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11161 SW SUMMER LAKE DRIVE U p f — 11161 SW Summer Lake LR i ..,,•��r-r�CSN NOT;CE /eK �t '�� ,�Oyy�•-firy�-'''s:�_�� �4..r "'���"„ '°" _ .v+. ��, _ t�yY� �' '=•A1���` i� ..w1��73'Lx ,�+� - �� .-,� '�O'v.� � �+, �Yry��.a4„ � �S v.G� �.�V � -71 ._ ry +CERTIFICACITY TE Off` OCC O TIG U D ORE GO. ► _ �, Owner: +. Permit No.891056 3r Address: PO Box 19524 Portland: Ore• �n 97� X19 � �T ` B ding Address: 1116 i SR -_ ' Summer Lake Dr. R; Occupancy: R3 Land Use Zone. R7PD Bl ��, Comments: dg. Type : . 1 Certificate is hereby given this 5th dayof Decemh .� that said b ,�1 19 c = building map be occupied and ;,hat it complies w requirements of the Buildingith all b the T Code for the Ci o f >b y Tigard City Council. t3' Tigard, as approved Wig. 1�<< � 3 �.... Fire I)eat. � _ �-; ��•'�`#�l- �'. ''� ✓� dinBInspector Building Of11cial /►jam Post CertificateJ C apt mous Place UA Mil-IPP" .-�� :`�:A��'� �"��S�6, '�`r"'+a�. ��y. �'. ,�-' ""''= �` --�F ��•l�qy, �lh�°�.SsS�t '4�� :� t����/+f/�.;�,�,�+'''�'`!e "`= 4�y�{� �CS oit 70< 7P ryj,• n '.w+` �r s ,�. - ADM . i:s \ INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 --t� Phone: 639-4175 Type of Inspection Date Requested— /// /Z _� Time __— A.M. AddressPermit #'—c Owner _ Lot r Builder The following Building Code deficie,,tcies are required to be corrected: Presented to — Approved Inspector /"bC,�`'' f Disapproved Date CALL FOR REINSPECTION YEa ONO INSPECTION NOTICE j City of Tigard Building Department P.O. Box 23397 Tl,1erd, C,'-egon 97223 Phone: 639-41�1755 Type of Inspection Date Requested Time P. Address �L//�� !_7�,�(�???c�ry �—� �"LG.�:—� Permit # Owner __ Lot # l �9S(O" Builder — The uilder _The following Building Code deficiencies tie requirel to be corroded: 71 Presented to __ ❑ Approved Inspector �!���—v — [ Dkrpproved Date CALL FOR ItdINSPECTION gi-�ES ONO WMJ1 MA ad INSPECTION NO_ICE City of Tigard Suilrling Department P.C. 3rix 23397 Tigard Oregon 97223 Pnone: 639-4175 Type of Inspection Date Request/!e//d// /� �� Time.�_ A.M.-P.M. Address 1_L_L Lam[___-_ _ � Permit # ^C ! Owner Lot #� Builder The following 'wilding Code deficiencies are required to be corrected: C Presented to � __ � ` Approved Inspector _ [_� Disapproved of Date CALL FOR REINSPECTION 0 YES CJ NO INSPECTION NOT ICE City of Tigard Building Department P.O. Box 23297 Tigard, Oregon 97223 Phone: 639-4175 / Type of Inspection Date Requested �Z. ` -- Time A.M. P M. 7Q Address Permit Owner _ _ ___ Lot #_ Builder The following Building Code deficiencies are required to be corrected: T 4 Presented to _ ❑ Approved Inspector �! I ODitepproved —^7 L+� Date CALL FOR RF,INSI FCTION YES ONO s• MAUNA I INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phore. 639-4175 Type of Inspection Date Requested 2-` Time_ A.M._ P.M. Address ___.. ,/177X-� -s62�--Permit # 4?1 1�/.