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Case File r N N W U] E by r H ;U d p 1 I� r� I 4 I I GH 1w ggns Ms GEM �" CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Lin#-: 639-4175 Business line: 639-4411 BUP Date Requested AM/o</j PM BLD Location /d a 3 5�_-1-'x�({ !�< ✓Z�'� Suite MEC C ' t;ontact Person , �o h n ave... Pn ��7G> V? k1c RLM Con tr r _ Ph _ SWR ftm!121 Tenant/Ownar ELC Retaining Wall ELR Footing Access: 1� Foundation b&&,Lv"V, /01 + fir,,— FPS Ftg Drain Crawl Drain Inspection Notes,.- SGN Slab �. ' �. � ��C�L SIT Pist&Beam Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation Drywall Nailing _ -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — -- — Roof Misc:� .—_ --- ------ -- -- 11ASS PART FAIL -- -- - ---- -- uMBING Post&Beam Under Slab Top Out -------- Water S3rvicc Sanitary Sewer - - - - - - - -- —__------ Rain Drains _ Final PASS PART _ FAIL -- .ECHANICAI3.._, � — ------- _-- -- _ —_. _ Post&Beam — — Rough In Gas in -- — ---- — Spw�e pers Final --- ---- — _------ ----- PART FAIL_ IrWTIRICAI DI i rvce D -I -----— ---- -- ---- ------— Low Voltage t n �l - ---__�_—_--- - ---------•-- ----- Fir ar _— i AS PART FAIL Backfill/Grading — --' - —� -- -- Sanitary Sewer Storm Drain ( J Reinspection fee of$ _required before next inspection. Pay at City Hall. 13125 SW Hall Blvd Catch Basin ( J Please call for reinspection RE: — [ J Unable to inspect- no access Fire Supply Line — --- ADA Z�► Approach/Sidewalk Date 1 �( Inspector _— —Ext Other _! Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. M CITY OF TIG,ARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Li;ile: 639-4175 Business Line: 639-4171 - -�-�� B U P - ------- __—Date Requested__ __—AM 'PM BLD Locations X35 Sw, , �f v�� _ Suite - MEC Contact Person 1,e _ Ph 5 PLM Contractor Ph SWR -- BUILDING Tenant/Owner FLC ---- — Retainino Wall ELR Footing Access -^ -�- Foundation FPS Fig Drain --• - SGN Crawl Drain Inspection Notes: - -- Slab --- _-- SIT Post&Beam -- Ext Sheath/Shear ;nt Sheath/Shear Framing Insulation - Coywan Nailing ------ IFirewall -- -- - Fire F;: inkler Fire Alarm Susp'd Ceiling — Roof Misc: - Final -^ PASS PAR? FAIL PLUMBING__ Post& Beam Under Slab Top Out Water Se vice _ Sanitary Sewer Rain Dra'ns Final PASS PART FAIL_ MECHANICAL Post& deam - - --- -- - Rough In Gas Line Smoke Dampers Final _ PASS PART FAIL ELECTRICAL -------- -- Service Rough In UG/Slab Low Voltage Fire Alarm - - �IP�-ASSPORT FAIL _____ Backfill/Grading ---- - -- - --- - -- — Sanitary Sewer Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Lire ( ]Please call for reinspection RE: _ ( I Unable to inspect-no access ADA Approach/Sidewalk Other Date _ _ Inspector 47A _Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION Msr �C�ll�� 24-Hour Ins[?,xtiofr Line: 639-4175 Business Line: 639-4171 BUP Date Requested �� d y � AM PM— — BLD Location Suite _ — MEC _ Contact Person _ ��h {�1 �._. _ F'n _�5 90 159(0 PLM — Contractor _ Ph SWR BUILDING Tenant/Owner _ ELC Retaining Wall F.LR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: 3GN --- Slab SIT Post& Beam --- ----- Fxt Sheath/Shear Mt Sheath/Shear ��— ------- -- Framing Insulation Drywall Nailing Firewall _.