10135 SW LADY MARION DRIVE O
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10135 SWI LADY MARION DR
CITY OF T IGA,RU ELECTRICAL.PERMIT
PERMIT#: ELC2004-00281
DEVELOPMENT SERVICES DATE ISSUED: 5/21/2004
111111111, 13125 13W Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111C;B-0100
SITE ADDRESS: 10135 SW LADY MARION DR
ZONING: R-3.5
SUBDIVISION: MARION ESTATES
BLOCK: LOT : 005 JURISDICTION: TIG
Project Uescription: 1 branch circuit to AC.
_ RESIDENTIAL IJtiiT _ _ TEM.!' ORVCIFEEDERS MISCELLANEOUS
1000 SF OR LF SS: 0 - 200 amp: PUMP/IPRIGATION:
EACH ADD'L 500.;F• 201 - 400 amp: SIGN/OUT LINE LT6:
LIMITED ENERG(: 401 - 600 amp: SIGNAL/PANE!.
MANF HMI SVC/FDR: 601+arnps -1000 volts: MINOR LABEL (10):
SERVICE/FE:-DER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION-
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 0 IN PLANT:
601 - i000 amp: PLAN REVIEW SECTION.
1000+ amp/volt: -4 RES UNITS: > 300 VOLT NOMINAL
^econnect only: SVC/FDI? —225 AMPS: CLASS AREA/SPEC OCC.
Owner: Contractor:
MCGREGOR,MARK D+ LYNDIA J GRF ELECTRIC
10135 SW LADY MARION DR 15460 SE PARADISE LN
TIGAr:,), JR 97223 MULINO,OR 97042
Phone: 503-684-4083 Phone- 503-829-4146
Reg #: LIC 76751
- — ----- ---- SUP 16555
FEES _ ELE 1-480'
Description Late Amount
_ Required Inspections
II:I.PRMTj ELC'Permit 5/21/2004 1:46.85 --`—
[TAN R State Surcharge 5/21/2004 $3 /i, Rough-in
lect'l n
F_lect'I Final
Total $50.6(
This Permit is issued subject to thy regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicabl.a laws
All work will be done in accordance with approved plans. This permit will expire if work is not started with.n 180 days of issuance, or if work .s
suspended for more than 180 days ATTENTION: Oregon aw requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set f in.OAR 952-001-0010 through OAR 952-rol-0100 You may outain copies of these rules or direr?questions to OUNC at(503)
2466699 800-332
r G—
Issued y: i.� ,h,Jr�J�� Permit Signature:, ��t - -
OWNER INSTALLATION ONLY
I he installation is being niade on property ! own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURf : _ _—_ _______—�-- ,__N DATE:-----
CONTRACTOR
ATE:____CONTRACTOR INSTALLATION ONLY
SIGNQ t URE (W SIJPR. ELEC'N: DATE:--
LICENSE NO —__—
Call 639.4175 by 7:00pm for an inspection the next business day
Electrical Permit Application fifoll 0I.-I.-'ICE USE OtIN
-- -- --- tseeta�ea
CI of Tigard I'ionning A prov Sign
'J b �. ECEI {.! Uatc/Bw _ _ Permit No.:
13125 SW Hall Blvd. HECEI Review` — ()that — --�
Tigard,Oregon 97223 uretdRx: — _ hermit No.:
Phone: 503-63913171 Fax: 503-598-10;,9 1 Post-Res rw Land Use
Datc/By` Case No,:
Internet: www.ci.tigard.or.us Contact ]•sY See Page z for
24-hour Inspection Iteque,t: 503-639-417*TY Name/Method: �, Suirlrltmental Information.