�� Owner -T - — - ----- Lot r Builder The following Building Code dPCci^ncigs are required to be (w rected: Presented to _ __ Approved Inspector _ ( � Disapproved Date CALL FOR REINSPECTION 0 YES U NO INSPECTION NOTICE City of Tigard Buildmg Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 / Type of Inspection Date Requested_ - — �T+ime A.M. P.M. Address �1�[ ���- 5 Permit # Owner__— _._ Lot # _ Builder —..tt�9i /72cr2� _ The following Building Code deficiencies are required to be corrected: zsz Presented to Approved Inspector __ [:I Disapproved Date -- CALL ,FOR.RFINSPECTION h1 YES I_] NO WrA INSPECTION NOTICE n City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection �3, -- Date Date Requested - G Time_±f7�A.M._ Q P.M. Address `j l(o .3 ��.� p r" Permit # 5� Owner--- -- ------__----__.-.- Lot #_ BuilderThe following, L4&lding Code deficiencies are required to be corrected: Presented to Inspector -(. _ ____ Disapproved Date — CALL YOR REINSPECTION YES ❑ NO INSPECTIGN NOTICE City of Tigard Buil:, tg Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-1175 Type of ;nspection Date Requested Time A.M. P.M. �-� Address Permit #+�' Owner _ Lot # Builder dlF'Ur'�-x �!✓E The following Building Code deficiencies are required to be corrected: 44- Vx, �rL� '�Jl �' i ��. �, ' 1.f�4!"�1 r 1 � v �.r�..�'C/�.�''4�R.. C::�.../ ✓ l' Presented to �� Approved 1 � Inspector -- Disapproved [late CALL FOR REINSPECTION ❑ YEs C-J NO INSPECTION NOTICE City of Tigard Building Department P O Box 23397 Tigard, Oregon 97223 Phone 639-4175 Type of Inspection Date Requested �O c Time!� A.M P.M._ Permit 4!�Z-0- Address 1'1 ' l -- •' 1�'�^ Gr1� Owner Lot Builder The following Building Code deficiencies are required to be corrected: � r � Presented to _ f Approved Inspector ❑ Disapproved Date •�� _l - — CALL FOR REINSPECTION D YES 0 NO l� 11F # INSPECTION NOTICE City of Tigard Building Department F.O. Box 23397 Tigard, Oregon 97223 Phone: 839-4175 Type of Inspection Date Requested_ Time A.M. P.M. Address Permit # ?Z Owner _ _ Lot # Builder_�6�1011T The followinf Building Code deficiencies are required to be corrected: Presented to .__ � � Approved Inspector Disapproved Date CALL FOR REINSPECTION D YES ❑ No FF INSPECTION NOTICE City of Tigard Building Department P 0 Dox 23:397 Tigard, Orpgon 97223 Phone 6:39 4175 Type of Inspection _ Date Requested :! ______�. _�_.../_�� _�_j�Time Address -_Ja _�%Ldl�iti_5� � Permit # Owner_ -- _ _-_ _- -__w_�_ Lot # Builder ._._.� .� ------- The following Building Code deficiencies are required to be corrected,. Presented to Approved Inspector _, _ -�' ❑ Disapproved Date. CALL FOR REINSPECTION ❑ YES ❑ NO Nib INSPECTION NOTICE GQ City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 C Phone: 639-4175 Type of Inspection / f �� -= ie1- A. --�.