10850 SW PATHFINDER WAY-2 ADDRESS:
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is\records\microf Im\targets\building.doc
INSPE(MI-QN NOTICE
ity of Tigard Building Department
13125 Sw Hall Blvd. Tigard, Oregon 97223
Inspe^.tion Line ( ec-O-Phone): 639-4175 Business Phone- 639-4171/
Inspection: )L) _ i�'N�5 QFC -f/�7Y�
- -- --
F->Jf:ng - 1lnderelaY, MacTf.'Rough-in Appr/Sdwlk
Found. Plbg. Top Cut Cas Lina FINALt
Poet/Beam Strurt. San. Bower Framing ('-Bldg mt�
Poet/neam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line Gyp. Bd.
Date Requested: uL � Timet AN PM
Address: // I ' IJO
1 l it ft� +�
Buildtr ��✓L l / ' �[1 0� d-
TBS FOLIAWING CORRECTIONS ARE REOUTRBD: 1-').r
_U JOLIQ
' --
u M b .5-- 93 -
)APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVP.
Call For Reinsp.
-----
1s.�PECTIUN NOTICE
City of Tigard Building Dw partment
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec--o-Phone)z 639-4175 Bueineee Phones 639-4171
Inspections_
Footing Plbg. Underelab Mech. Rough- in Appy/®dwlk
Round. P1Lrg. Top Out Gas Line (�DINAL.
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drai.s Insulation -tlumb.
Plbg. Underfloor water :.ine Gyp. Bd. < -Nech.
a
Dace Requested: '� � " '!'1me: �� AM PM
Address:_ �'. ` _ Permit
(wilder:
THE FOLLOWING CORRECTIONS AAE REQUIRED: L
VC�I.; V,0Y`•f T
Inspector: V '^�� _"� Date:_/ I l
APPROVED DISAPPROVED __ APPROVED SURJSCf To ABOVE
`� _0-111 Dor Reinep.
INSPECTION_N IC--
City of Tigard Hull.ding Departnent. 1�
131:35 Be Hall Blvd. Tigard, Oregon 97223
Inspection Line (nec-O-Phone): 639-4175 '.funinean Phone: 639-4171
Inspection:
Footing Plbg. Underalab Mach. Rough-in Appr/:.dwlk
Found. Plbg. Top Out Gas Line �� FINA'.:
Post/Beam Struct. San. Sewed Framing -ridq.
Font/Beam Mach. Rain Drair Insulation -Plumb.
Plbg. Underfloor Hater. Line Gyp. B4. _Mech
Date Requested, �I -`� _Time, AM PM
Address: V5 1 (.� (/�1�1/Z!'Q 1J' P[ Permit #, "J �'
Builder:
THE FOLLOWING CORRECTIONC ARE REtQUIIREDt
Inspector,_, _l,+►_.._ Date:
__APPROVED _ DI8APP1tOVEL APPROVED SUBJECT TO ABOVE
—Le:f6all For Reinep.
�NSECTION NOTICE
City of Tigard Building DeFartment
13125 811 Ball Blvd, Tigard, Oregon 97223
Inspection Lis._ ;"^- 1).-Phona)s 639-4175 Business Phones 639-41.71
Inspection:
foutinq Plbg. Underelab Mech. Rough-in P,ppr/Sdwlk
Found. Plbg. Top Out G,ta Line FINALS
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Neter Une Gyp. Rd. -Mach.
Date Requeetods I��11 ( \ Time: _AM PM
Addrea e: _— ` �/\"Q 1( G .11. —_ Permit
Builder:
THE FOLIAVING CORRECTIONS AAE REQUIRED:
i
Inspector: —- _ Date:
l�-J---APPROVED DISAPPROVRD APPROVED SUBJErT TO ABOVE
E
MVV/"` _—Call For Reinsp.
�sasaaa
.INSPECT?ON NOTICE
City of Tigard M.11d+.ng Departw0 t
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Pac-O-Phone): 639-4175 Business Phone: 639-4171
Inepartion: — V CY._ �\ivY�—.�
Footing Plhq. Underslab Hoch. Rough-in Appr/Sdwlk
Found. rlbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewor Framtng • Bldg.
Post/Roam Hoch. Rain mein Insulation -Plumb.
Plbg. Urderfloor Fater. Line Gyp. Sd. -Hoch.
!