F�1.RM11iF1V(�i�11r,FHif+t_, -- --- —
TYMOF WORK PLAN REVIEW(Olease check all'that apply)
New construction Demolition Service uver 225 amps- Health-care facility
commercial ❑Hazardous location
Addition/alteration/re 134ement Other-: ❑Service over 320 amps-rating of ❑Building over 10 mut)square feet,
CATEGORY OF CONSTRUCTION I d't 2 family dwellings four or more rerrdential units in
1 &2-Farnily dwelling ❑Commercial/Industrial G System over 600 volts numinal ono strdt:ture
❑Building over three stories ❑Feeders 400:mps or more
AcccSso Building Multi-Family_ � Y _ ❑Occupant load over 99 persons ❑Manufactured stn.-tures or RV park
Mastcr Builder LE Other: ❑Egress lighting plan ❑Other:-
JOB SITE INFORMATION and LOCATION Submit_sets of p ans with any of the above.
The above are not arplieable to temporary construction service.
Job site address: S S r icl :- 14.0 A rj Y r'a FEV SCREDULE
Suite M Bldg./Apt.#: 1�y' Number of ins ections er • -mit allowed
Project Name: A4y,(' Ds serf tlou Q1 I Fee(ea.) Tout
New residential-single or multi-family per
Crov.s street/Directions to Job'5lte: dwelling unit.inc'ades attached garage.
Service Included:
1000 sq ft.or less 145.15 4
Each additional SQU sQ.H.or nionthereof 33.40 1
SUbdiV;olUn: — --TLOt#: Limited energy,residential 75.00 2
_ Limited energy,non residential 75.00 2
Tax map/parcel#: Each manufactured hone or modular dwelling
'- wrvicc and/or feeder 90,90 2
nIESCRIPTION OF WORK
Services or feeders-hntallatlon,
_♦' !;,Y-L��_,t � — alteration or rtloc&O-m:
200 amps or less 80,30 2
-- --- 201 amps to 400 strips 106.85 2
401 ams to 600 ams 160.60 2
OP TV MAR TENANT 601 amps to 1000 amps 240.60 2
/� Over 1000 amps or volts 454.63 2
Name: r;w �4_ /V C_L�t`e iS t ice' [reconnect only � 66,85 2
Address. / / ? �5 _0• LA / A le% 'temporary services or feeders-installation,
alteration,or relocation:
200 arrps ur)ess_ 0.85 _ 1
�Pbone: G Fax: 201 ams to 400 am res _ _ 100.30 2
4111 to 60
AP , :
PLICAN -. ' - CONTACT OERSON, Branchcamps 133.75 2
circuits-new,alteration,or
Name: extension per panel:
Address: A.Fee for branch circuits with purchase of
service or_feeder fee.each branch circuit _ _ 6.63 2
City/State/Zip: _ n.Fec fur b..nch circuits wittinut purchase of
service or feeder fie-,first branch circuit 46.85 Lf lo 2
Phone: Fach addida 0 branch circuit 6.65 2
E-mail: _ Misc.(Service at feeder not included):
r'. COITITRACTOR fachdrumyor irrigation circ!. 5 .40 7
Each si n or outline li hti — 53.40
Job No: Signal circuit(s)or a limited energy panei,
alteration or extension Page 2 2
Business Naline: 6 F—CI-C_ _ � Description: —
Add"re_s_ �— p
Each additional Inspection over the allowable in an of the abovc:
_C� tate/Zip:rM � r 1_ Z
Per inspection per hour tin.I(tour)_ 62.50
Phone: q Fax: Sb3- jf =�Z Investigation fee: _
4 C, other:
Cf;_$ Lic. #: 'Z Lc.#: 3- Electrical Permit Fees* i
Supervising electrician _ Subtotal S Li
s pature required:~ _ - Plan Review 25%of Permit Fee $
Print Name: WjiLic. #: r - _ State 5urchar c 8%of Permit Fee -
// ' r TOTAL PERMIT FEE S 7
Authorized 1.) i G' FJ—•f Notice: This permit application expires if a permit is not obT Ined within
Signature: — _ Date: 180 days after It has been accepted as complete.