---P-.MDate Requested - Address / /?�1 22 4f - Permit # Owner Lot # Builder_ - 7', z2l"' The following Building Code deficiencies are required to be corrected: Presented to Approved Inspector Jf— - _ - ---- Disapproved —/S�`- Date _ ---- CALL, FOR EINSPECTION YES 0 NO C17YOF T'FARD NO . - INA491056 CITYOF7WAFM COMMUNITY DEVELOPMENT DEPARTMENT 7/ '19/89 13125 S W.Hall Blvd..P').Box 23397,Tigard.Oir.gon 97223,(503)639-4175 1-)Q'11`1 PM I' NO 0 91056 JOB AI')DPF;:SS : :I.', 161. SW SUMME:P LAKE- DP TAX MAP/LATT' 1.c!:1" 33AD 15-100 SUD : SLIMME 3"J RK : I AND USE* : P"F11) 1 .01, 51ZE : VAL.I.)ATION: $ FPKIN'T �.'2 0 P F:AR WOPK Cl ASs . til;:*w :LU Pilt'.444, 5 USE TYPE-.: ".-i'VINIGA.1. 1: (W[L.Y NO . BEDR(I"IUM-1 . 3 EXT . 1AAI I `0W0 CMISIST . *T'Yl:)I-.: : VN NO. F3ATHS : 13 N: S : W OCIC"Up .GRID . PIPIDT .OPEWINGS . C)CICUP .LOAD N FK W APEA: :1.1)::10 NO. ST(JP:r.F-.':S : 2 1.S T': 1050 POOF I*." F 1PL Rr-.'.*T.'? HEA:C.41-IT : i'U 2ND: 9 AREA SEPAN'? RATER) 13A96MEN'T"? 3RD: OCCUP . SILEPAPI? PATED: MP-.ZZAN:I'.Nl:::'? DASE'I'll' I 1:1 OcIP I OAD 410 G A R A G 1:-: d'4 ZI F'1PE: SPAKI P'? ALARM? FL.OW(UPM) yi:.s Yl)l::. GAS Hl)('.,I:) ALIC'E'.SS'? C 0 14 P I? PI AN C31L.CK F r.W:Mol:'1KS : $30 2 'F.,xt-l-kj I'ecl 1:1.1-10 clripik?ia PLUnSUE OF NO. 081,0ZIR LAST WEA'.5SUE FEES : MORlYi DON PIL .4m:l:,r *39,9. 00 W rN 4.1 ROX 1.9..1.) Al pti-AN REVIEW 11111,40 . 00 N E F)11"t I"t I'l(:I n r- 97219 F-I'Mi: DEPT R PHOW.. urws) zm4 51;3:1 i STATEK TAX $19 . 70 0 THE 14 $30 . 00 OPMENT (:,HAA(*.,F.-.'5 C' UON SDO(STORM) 0 4;L!'15 0 . 0 0 N DON MDWESSETTC-v. 11L1I1...1:)EPS 1M." . S DC1( ST PEET > $600 . 00 T P 1:1 1 r4(')X 1.9524 PDC11#1 $2150 A 1)131"tl Ot I-I(1 97 f?19 P rl I-*P A 3:0 < 91/10 0 0) C uisozi) ,.-m,4 ;P.s j.'4 T U NO. 351533 TOTAL. : $:I. ,o,i,elA R NO. M1411� This permit is issued Subject to the regulations contained in Title 14 ............"""'•"'""'""""""""' of the TMC, State of Oregon Specialty Codes, zoning regulations PF.-'.:QU.T.PUD 11SISPIEZ11J.ONS and all other applicable codes and ordinances. and it Is hereby F;'(:)(:)*I':r.W., S F:W F P agreed that the work will be done in accordance with the plans and F(:)t.)Nl')A*1'1(:)N WAI I QA:rN DRAINS specifications and in compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive POSIT & F.-+..AM WATER LANIF.' covenants. Contractor and subcontractors shall have current city PI—l'?l . UNDEPSI AW CITY APPINA-II/Sw tiusiness tax permits This permit will expire and become null and 51 A8 FTNAL. void if work is not started within 180 days,or if work Is suspended or 171...E1. TOPOUT abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permittee to assure F'P 0 M 3:W3 all required nspections are requested and approved F:*:r PE 1:1 ACK required nsp, a 'r.NGULAT J:ON (� BOARD Permitt gnature - �HA - Issued By ()I..I FOP J.'NGF'I'T,'TT0N 63 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE SEW-44 I::,F;,.PM1 I CITYOFTIGARD CC74i�61111D FIE'AM11' NO SFA391.059 COMMUNITY DEVELOPMENT DEPARTMENT o"11M 13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard.Oregon 97223.