Date Raquesteds A I i- ,7 -__Tice _11 AH __PH
41 � 1TT--
Addresa:1r `� Av__ �.y 6' Peron � 5L„` �
Bulldez :
THIS FOLLOWING OORRECTIONS ARE REQUIRED:
- --i ---- - C _--
':_r --
Inepeetorz
Y/APP743M DISAPPROVED __ APPROVED SUB.TECT TO ABOVE
(� Call For Reinap.
City of Tigard Building Department
13175 SO Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone):
166339-4175 B Inas Phone: 639-4171
�:napection:—._____
Fo')ting Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plhg. Top Out Gas 7 ine Qy11QFIN /
Poet/Beam Struct. Sewer Framing -81dq.
Poot/Beam !tech. Rain Drain Insulation -Plumb.
Plbg. Unuertloor yyWater Line Gyp. Bd. �Meo
Date Re7
quasteds_ �I) / I _Times M M
Addre9o:._..__. 7 I Ci_44 �� i!r .' Pe—it isbe `/3 evi '
Builder: ► `
TNR FOLLOWING CORRECTIONS ARE REOUIREDs �-�? 0tJ �y `
17 VA S�\s
y\ �t_
r e,=
cti1 � � IL
-r
y��cr r tet.. �-✓� �--�� 'a. .-- A '�{l L a_j t_
Inspec'_ur: '` "'' _ bates I (
APP110Vlb DISAPPROVRD +� APPROVEb SUBJECT "O ABOVE
�` Call For Reinsp.
INSPECTION NOTICE ?'
City of Tigard Building Departraent.
13125 SW Ball Blvd. Tigard, Oregon 9721.3
Inspect: ..: line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbg. Underalab Mach. Rough-in Ap�pr/Sdwlk
Found. Plbg. Top Out Gas Line Y� �ZNAL.
Poet/Beam Struct. San. Sewrr Framing
Poet/Beam Mach. Rain Drain Insulation -Plumb.
PJ.bg. Underfloor Water Line Gyp. Bd. soh.
Date Requested:
C� �` 1 _cine: AN PM
Addresn:._ ` U b 2 '- "� Permit f: o2_1 1_
Builder: _
THE FOLLOWING CORRECTIONS AAE REQUIRED:
4o ' s
CA
� + _ asp d.�-2
S.
Q 1 --.� r cy 5 ` _.3,
r =
Q.
Inspector:_ �-
APPROVED DIBAPPROVED V APPROVED SUBJECT TO ABOVE
K G'( Y Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall HI-d. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171
Footing Plbg. Undermlab Mech. Rough-in App_/Sdwlk
7ound. Plbg. Top Out Gas Line FINALt
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Hater Line Gyp. Sd., -Hoch.
Date Requested: /�/ Timet 211M _1fpN
ddress s_ DU 9 ' �v �N Permit «s �17_13
Builders L� r Q+
THE FOLLOWING CORRECTIONSR.gQUIRED:
Inapecturs
-APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
-call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Deparim"nt
13115 811 Ball Blvd. T19ard, Oregon 97223
Inspection Line (Rec-O-Phones 634-4175 Business Phone: 6i9-4.171
� 4
Inspect ion t. )fA p _� -�----
Footing Plbg. Urderslab Mach. Rough-in A
Q ppr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. sewer FramLng -Bldg.
Host/Beam Hach. Rain Drain sYlltion -Plumb.
Plbg. Mulitrf.loor Nater Line Gyp. ad. -Hoch.
Date Requestedt-_1 _ _Timet AM _ PM
Address: ,sv Permit
Builders
i --
THE FOLLOWING CORRRL-TION3 ARE "WIRLOt
'
/ Dater
Az PPRO:?D DISAPPROVED APPROVED SUBJECT To ABOVE
_Call For Rainap.
INSPECTION NOTICE
City of Tigard Building Mi-•.+snes+t
13225 911 Ball Blvd. Tigard, oregon 97223 `.�.
Inspection Lint (Rec.-.O-phone): 639-4175 Business Phone: 6'9-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Rowerremin4 -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line^ Gyp. Bd. -Mech.
Date Requested:__ .� 1Lmes AM /� PM
or f 1 1 TT"
Address: L/ / armit ii�� ��
Builder: ' (/ >
THE FOLLOWING ODRRECTIONR ARE RzQt1IREDt
LA X
W-z,l s. 1�u '
Inspectors_I,/_ • ^='�-_� Date: // I "1 "13
APPROVED D79).PPttOVED APPROVED SUBJECT TO ABOVE
_`Call For keinsp.
jNSFKCTI.ON NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Pec.-O_phone): 639-4175 Businees Phonet 639-4171
Inspection:__ ell'V4'.,
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FIF'L:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line Gyp. Bd. -Hoch.