-- ----_� Fire Sprinkler Fire Alarm Susp'd Ceiling Roof - - --- -_. Misc: Final - -- _ PASS RT FAIL LU BI &Beam - - - Under Slab Top Out - - - Water Service (Sanitary Sewer - Rain brains PAR1 FAIL k4MHANICAL Post& Beam _ Rough In Gas Line - - Smoke Dampers Final - - PASS PART FAIL ELECTRICAL -- - Service Rough In --- ----- ---- ----- UG/Slab Low Voltage Fire Alarm Final --- PASS PART FAIL SITE Backfill/Grading -- - -- Sanitary Sewer Storm Drain [ J Reinspection fee of$-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: _ [ J Unable to inspect-no access ADA l� Approach/Sidewalk / Other , Date �' _ InspectorExt Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. �� I��D _ ELECTRICAL, PERMIT PERMIT#: ELC1999-00328 DEVELOPMENT SERVICES DATE ISSUED: 6/1/99 13125 SW Hall Elvd., Tiqard, OR. 97223 (503) 639-4171 PARCEL: 2S110EJ-01600 SITE ADDRESS: 12235 SW BULL MOUNTAIN RD SUBDIVISION: ZONING: R-1 ui_Ot-K: LOT : JURISDICTION: TIG Project 'Jescriotion: Service or feeder to 200 amps and branch circuit PRESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: :IGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): _ SERVICE/FEEDER �� BRANCH CIRCUITS_ ADD'L INSPECTIONS 0 - 200 amp: 1 W/SERVICE OR FEEDER: 1 PER INSPECTION: 201 400 amp: 1 st W/O SRVC OR FDR: PER HOUR: 401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ _ PLAN REVIEW SECTION__ '1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: _ _-_ SVC/FDR >= 225 AMPS: CLASS AREWSPEC OCC: Owner: Contractor: BRET/PAM JOHNSON PARKIN ELECTRIC INC 15665 SW BUIL MOUNTAIN RD 20250 S MOLLALA AVE TIGARD, OR 97224 OREGON CITY, OR 97045 Phone: Phone: 246-1301 Reg #: SUP 4241S LIC 35151 ELF 34-4C FE'S Required Inspections Type By Date Amount Receipt — Elect'I Se-vice PRMT BON 6/1/; $65.00 99-315806 Elect'I Final 5PCT BON 6/1/9: ?11.25 99-315806 Total $F .._5 ORIG11 � This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws Ah work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or 4work is buspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set frith in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-198' Permit Signature: LT �� .0�� _ Issued By: ------OWNER INSTALLATION ONLY The installation Is being made on property I own which is r,ot intended for sale, lease, or rent OWNER'S SIGNATURE: —_ DATE: CONTRACTORINTALLATION ONLY SIGNATURE OF Sl1PR. ELEC'N: DATE:— '-�--�_ ----- ---�--- — --- �- --- LICENSE N O: ------ - - ---�._ — -- -------- Call 639-4175 by 7:00pm for an inspection the next business day CEIVED Commun;ty Development ELECTRICAL PERMIT APPLICATION 1 125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. UN �,1G161 Phone (503) 639-4171 Date Issued -1`) WV N• FAX (503) t 94 7297 CITY OF TIGARD TDD No. (5C3) 684-2772 Issued by Inspection (503) 639-41 75 1. .fob address: -- 4. Complete Fee Schedule Be.'ow: 1 Name of De velopmenttl � / SL✓ /.�+' /`/ / Number of Inspections per permit allowed — Address1 d�13� '5 �{ /72 Service Included Items Cost(da) Sum City/State,7lp / /��/L.�, I�)• 4a. Residential- per unit 1000 eq I I m 1064 _ $11000 ( )-1 VQ'U(SO✓l Each additional there 500 sq It or Name or name of business)-& / gonion thereof $2500 ' Commercial 0 Residential❑ Limned Energy =7.500 Each Manul'd Home or Modular Dwelling Service or Famrtn, sm 00 Parkin Electric, Inc 20250 S Molalla Ave. 4b.Sarwces or Feeders Oregon City,OR 97045 503-657-4958 fax:557-1059 Installation,alto ration,or relocation Q 200 amps or lees _L sow oo Contractors License# 34.4C exp. 10-01-99 201 amps to 400 amps $8000 Supervisor: 4241-S exp 10 01-01 401 amps to 800 amps $12000 — 601 amps 10 1000 amps $18000 Contractors Board Reg#:?j151 exp. 10-12-00 Over 1000 amps or volts $34000 Metro f/ 2.416 'xp I t-0 t-911 Hecunned only -- x5000 Owner: 4r. Temporary S,)rvices or Feeders Installation alleration.or relocalicn Signature of Supr. Elec'n 200 amps or lase $5n on License No. Phone No. 701 amps to 400 amps ---- $7�oo 1,-- - - 401 amps to 800 amps $loo 00 Over 800 amps