(503)639-4175 DA11K 1 S S 1.)E,D 7/19/6'J Wtd'l* JOB ADI)PESS : 1.116:11. SW SUMME".—I LAKE:'. DP 05A NUMBE14 : 3*7595 TAX MAP/1 01' 1.90. :33A1:) 1.54100 SUB. LiUMML11:41 A K E". L'T' : 35 1:;:I< : I AND USE : 1:47PI3 SP,11TION: 313 Will' : 1.is PNG: J.w WORK CI ASS : NEW STNGLE. FAMILY The aplA ic!iant acir-l"Osi tcl enInj:)*l.y witti 111.13. aricl 11-F t h e 1.)1.)J.-F J.F-:?(:I Aganc-y . 'T'he ly rini.t exii-)iren; tf.:'.O (filkylli, fl`431111 thk) (JiILt(--.4 il1;lI,lAe(.J . 'Thiv.- ainnunt plaid wi),I. 1-F the t)er*tn:I.t 1'he Aqeiiey (J(:)e!;i ric)t c1cial al.11tee the aec.4.11-acy 1:1•N the J.ciri!ill,tiiin of the iii i(le.? mewer- :Lill ter,lit il;i . Tf the 1-l1:►t at, the 5;11-vee , the 1;hr-0.1. 3 :1.1-1 all fr-131n th(--.1 (Jillitvtrl(:" givell . Tf ricit so 1.cj(;)atecl , thc�� :Lrimtat]..Ier• ilihitt].I. ilk "I*i1ki.) ancl Sicle Sewovl' Per-mit w.n(I thir.-I Aqv.-)llc)y WJAI. J.111ita"I.I. 1. NS TAI L . 'Y*YPE : PUT I 1:)]:N(.; SEKWEA IMPLAVIOUS AREA: F'XXTURE UNIA'S : *TENANT TAPPOVEAFEN'T' : DWELLING, UNITS : 1. NO. OF 1.31 DUS . 1. 0 W MODISSETTEK DON PE11:4MIA, $35 . 00 N p cl BOX 1.9542-1 CUNNEKUTJPG&K ON CHAqi:1. E R p a r-t 3.a ri(:I cl 1- 197 f.?i 9 1 TNE I'All-I TWEVY'Al L . PHONE (303) 2,e141-931,41 (YTHE-14 C 0 N m(IA:rssr-.:,rTE: WIN T DON WIN I'S SE114K BUTLA)CAS :I:N(., . R A 1-)13 PDX 1.9512A C r)a r,t:l.a n(J (:)I- 19"71.T 0 PHONE (503) E24141-93141 L R I NO. 355-3.3 PF15 . This permit is issued sut lect to the regulations contained In Title 14 1*-WCE1l:'1'T NO. of the TMC, State of Cim-ion Specip'(y Codes,zoning regulations and all other applicable ct.,4--A sri ordinances. and It is hereby PEW-UPEA) JASPE—CIA'ANS agreed that the work will be done in accordance with the plans and RDUC..'H-1.N specifications and in compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have Current city business tax permits This permit will expire end become null and void if work is not started within 180days,orIfwork i8suspended or abandoned for a period of 180 days ary time after work has commenced. 1118all be the responsibility of the pr rnittee to assure all required i p tions are requests approved. Permittee gnZris Issued By: \A (Al I... 1::*(.)I.,, INSPF:(�'110N 639—A17!5 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE �' O� �'��� MF:CHAN TC01 VIE:41`1`411 Pv:*PMTI' NO. IIE"91.05H IYOFTWArD COMMUNITY DEVELOPMENT DEPARTMENT 0410044 13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard.Oregon 97223.(503)639-417' 0A 11:'. *1 L'iSUED -7/ :1.9/09 NEI. 89.1.05 6 - JOB ADDPIESS : 11161 SW SUMMEJ4 L.AKH. DP TAX MAP/LD1' 153. 33AD 1!*.'),el00 SUD : I...'1' 3!