Date Re
gueatede _ T,met AN —X—PM/ U
Address: L� PetiL�t rl(/.]Tv'U0 /L
:
Builder:
THE FOLLOWING CORRECT70NS ARE REQUIRED:
InSpectort ---- ----- Date:
APPROVED DISAPPROVED AppROVED SUBJECT TO ABOVE
For Reinep.
INSPECTION NOTICE
City of TI^trd Building Department
13125 BN 'call Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in hppr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
j a" 8truct. San. Sewer �+aminq — -Bldg.
et-Mam !tach. Rain Drain C Insuldtio _Plumb,
�_.
1Sq. Underfloor Neter Line Gyp. Bd. _ h.
G 23 Date Raquestedi 1_ Ti14ef -�' 1Mc
Address: �7 U % Permit t 7 Z
Builder.:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector=
Data:
_APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
i
INSPNCTION NOTICE
city or Tigard Building Department
1312E SR Hall Blvd. Tigard, Oregon 97223
Inepwation Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspection:_ --
Footing Plbg. Underslab Noch. Rough-in Appr/Sdwlk
Found. Plbq. Top Out rias Line FINAL:
Poet/Nae ftruat. San. Sewer Framing -Bldg.
Post/Ream Noah. Rain Drain Insulation -Plumb.
Plbg. Underrloor Mater Line gyp. Bd. -Mech.
Date Requested:_ / 5 l-7!� _limos AM PN
ii'
A7ddress:-_�:�L11 �� !J �L ' ''�— Pormit 1s q
i
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector.: Dates_
�- --
/ APPRDVED DISAPPROVED APPROVND SUBJECT TO ABOVE
__-_call For Reinsp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oreyon 07223.8100 (503)830.4171
z��� �►�"ez{{
r 13t25Swriaff B4%d. PLNCK/RECT # 7 ' &�___
(21TY or TIGARI� PERMIT # ����i ' G a2 /
COMMUNITY DEVELOPMENT DEPARTMENT Ti�cd Oregon 972.23
(503)63"171 DATE ISSUED
JOB ADDRESS: /Lf R.S« �J Pik iii h��vy�/� dust-y TAX MAP/LOT --0 1 y Gu
SUB: ileo _� LOT: /) LAND USE: _
VALUATION:
OWNER PECIAL NOTES
NAME: k I- S./4 Li.r .O _. REISSUE Ot=:
ADDRESS: /�3��O 5 cJ (�l�i'1�,��nf� �ti �___ LAST REISSUE:
774 r+-a-D cC/L f- FLOOL PLAIN/
PHONE: t.��! 3 5-? s2- SENSITIVE LAND:
CONTRACTOR APPROVAL. REQUIRED
NAME: L 0-er-t-ST L st fj A PLANNING:
ADDRESS: f l "Cry S L Sr= ENGINEERING,:
A-nb CQ 2 c( "7 _ 3 FIRE DEPT: _
PHONE: 2- _ OTHER: Tn
CONTR. BOARD #: 5-79 EXP TE:
ITEMS RE. l(� IIPEfQ
SUBCONTRACTORS: PL`/
Y`,IB: _M)f 5 rv; D��M jq1_ LIST/SUBCONTRACTORS:
MECH: niy1,,,w CeyzsT _ BUS TAX:
ARCH ENGINEER CALCULATIONS:
NAME: — 1�>e- TRUSS DETAILS:
ADDRESS: _ OTHER:
PHONE: CQ N s^' Z 6
PROPOSED BLDG. USE:
COMMENTS: L 3 5
APP "ICAN IGNATURE
Received By: _` C`�%z Date Received: `II
PERMIT # ACCT a DESCRIPTION AMOUNT AMOUNT PD. GAL. DUE
r�5 3 God 10-432 00 Building Permit Fees % �� U ��' -`-7
10-431 00 Plumbing Permit fees O �'U• �
10-431 OI Mechanical Permit Fees 3 cti
10-230 01 State Building Tax (5%) � r � �y
Building
Plumbing _ G U
Mechanical _
10-433 00 Plans Check Fee
Building
Plumbing
Mechanical 2 5
10-230 OG Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIS Fees
25--448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
2.5-448-01 Residential Traffic Fees _-
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) _
2.4-445-01 dater Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
r
nm/3587P.WPF
CITY OF TIGARD - RECEIPT OF PAYMENT RECEIPT NO. :93-2407g?2
CHECK AMOUNT r 205. 23
OME a LEONARD CONSTRICUCTION CASH AMOUNT 0. 00
DDRESS t PAYMENT DATE 06/IZII/ )3
11200 SW 115TH SUBDIVISION
TICiARD OR
-'URPOSE OF' r4YMFNT AMOUNT PAIL) PURPOSE OF PAYMENT AMOUNT PAID
UILDING PERM 104. 50 PLUMBING PERM 60. 00
CCHANICAL PE 25. 00 ST. BUILD PER 9. 48
'LAN CHECK FE 6. J15
ST 9-7-0211
10850 SW PATHFINDER WAY, LOT 15 PATHFINDER
('1Ti')1,. AMOUNT PAID
r 7 i o r'I C.i
P Lj, k7E7 C. J r''1" rir j
67.
