD 12/01/95 95-^,7345;;
0A JSD 12/01/95 9., 273,45:,
PF'LC � 4_,.... _IJame : � �vxt, _ . • n5p'(: `1, 34. 78 Jl;D 12/01/95 95-i?134`x?,
Addres : (�y7(q,�� ( rrll�.. _ . _ .. � 1�..:_ __...
PARK 4 500- Ic"IVI JSn 12/01/95 95- 7.":;4t;3
City: ka �Z k� Si at e: , Ir1PRT 1 45. 0111 JSD 1�'.i Q11/9 i 95 27:x453,
Z.ip:# � �(, F'hunetl:.? j�..��.3 MPLC $ 11. ='5 TSD 12:/1711/95 95-c 7.�4.r.,
Additional. fees not 'yhnwrl "'. . . . . . . .
Rpca
----- - - REQUIRED INSPECTIONS
This permit is issued subiect to the reg--
T.rlations contained in the Tigard Municipal Footing Insp Low Voltage
Code. State of Or-e. 5pec-ialty Codes and all. Fol.tndation Insp Fir-eplace Insp
other- applicable laws. V-111 work will be done Post/Beam Str-Act Gas Line In=p
in accordance with arapr-oyed plans. This Post/Beam Mechan Insulation Inst
per^mi.t Nill expire if' work is not started Crawl Drain Gyp Board Inst
within 1E10 days of issuant_e, nr^ if work is Pl.m/i.mrisl.ab Insp Rain dt-ain Insp
suspended for more than 180 days. PLM/Ilnderf loot- Water Line Insp
Mr(_haniral In'3l71 Water Set-vice Ir
Plumb Top Out Appy^/Sdwlk .Insp
Electrical Servi Gler.trical Fina',
Electrical Rough Mechanical Find.
Framing Insp [:-11.Imb Final
d�.ttharized F'l�.tmhing ontr^actor' ,ignaC�lre
Call for' inspec=t ion 639-4175
ontractor Notes :
`
N» - -- -- - -' - --�' --'---'- --- --------'---' ---------~-----'- -------- -- --
�
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
PostJBeam Mech. Shear/Sheath Framing JAech.
Plbg.Und/Fir/Slab Plbg. Top Out insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp, Bd. 40
San Sewer Gas Line A.ppr/Sdwlk Reins.
Other. - ---
Date I �
1 V -- AM ____P.M. Entry:— --
Address:
Teoant: — -- ----- St - -_ MST:
- 3UP:
Con/Owr --- - MEC:.------
—- PLM: ---
ELC: _THE FOLLOWING CORRECTIONS ARE REQUIRED ELR:
Irspec �— _ Date: '
—�1" -
APPROVED _.DISAPPROVED/CALL FOR REINSP. CF CO
SEE 35MM
ROLL# 22
FOR
LARGE
D OCUMENT