Ver methodolop•set by TrWounty Building Industry Service Board.
_-- -- (Please print name)
t\Dsts\F'errnil Fnrm s\i:lcPcrrnitApp.doc 01/03
1 'd LbLS6ZHE0S t���a13 AM9 S1 Few
Electrical Permit---�1-A r ication ' ' ON
------ Received L•lectrical
DatelB : �) Permit No. lJV _
City of Tigard PEC ��,� Datc/ngANprov Sign
atc/By. ^ermit Na..
13125 SW Hall Blvd. Plan Review Other --- ~'
'Tigard,Oregon 97223 —!late/Ry: _Permit No,: _
Phone: 503-639-4171 Fax: 503-598-146661 Past-Hcview — IA td Ilse
Datc/)- ay: _ (ase No.:
Internet: www.ci.tigard.orms Contact It'f's See Page 2 for
__
7.4-hour hispection Request- 503-639-41'�IIY Name/Meth /od: r Sun lemcntal Infm
oration.
TYP&OF WOKK __ PLAN REVIEW t tease check all that apply)
New construction I Demolition Service over 225 amp,- 0 Health-care facility
commercial El Hazardous locatirn
Adu;tion/alteratlt)n/r�]lact mart Other:�_ t]Service over 320 amps rating,if [j Building over 1Q000 square feel,
CATFGORY OF CONSTRUCTION I &2 family dwellings tour or more residential units in
i &2-Family dwelling [ Commereial/lndustrial ❑System over 600 volts norniaal one structure
❑Building over tbrer stories ❑Feeders,%00 amps or more
Ace sso Buildin _M_ulti t anvil
_� ❑Occupant load over 9h tictsans ❑Manufau ed structures..r IZV p;trk
_ Master Builder _ ❑ Other: ❑Egress/lighting plan ❑Other.• _ _ ,
JOB SITE INFORMATION and LOCATION ! Submit__sets of plans with any of the above,
Tne above are not a r rlicable to tent rorar construction service.
Job site address: 3 .5 kl '�G�LI.;! Mr' FEE*SCHEDULE
Suite#: i —� Bld ../A _—_ _ _ Nurnher of ins ectionsper�crmit allnwed
Project Name: tr :/tscri tio❑ Q13, Fee(ca) Total
Ci0S5 SiCCet�lrCCtlOnS IO Ob Slte: New residential-single or multi-famlly per
dwelling unit.Includes attached garage.
Service Included:
I u00 sq ft.or less 145.15 4
Ea_h additional 500 sq.fl.or porticn thereof 33.40 1
Subdivision: —� Lot#: Limited ener ,residential _ 75.00 2
_ Limited end er�y,non residential 75.00 2
Tax ma / areal M Each manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
^ 71ces or feeders-installation,
ration or relocation:
amps or less
- - - .r I amps to 400 amps _ 106 35 2
401 amps to 600 amps 160.60 2
ft
OP TY.OWNIT T NANT 601 amps to 1000 amps 240.60 2
Over 1000 am is or volts 454.65 2
Name: /leiReconnectonl _ 66.85 2
Address: A,1,4.YI-e tom`, Temporary services or terders-Installation,
r alteration,or relocation:
Citv+/State/Zip: ( t c -' G! '� S� 200 amps or less 66.85 1
Phone: L 4 - .n o 201 i-em s to 400 ams 100.30 2
_ 401 to 6U0 ams 133 75 _ 2
APPLICANT,; _ CONTACT P'RSON, Branch circuits-new,alteration,or
Name: extension per panel:
- -- A.Fee fur branch circuits with purchase of
Address: _ service or feeder fee,each:ranch circuit 6.65 2
Cl /State/G(j1. B.Fee for branch circuits without purchase of !