`.,1 Ei K L.AND USE: : P7PD I.-OT S:EZE . NO No WORK CLASS : NEW I':'URNA(."t::. (:L00K ATP HA-NI".)L_R <10 USE: TYl*-*,I'-". : SIN(.A In: FAM"Ll Y 1;:11111NACE.". 11.001(.4. .1. AJ.P HANDLP 10K C'X.11IN51' . *TYPE: 1.114 PI 00P V*UPN1-')CI:_:' E.:VAVI . EW O(:1C1tJ1::1 . GRP. : 1143 HrEATIEP Vl'.:,:N'V FAN Vl;:''Nl' VENT . SYSTEM 911"R/ClOMP <31-11.') HOOD :1. NO. STOPlES : r.? El o...P/C,0 M P :3-••1.51 T NE':I*.NE.RA'TOR(DOM DWELL.. .UNITS : 1. 13LP/GOMP 15 301-IP 1NC1NL.PA'T*0P(COM FUEL TYPE* GAS DI P/COMP 30---,:i0HP PEKPAIP UNIA!-­1 MAX . INPLYT BUZI/C.OMP 504-11-47 011-401- F:JAF.:*. DMPAS7 (1A5 P1P1NG OU'I'LIE'T!i 4-TAW fit .MAVIKS : 0 W M 0 P T.SS IL.. Err DON P Ei:P M I'T $10 . 00 N E P Cl BOX 191151t?lel PI AN AF:'.V:1:1-:W $ 1 .P5 I..)a r t 3.ilk 1.1 d ar. 972119 1=JX,11111ES **35 . 0 0 PHONE. (!503) PA41­9.31.41 STA'T'E: 'TAX P.r.? 01+411H.A C 0 N T H1:::A'IJN(*., :[*N('. . R A 1.55605E: l:-'1*1AZZA AUEE C T CI ACKAMAS OR 9701!) 0 1::'I1ONE: (503) 2_43­11841 R1;-­G1STPATT0N IN('.). -IA 7 11TTAL 1111158. 50 This permit is Issued subject to the regulations contained in Title 14 P!::.CE1P*T NO. of the TfAC. State of Oregon Specialty Codes.zoning regulations and all other applicable codes and ordlns..�nces, and it 15 hereby PEEWLYI:PE.D 1NSPr_k7,1J.0NS agreed that the work will be done In accordance with the plans and specifications and In compliance with all applicable codes and LJNF. ordinances The issuance of this permit dot?a not waive restrictive BIDS 1* P1 Br:::AM covenants. Contractor and subcontractors shall have current city r41l:1lL1GH---I N business tax permits This permit will expiry and become null and I I'NAL. void If work Is not started within 180 days,or it work is suspended or abandoned for a period of 180 days any time after work has commenced. It shall be the responsibility o' the permittee to assure all required spections are request and,approved L w _ required Perml gridtUte Issued .3y L L CAL I FC.IP IN' 639--.4175 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE CITY OF T167A RD C. 'LIM PI:::PM1'f* NO . : PLW,;�I.0,157 COMMUNITY DEVELOPMENT DEPARTMENT 13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 i, .1.19 0 9 .. OBI ADDRESS : 111-6:1 SW !.iI.JMMFP LAKE DP TAX M()I'-"/I-.C)l 1,51 3.3AD 1.5/100 SUMME.P1 A K I-*' L T 3".) E.?K I. AND 1. SEE 1:47 I) 1-1:111* 51ZE: NO : NO W(:)PK C.L.ASS : NE'W WA*FE:P (',LOSET 3 TPAP TYPE , FsINGvI-+:: FAWLI Y UPINAI I.*DKF­LX)W PIPMVP (NIN51' .I*YPI! VN LAVORAI'OPY 3 TPAP PRIME[4 143 TUB 5HOWIE-A 2 It.46KASE 111AP5 DISFIWA51,4EP :1. (3AR"A(.3F,: I)V5POt3A- I.- 1. NO. STORIE S : 2 W051-CING MA(*.H:I:NF.:: 1. DWELL—UNrrs : I I AUNI)PY TPAY BLDG. DPAIN (DIA F1.00141 DPA-IN 5 1:N K I SEWEA (FT) WA71-1:1 3. 5TOPM/PAIN (F--'T (TTHE.p IAV�M(VWS 1 : 0 PIKIES : w morctssr::,urr:: [)(IN PE,I-111 I T N E P 13 DOX 1.19115210 R r)es r,tl at ri cl Y721.9 F I X I'U 1:4 F: K. 1:'11-40NI-K ('503) 24.1 9,31.