to 1000 vans 2b. For owner instr Ilations: see W above 4d. Branch Circuits Print Owner's Name— New,alteration or extension per panni Address a)The tee for branch arcuns with City — State Zip r purchase o/service or boder Ase. Each branch circuit $5 n0 Phone No. b)The tea lot branch circuits without The installation is being made on propert: I own which is purchase o/*souks or Raeder hoe. not intended for sale, tease or rent First branch circuit $31,00 Ead.addAronal branch ca ud -- MOO Owner's Signature 4s.Miscellaneous (Service or feeder not included) 3. Plan Review section (it required): Each pump or irrigation arae $40w Each sign or outline lighting $4000 —_-- Signal crrcurl(s)or a Ixnded energy Please check appropriate item and enter lee in section 58. panel.alteration or extension $40 CJ 4 or more residential units in one structure Minor Labals(10) _ $too oo Service and feeder 225 amps or more — System over 600 volts nominal 41. Each additicnal inspection over —_Classified area or structure containing special occupancy the allowable in any of the above as described in N E.0 Chapter 5 $3500 Pw not• $55 00 _ h,Picini �� $55 00 Submit 2 se,a of plans with application where any of the above apply. Not required for temporary construction services. �. Fees: NOTICE 5a. Enter total of above foes $ 5%Surcharge(.05 X total fens) $ PEOWTS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Ente-25%of line A for CONSTRUCTION OR WORK!S SUSPENDED OR ABANDONED FOR Plan RoViiw if required(Sec.3) $ A.PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED ❑ Trust Account N $ Balance Due $ —tt—fty w Pm Ott TY OF TsGARD ORIGINAL MASTER PERMIT PERMIT M h1ST1999-OJ160 DEVELOPMENT SERVICES DATE ISSUED: 4/2e/99 13125 SW Hall Blvd., i igard, OR 97223 (503) 639-4171 SITE ADDRESS: 12235 S'N BULL MOUNTAIN RD PARCEL: 25110^C-01600 SUBDIVISION: ZONING: R-1 BLOCK: LOT: JURISDICTION: TIG REMARKS: Add new porch, and deck and doing interior remodel and adjust roof from hip to gable. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED _^ CLASS OF WORK: ALT HEIGHT: 24 FIRST: of BASEMENT: of LEFT: 42 SMOKE DETECTORS. Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: of GARAGE: al `RONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS. 1 FINBSMENT: of RIGHT: 60 VALUE: $50.000 00 rJCCUPANCY GRP: R3 BDRM: 1 BATH 2 TOTAL: at REAR: PLUMBINr- SINKS: 1 W'.TER CLOSETS: 2 WASHING MACH. 1 LAUNDRY TRAYS: RAIN DF.AIN: TRAPS: LAVATORIES: 2 UISHWASHER6: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 2 GARBAGE DISP: WATER HEATERS: WATER LINES. BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL _ FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: ! CLOTHES DRYER: 1 GAS FURN>•100K: UNIT HEATERS: HOODS. OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 5 WOODSTOVES: GAS OUTLE-,S: _ ELECTRICAL RESIDENTIAL UNIT_ SERVIn_E FEEDER T!MP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS AUD'L INSPECTIONS 1000 SF OR LESS: 0 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 5009F: 201 400 amp: 201 400 amp: tat W/O SVCIFDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 -600 amp: 401 1,001 np: EA ADCL SR CIR: SIGNALIPANEL: IN^LANT: MANU HMISVCIFDR: 601 • 1000 amp: 601*amps.I IOOv: MINOR LABEL: 1000+amplvolt PLAN REVIEW SECTION Reconnect only: >-4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRIC'.L•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMEPCIAL AUDIO&STEREO: VACUUM SYSTEM: A'JDIO&STEREO: FIRE ALARM: INTERCOM/PAGING OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 706.26 BRET/PAM JOHNSON CRAIG LARSr)N INTERIORS