service or feeder Ice,first branch circuit 46.85 2
Phone: _- —__ rax: iiach additional branch circuit 6.65 2
E-mail: Misc.(Service or feeder not included}•
CONTRACTOR Each pump or hrigation circle 53.40 2
Each signor outline li hti_y _ 53.40 2
Jub NO: Signal citcuit(s)nr a limited energy panel,
• alteration or extension Page 2 2
Business Nallbe: 6 Description:
Address: 15- Q_ � �'14 If- A
City/State/Zip: /1/�L,,l�. ��,�r ` Each additional inspection over the allowable In an of the above:
_Ll L— �IZ Z Per inspection per hour min. I hour) _ 62.50
Phone: 23 Fax: 5D3- � Invesliw'tion fee: _
Other:CCB Lie. #: b?55 Lie. #: 3— C Electrical Permit Fees* r
Supervising electrician— — Subtotal S H_4 .
se required: � �^' '— Plan Review(25%of Permit Fce S
Print Name: W M; ,,, Lic. #: (p S S- _ State Surcharge(8%of Permit Fee) S _-
-" Tj� TOTAL PERMIT FEE S J 3`
Authorized 11) '1 64 Notlee: This permit application expires If a permlt Is not obtained within
Signature: _ —_e— Date: _ 180 days after It has been accepted as complete.
*Fee methodology set by 7•rl-County Buildlnp,Industry Service Board.
(Please print name)
t\Dsts\Pemrit Fr rn&,ElcPcrmitApp.doc 01/03
1 'd LbL5GZ8EOS �t�loal � �yO c4s :ao bu 6I I+wW
CITY OF TICARD 24-Hour
BUILDINGInspection Line: (503)639-4175
MST'
INSPECTION DIVISION Business Line: (503)639-4171
( Bt1P
Received -- —__ Date Request —_ AM________PM Blip _— —
Location — 3 S __ _ 11
Suite MEC
D
Contact Person -�__ _. �.._-- _ Ph(_—_—) '�`�s --. PLM
Contractor ---- - --- Ph SWR
BUILDING Tenant/Owner ___—_ f __ ELC
Footing ill ELC _ -
Foundation Access:
Ftg t,,ain ELR __-
Crawl Drain ---
Slab Inspection Notes: SIT
Post& Beam __--- !'�C,A�� "--�
Shear 1nchors l J , Q 6
Ext Sheath/Shear -- - -- -----—
Int Sheath/Shear
Framing --- ---- - - -
Insulation - -�
Drywall Nailing ---
Firewall
Fire Sprinkler
Fire Alarm
usp'd Ceiling - -- -- --Roof
Other:Other: - -. .-- --�--- —
Finol
PASS PART FAIL
Post& Beam
Under Slab --
Rough-In
Water Service -
Sanitary Sewer
Rain Drains - - - _ - - - -----
Catch Basin/Manhole
Storm Drain - -
Shower Pan
Other: - - -
Final
PASS PART FA:L
MECHANICAL ---- --
Post&Beam
Rough-In --- -- - - ---
Gas Line
Smoke Dampers -
Final
PASS --PARI' FAIL ------- _ _- ---_- ---- ----- -- _ _
t -- -
ELECTRICAL
Service
Rough-In -- - -- -
UG/Slab ---- ------ -
Low Voltage — ----- --—----- —_ -- --- --- --
Fire Alarm
rna 7 Reinspection fee of$_ -- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd,
ASS PART FAIL
L] Please call for reinspection RE: Unable to inspect - no access
Fird Supply Line ^ ` -
ADA L
Approach/SidQwalk Onto ._��( _�. Inspector_—_ M1 fl SX Ext
--
Other: --_
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
UILDING Ing do e: (503)639-4175
INSPECTION DIVISION Busine ine: (503) 635-4171 MST
BLIP
Received ---- - . Date Re Rested --�1_.._ AM------ PM .- BLIP
Location �j Suite -- - MEC "0��
Contact Person _--_--_- — - Ph(--_-) .2-3PLM ---_-__-- -_--_
Contractor Ph( ) _ SWR _
BWP DING Tenant/Owner — ELC
Fncting - -- --- —----
Fc,undation Access: ioc mvcncic-tiELC -_------__--. _.---
Ftg gain
Crawl Drain ELF!