•el S*T*AI'F.-*. TAX !Pel . 63 C 0 N 1iI-4(3F-.I4AKF.:P 1-4 A 11(:l1 1) T R 14-10EMAKE'14' 5 VII-LIMPIN13 A 1:)(3 13 0 X i?;:i0 C epttinx.mWill tir 9*70P?3 T 0 f"HONIH.: (303) 630----77e8 R I r*X..,:I:!iTPA'1JE)N NO. 392r? This permit is issued subject to the regulations contained In Title 14 PEXE:JI*-1T NO. of the TMC, State of Oregon Specialty Codes, zoning regulations -•••-••••••••••••-•••••_•_•_••-•-•-•••-•-_......-........ and all other applicable codes and ordinances, and it Is hereby PEQUIRED INGPE(:TIONC, agreed that the work will be done In accordance with the plans and V`l H . 1.IN1:)EAS1 AD specifications and In com)IIance with all applicable codes and ordinances The issuance cf this permit does not waive restrictive POS T & 11F.AM covenants Contractor and s,:I)contractors shall have current city W(YTE44 LINE business tax permits This permit will expire and become null and IN 0 . 1,0130ITT void If work Is not started within 180 days,or it work is suspended jr r4A'.I.N DPAINtii abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permittee to assure FJ NAL all required, Ins required Ins requested,and, approved. Peirnitte S lure Issued By. LALL. F(311 1W.-iVIECTION 6:39-41.'l SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE CITY OF TIGA' RD $"4, 2a PLAN CHECK APPLICATI 'N aJ '1\ CnTO(IIGAPD PLAN CHECK H -� :>A-- COMMUNITY DEVELOPMENT DEPARTMENT'J PERMIT H miss.w.weep.P.o.oo■ziny.ns.«a.o.egor nsrm, o3l6"41rs DATE ISSUED JO ADDRESS: � I F(a I S w S Uvhv►. </L 4�� -i AX MAP/LOT �Q�1 1.5-4/o U SUB: 1IL� LOT: 31 _ LAND USE: 2C; ?Pk, VALUATION: OWNER II SPECIAL NOTES NAME: 0(' IS SET LS_ t� �.1C REISSUE OF: ADDRESS: �; 2 _ LAST REISSUE: U - - — �+ (. -7 .2 ► l FLOOD PLAIN/ �-f--- SENSITIVE LAND: PHONE:— ,� L _ � — - �Ti APPROVALS REQUIRED CONTRACTOR PLANNING: NAME: _ [ENGINEERING: _ ADDRESS: FIRE DEPT OT14ER: PHONE: ITEMS RE UQ IREO LIST/SUBCONTRACTORS: ARCH/ENGINEER BUS TAX: NAME: ��:�—_�I 1� C - CALCULATIONS: _ ADDRESS: _ �— TRUSS DETAILS: PARKING PLAN: _ - LANDSCAPE PLAN PHONE: T _ OTHER: COMMENTS: I PERMIT N Acct' H DESCRIPTION AMOUNT AMOUNT PD. DAL. DUE Q /U S( 10-432 00 Building Permit Fees -3 q! ^ -Ai 7�f'.rc' ZGo, - �jq 057 10-431 00 Plumbing Permit Fees 32-07) Q /p -5 k 10-431 01 Mechanical Permit Fees 10-230 01 State Building Tax (5X) , T-r G.7.0 Building Plumbing 6.63 Mech .2.Z.; 10-433 00 Plans Check Fee Building Plumbing _ Mech 30-207 00 Sewer Connection __ 30-444 00 Sewer Tnspection 51-448 00 Street C,ystem Bev Charge (SDC) 52-449 00 Parks System Dev Charge (PDC) .SSG 0'2J U 31-450 00 Storm Drainage Syst Dev Chrg (SSOC) 10-230 09 TRFO 10--230 OG Washington County Fire H1 (95X) 10-220 00 Amart/Wedgewood REC H :2_7 3 5,63 APPI Ic:ANT AT IRI ! /30' �- Received By: ( V Date Received: / �� O �� cn/3587P/18P (.-AA�if �$f1lnUY