LEIDNARD CON,-,00-IGI-ION 0. ,4. 0
& W-SIGN [IA1't,1FNT 00'rr04/'0 1
;:rtwr j-4 jyj n L 114 1* 1:'A11) t-,o. or
f'f R 67. 9
POTHFINDUR WAY
1 01PL 0MO(JNT PPI L,
INSPECTION NOTICE --2
City of Tigard Building Department
13125 Bit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 63941755 BusinesP Phone: 639-4171
Inspection._ �-� >-? —,—
Footing Plbg. Underalab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINAL:
Poet/Beam Struct. San. Sewer. Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hach.
Date Requested:_— /i2 %Z -'`? %� Time: �' AM PH
Address: /G'J'ti: c.i y Permit
Cts
Builder.:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspect�orr: � Date:
PROVED __ DISAPPROVED APPROVED SUBJECT TO AROVE
Call For Reinnp.
CITY OF TIGi4 RD CMOFTWARD MECHANICAL
COMMUNITY DEVELOPMENT DEPARTMENT OR100N F:,r--RlvlIT
13125 SW FW1 8tvd. P.O.am 23397,TOW,Or"m gf7223(503)SW-4175 ERMIT #. . . . . . . : MEC9a
ADDRESS. . . : 10550 S%W PAtHFINDER WY PORCEL. 0S000xx--00000
7,1J801VISION. . . . ZONIW):
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . .
U.ASS Of- WORK. . :ADD FLOOR FURN. . . . .. F-VAP COOLERS:
TYPE OF tJ(3F-. . . . :5F LJN I T HE 41-E RG. . : VE19T FANG— -,
OCCUPANCY GRP. . -R3 VENTS W/O APPIL: VENT 3YSTEMS:
5?-DRIES. . . . . . . . : 1 80 1 LE P(G 3/COMPRE 5 SO RS HOODS. . . .. . .
0-3 HP. . . . . I DOMES. INCIN:
if 3-15 HP. . . . . COMML. INCI1',1-
1y1A X INPUT: BT Li 15-30 HP. . . . REPAIk UWTS:
FIRE DAMPERS% . : 30-50 H P. . . . WOODSTOVEI;. .
C,AS PIREqR-UPE. . . 504, HP. . . . CLO DPYERS. .
HIL OF LJNT'Tc; -- AIR HANDL I Nry Uhl ITr
OTHER UNIT5.
VURN 100K BTU- 10000 cfm: l GAS OUTI-Ers.
I URN 1 -1001/ BTU: > 1X1000 ci M -
Remarks s
f-loo t I 011a I
3. 14. 70 permit fee L)aid ( 1 of original fee)
r-)Wnet-: -----.-- -- - --- - —--- - -- FEES)
k-'+.N SISELIAN tyre amol-Int by date -ecr-i
0650 SW PP1H1-- 1r0L)1"R WAY PrR11T 6 2.5, 00 TF1 0(3/0` 9
TjPCT 1. 25 JH 08/05/9C
I'I() IRD 01IR 972P,-,
lAinne 639-6397
L
26. 21!5 TGTAL
?i. . 61?196
-------- RE.L41J I RED INSPECTIONS
his permit is issued st.tbject to the regulations contained in the +=i nal inspection
Tigard Municipal Code, State of M,e. Specialty Codes and all other
applicable laws, All were will be done in accordance with
-ooroytd plans. This oermit will expire if work is not started .......