This permit is subject to the regulations contained in the 15665 SW BULL MOUNTAIN RD 10010 NW 4TH AVE Tigard Municipal Code,State OR. Specialty Codes and TIGARD,OR 97224 VANCOUVER,WA 98685 all other applicable laws All woo rk will be dune it accordancewith approved plans. This permit will expire N work is not started within 180 days of issuance,or if the work is suspended for more than 180 dans. ATTENTION Phone: 639 1602 Phone: 3P.0-574.5705 Oregon law requires yo„to follow rules adopted by the Oregon Utility Notification Center Those rules are set Reg#• LIC 55390 forth in OAR 952-001-0010 through 952-001-0080 You may Obtain coplos of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion 844-8444 PLM/Underfloor Rain drain Insp Fooling Insp Mechanical Insp Mechanical Final Post'Beam Structural Plumb Top Out Plumb Final Post/Beam Mechanica Framing Insp Final Inspection Undertloor insulation Insulation Insp Building Final Issued By Permitte e Signature r Call (503) 63q--4175 by 7:00 p.m. for an inspection needed the next business day % Reed By_ OF TIGARD Residential Building Permit Application Chec 13125 SW HALL BLVD. New Constructior TIGARD, OR 97223 Single Family P.ttacf,ed Date Rec'd �� _ V 503-639-4171 9 y Date to P.E. Date to DST F 503-684-7297 -� � Permit#/k,F-/fff-6c3� Print or Type called -1'2a Incomplet or illegible applications will not be accepted _ N.ine of Project - - - - - - - -- _ - Name,,,- Job r,0, ,� _ �ie�h,o•�G( �LC� ti-I.1 r Address Site Address - Architect Mailing Address / !?,.SII 4 (L n-1 f't� " l t f~' -- City/Slate Zip Phone Name (�ro,w+ � `7 Z � ��- � r•,r v, ��Y,_�t�e Tit -s.•.�. -- Owner Mailing Address Name /.'1 6,.S 1.w. lr: LA It 1144 12 . .1 f3��'' - Mailing A, ress City/State Zip Phone(-,V-,, I') Engineer II g -?,6 Cil,,6tate Zip Phone General Na �, n �� Zz7 •• Contractor Krn r+k. Lex it ITV1+cf l Describe work New O Addition* Alteration& Repair O Maili g Address to be done J d ,,, ,. Prior to permit r ; „ A V,r,N< Additional Description of Work: issuance, a copy City/State Zip Phone 3 c- __A.1 -• ►" �.� •w h' 1 of all licenses V- are required if Oregon Const.Cont.Board Exp.Date PROJECT _ expired in COT Lic# VALUATION_ database Mechanical Name / A,,�ery. NEW CONSTRUCTION ONLY: Sub • ,i- ,x•._uw. ktR•I�-. Z„ Sq. Ft House Sq. Ft. Gcrage Contractor Mailing Address Prior to permit 5 :-3 (,-' N - I �� (G� Indicate the restricted energy installation by the electrical areas_ issuance,a copy City/Stale Zip Phone subcontractor in the followin- -- -� -of all licenses leviz. "it._ �:,� 3 r; Restricted Audio/Stereo are required If Ore on Const.Qpnt.Board Exp.Date r Energy S stem Alarms _ expired in COT Lic.# t?,f%i}t (1 9�I /p _ �A � Installations Vacuum Irrigation database System System Plumbing Name �a.� l- k q (check all that Other: Sub- :�.,�,n.t, .�,. apply) t" �'l Contractor Mailing Address Number of Units In Building Unit Number Designation k"-,I { SE Lar A Hes the Subdivision Plat rocorded? N/A I YES [NO Prior to permit City/State Zip Phone issuance a copy P,X i'l.,,J Ctz_ 1772, 2"i^, -?�, r of all lir.anses are Oregon Const.Cont.Board Exp.Date -equired If I u:# Z�, y — — e.;,pired in COT �' I Nearby acknowledge that I have read this application,that the da -case Plumbing Lic.# Exp. tinformation given is correct,that I am the owner or authorized agent 9 -Date.� of the owner, and that pla.is submitted are in complian.e with Ore on State laws - Name Signa f Owner{Agent Da e Electrical r� �_i h �(.�.c.1sr rr, -` •-• �//—^ Sub- Mailing ress �ontac Per on fy�me hone# Contractor :.