Slab Inspection Notes: SIT
Posi& Ueam _
Shear AnLhor8 �1 --- ----- - —--
Ext Sheath Shear � �v
Int Sheath/Shoar
Framing - - - .. --------—._ ------ - _. - -
Insulation �lj�,� d�Y� ✓-� j` lG )
Drywall Nailing �} ( -
Firevvall
Fire Sprinkler -- ------- - - - ---- --- .. - -- ------- .. -
Fire Alarm
Susp'd Ceiling - -- --- — - - - .. -- --- --- ._..._. --- -- --- ..___---
Roof
Other:____ _ -- - - — ---- ------ -
Final
PASS PART FAIL —_ ------- - - - - - -- - --- -- -
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains -- - - -- -- --
Catch Basin/Manhole
Storm Drain - - -- - -
Shower Pan
Other:
Final -
PASS PART FAIL - - - - - -
MECHANICAL
Post& Beam
Rough-In _- - ---- -- - ---- —
Gas Line
Smoke,pampers - - - _ - --
.1
ff
HART FAIL - — - -
R
CAL
Service
Rough-In
UC?/Slab
Low Voltago
Fire Alarm --
Final El Reinspection iee of g� _required before next Inspection. Pay at City Hall, 13125 SW'16;i Blvd.
PASS PART FAIL
SITE Please all for reinspection RE: - Unable to Inspect--no access
Fire Supply Line /
ADA
Approach/Sidewalk Date— �` Inspector - �� Ext
Other: _
F incl - DO NOT REMOVE this Inspection record from\he Jab site.
PASS PART FAIL
CITY OF TIO`ARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00338
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 6/3/2004
SITE ADDRESS: 10135 SW LADY MARION DR PARCEL: 2S111 CR- 3200
SUBDIVISION: MARION ESTATES ZONING: R-3.5
BLOCK: LOT: 005 JRISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOCJS:
FUEL TYPES 0 - 3 HP: 1 DOMES. IN'CIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOGDSI'OVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: _ AIR HANDLING_ UNIT CLO DRYERS:
FURN >=100K BTU: <= 10000 cfm: -- OTHER UNITS:
10000 cfm: GAS OUTLETS:
Remarks: Install AC' Unit
Owner: _ _ FEES
MCGREGOR, MARK D + LYNDIA,1 Descr,ption Date Amount
10135 SW LADY MARION DR X11 t l l I'rinni I rr 6!3/2004 $72.50
TIGARD, OR 9722: �l A Y:1ir `�111dim! 6/3/200,1 $580
Phone: Total $78.30
Contractor:
SKY HEATING + AIR CONDITIONING
1637 SE NEHALEM
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: '15-im8; Mechanicallnsp
Fin iI Inspection
Reg #: LIC 50244
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699.
Issued By Permittee Permittee Signature: ,fy- L �1 _
_4
Call (503) 639-4175 by 7.00 P.M. for inspections needed the next business day
Jun 01 04 06: 53p S!Ky Heati.n- & R/C 5032350454 - p. 2
k
ID
A" ,ICill P . j� lie. n
City of Tigard
1 s 125 S W Han Blvd,TiesDR 97273
Reccivod
Phone: 503.639.4171 Fax: 03,39 bhp ►Ga t>are/By Kermit NnO
Inspection line: 303.639.417 vt• D`v t;10 Plan Review ,(Z 00 - 0 31,,k/
I�OWBY
Internet: www. , (hirer f'emrir
oi.tigard.or.ua �}�tt._C)1NG
Dole Readyroy
Notified/Metivxl relu Ed Sae Page 2 ter
-_ Supplemental lnterm,rlon
TYPE OF WORK
❑New construction Cnr>�ULCIAL FEE SCkIEDULL -- USE
'�ddition/wterROoll/replacenient t 71p,CKL1bT
❑hettlohtign Other Mechauit al permit feu•arc based--tire value of tile worts
Ixrf`�e`.JaZIr !tc vatic(rounded to the neatmst dollar)of all
TECORY OF CONSTRUCTION ---- - ---` m0`__Ncc1U materials,cYL,ment.labor overhead,and profit
l-and 2-family dwellin
R ❑COMMC-tial/industrial ❑Accessory building •�ElY7IAI
Multi-family [3 Master builder ------ EQ�PMF.NC/SYSTEM FEE5•
4 ----__ (hht t /'or spacial ialormonou rtae checklist.