:1thin 180 days of issuance, or if work is suspended for more
than 138 days. ........
py . Gall for i I nsvec.-,tion 639-41'75..
City of Tigard '
13125 sir Holl ""A— APPLICATION Permit #
PO Box 23397
Tigard, OR 97223
(503) 639-4171 ()t
Table 3A Mechanical Code QTY PRICE AMT
I G c r 1 ,r y, .0• 0- moo
Job
►: �1� 1) Permit Fee
Address
2) Supplemental Perrnit 3.00
G.+`�,>,V,�.,� ...T urnace to 1
1 Lyuc 1(l.l 1 1) incl.duct;, A vents 6.00
wy AmKt '- urnace0,U00 9 f U +
�C t 1 ;y 2) incl, ducts 8 vents 7.50
Owner VU orloor Furnstnco
3) incl vunt 6.00
We" n ..«. uspendede ter,wall heater
4) or floor mounted heater 6.00
Vent not me,t(n—�
Occupant 6) apphanoo permit 3.00
ru Repair of healing, refrig
6) cooling, absorption unit 6.00
of er or comp, teat pump,err con .
7) to 3 HP absorp unit to 100K BTU G.00 ,
`. K• -o e, or comp. heat pump,air Gond. +
8) 3.15 HP absnrp unit to 500K BTU 11.00
Boiler&comp, leaf pump,air cond��
IJY-}Af-, W.
�� � 9} 15.30 HP gbsorp unit 5.1 mil BTU _ 1$.00
im...�r.a.,r. odor or corny, eat pump,air conR.
10) 3050 HP absorp unit 1•'.75 mil BTU 22.50
` =
•,i,;s, w ,,, , have rea tis app icauon,that the
Poiler or comp, eat pump,air cord
I inl:,rn,tt' �,1 ntct,Uiat I am the owner or authorized agent 11) >50 Hp ab5orp unit 1.75 mil BTU 31,50
innr ,uk. nitied are in compliance with State v landling unit to C�71
w 11t the Construction Contractor's Board, 12) 10,000 CFM 4.50
;,, it .c•rrrct (If exempt from State registra4on, it an inggunit
c i, '..P•'crN) 13) 10,000 CTM + 7.50
Non portabT-��
td) evaporatq cooler I 4.50
ant ran connectod�� .�.
15) Io a single duct �- I 3(A)
anti etion system not
16) included in apnl anoe permit 4.50
r• ,;1.-� _ o servM by
t r 17) mechanical exhaust 4.50
osr�o work Xr.o f� addition a teration U repair Commerc al or indduslnar—_
to ne done rNtidrntal(' non-ted:dential () 18) type incinerator 30.00
rusting use ofOYier i,e.,wo stove.water
building or proporty _ 19) heater, Solar, clothes dryars,e1o. 4.50 :
r•nposod use o1 20) Gas piping one to four outlets 2.00
building or pretppny _ _ _.._
21) More tl,on 4-per nutlet
Type of fuel -oil(-) natu'el nos �_, L-f'G Q electric O —- - —
Minimum Fee$25 00 SUBTOTAL.
PERMITS BECOME VOID IF A'`JRK OR C:ONSTRUCiQN
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%`;URC14ARGC _
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTFR WORK IS COMMENr)ED
TOTAL �.
Special Condtions
_ 1u issued
tWi,1EC11iVT
ard�.MA1v
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CITY OF T'160PD _ RFUE1F''1 OF F'()YME:NI' NECE'lPT NO. .92-2547023
CHECK AMOUNT a 2'6. 215
NAME : [;I._I MA TE-_ 601141 R II r.t cAsi-i AMa.Jhrr 0. qlo
ADDRESS c 3.31`:' NW 26TH 114 PAYMENT DATE' 08/05/92
!'UP-D I V 151 ON
1=OPTl_(1ND, CR 97;*-'112.1-
r'UREIDGE OF PAYMENT AMCHINT r,ruo P(IRFUE4 01 F'AYM[--NJ AMOUNT PAIL, 1
MF CHAN I CAL r'E 25. 00 ST. BUILD PER
i
I
T.BEL T AN 1 V 8 0 SW i�,ATHFf ND R WAY I
1
10T'AL PAOUNr PAID 26. f,-,5