-- :. ;�� /' //A A l.e. City/Stateip Phone Prior to permit issuancr• a copy de-- „ 'e, liNIIr f y i c ! +. of all licenses are Oreon C I.Cont Bo Exp.Daie FOR OFFICE USE ONLY- of required if Lic.# Plat# Map/TL#: expired in COT c l S/ (:) , L-�. - -- 5 �/0BLr -Ol(cc database EI rival Lic.# hExNDate p Date S cks: Zone: 3 ._ 4C. _ r ""f1 L - 1 Electrical Supervisor Lic # Engineering Approval: Planning Approval: i\dale%fnrmelafa-new doe 11/20/98 25- • I f3re-,+J04 1 � I c i �a h - � 3d 1 .l M e l � �b 1 ^ , r CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd,, Tigard, OR 97223(503)639.4171 i i RECEIVED FFb Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. UNITY VVEI.OPPi" Tigard, OR 97223 Planck/Rec. # .�.,� Permit # �1,6 .,7 )- Phone )-Phone (503) 639-4171 Date Issu - CITY OF TIGAIRR► FAX (503) 684-7297 Issued bA' �� ,��.�-77 f DD No. (503) 684-2772 -- Inbip"tion (503) 639-4175 1. Job Addres-: 4. Cornplete Fee Schedule Below: Name of Develtripment ! Number of Inspections pet permit allowed Address 12225 &L .6U11 /yT. O -/ Service included Items Cost(ea) Sum City/State/Zip_ I/ D� /0102`7 4a. Resi,.;entiol- per unit D0 4 1000 art It or lose $110 0.) Name (or name o usiness) - hr LS or) Each addthorwi 500 sq it or portion thereon -y $25 00 1 Commercial❑ Residential E'moed Energy $25 00 Each Manul'd Horne cr Modular 2 Dwelling Smvire or Forder $6800 Parkin Electric, Inc. 20250 S Molalla Ave. 4b.Services or Feedero Oregon City,OR 97045 503-657-4958 fax:557-1059 Irrdauation alteration or relocabo 1 2 Contractors License# 34.4C exp. 10-01.99 200 amps or leab $60 00 2 Supervisor: 4241-S exp. 10-01.01 201 amps to 400 amps $6000 2 401 amps to 600 amps $12000 2 Contractors Board Reg#:35151 exp. 10-12.00 601 amps 10 1000 amps S1R000 2 Metro 11 2416 exp 11-01-99 Over 1000 amps or volts $34000 _ 2 Owner: Reconnect only $5000 4c.Temporary Services or Feeders Installation alteration,or relocation Signature of Supr. Eler'n 200 amps or lees $5000 License No. Phone No. 201 amps to 400 amps $7500 _ 401 amps to 000 am pe $10000 over 600 amps to 1C)0 volts 2b. For owner installatl°ons: sea-b•above 4d. Branch Circuits Print Ownir's Name New allpraiion or extension per panel Address a)the lee fol branch circuile with CityState Zip purchase or service or feeder W. r Phone N0. Each branch circuit $500 h)The foe for branch circuits without The installation is being made on property I own which is purchase or service or feeder fes. _ not intended for sale, lease or 'ant. FirstEact branch circuit $3500 additional branch arcu,l $500 Owner's Signature _ _ 4e. Miscellaneous (Service or feeder not included) 3. Plan Review section (it required): Each pump or itrigation circle $4000 _ Each sign or outline lighting $4000 Signal cimuil(s)or a limited energy Please check appropriate item and enter fee in section 5B. panel elle-ation or extension $4000 4 or moue rosidential units in one structufe Mmor I antis(10) $10000 Service and feeder 225 amps or more ---System over 600 volts nominal 41. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N E C Chapter 5 Per inspection _` $1500 Per hour $5500 Submit 2 sets of plans with application where any of the above In Plant $5500 apply Not required for temporary construction services. 5. Fees: NOTICE So. Enter total of aoove fees $ ��D 5%Surcharge(05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ jzo 1:2 AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plen Review if required(Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME X TER WOr4K IS Subrora� $ / COMMENCED ❑ Trust Account ll $ Balance Due s 07) .'wfeeRW'nWt'gT�q