J06 INFORMATION ANp LOCATION
_'-- lleaaipti„n_------ _
Job xil' a address. /�/ Qh'• E& Total
----L f �" / '3 H 000lln
City/StatdZlp: Air crouditionirg or heat pump
r uire situ 1M shnwur lacemeru
Suite bldg./apt,no,; - Furnace Ion F 14.00 ^-
- (dur_tnu 14.00
_ Project name: Furnace 'no000#-13711 ducts/vents
Cmss stroeUdirectiona to job sit : (Sashcat��'L- 17.90
14.00
Uun work _- 14,00
onic hot wu_ayYstcni-_ 14.00
�---- Residential boiler(radiator tx
- ---- _!!ydrrmic)
Unit heatem(fuwtype,not electric), 14.00
511bdivisinw - -- in-wall in-dui au nded,etc.
Lot no.; Fludveo!for t of above 10.00
Tax
map parcel no.:
Other: 10.00
Other MN annllancea 10.00
SCRIP
TION OF WORK ---------
Water heater
Gas fire lace 10.00
Pluc Vernfrn water liramr a gaa Iwo
-•-`- ---_-�__-__--_ Fire Ince
C (gaa) 10.00
Wood/ ellet glove 10.00
wood fire laoe�inaert 10.00
PROPERTY OWIYL _--_� ----____- 10,00
Nie. O TENANT Chioin i'liner qu-_ate — 10,00
�- Olhcr - ----
1~nrlronmental esharu,t and v 10.00
- en(W.,on
--- --_ Range hnod/other kitchen
'its/State/zip• --
�uipment
Clothes a exhaust 10.00
hung:( `�--- 10.00
-� Lax:( ) Single-duct exhaust(halhrnnrtla,
❑ APPLICANT toilet L0111 aninent-x utility rooms
usiness name:
CONTACT PFRSON Attic/-wls ce fans 6.0 --
- Other•, 10.00
intact name: Feet I Ind 10.00
Idreas. 39.40 ror first rue 31.00 for each additional
y/Statd7.IP: Fumace,etc.
-- - Oaa heu p_ urnp
me:( ) Fax: ( _ W44_112 ended/unit heator
tail: --- •-
1 Water heater
Fir lace �Y-
t. N•1'RACTOR Ran a -__--
ineAa name. -- Barbecue ~
Clothes
IL
ns: r �- �� dr�crsgas) -r
Lother.
Statd7,IP: ' - -- MF.CHANICAI.pp. PEES.
Z-
r. - Subtotal
lic.: _� - 'Z- ) _-O f Minimum permit f�SOj —
f Ian revie-r(25%of permil fee)
----r— _ _ State aurcharg.(g•%o0�p�it Pee)-
nixed signnurrc: ✓/ Q��7ie
�..� - -TOTAL PERMIT FEE �-
Thh permit appllntinn csplrc f+f+ ,a It la net ohlalned Mthle IAA
d,�r ener n hnbarn,eerplyd n aempletr.
Jun 01 C14 05: 53P Sky 1-leat;i ng & R/C 5032350454 p• 3
HOMF, I AVOU7'/S1.,,; PLAN •-
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' 7 REE'*
_._.._______ ._