9504 SW WASHINGTON SQUARE I
All
9504 SW Washington Square Rd
1S1 2bC
canna shop
i30155 ( Shutter Bue)
arc 1
4►
3 0 3 5 5 5/7/1,, t 7/e R goy 81 u 4 ELInspector
. `t,.COPYLOW P "
PERM, NO.
APPLICATION FOR BUILDING PERMIT GOLDENROD PINK Cashier
ry
GREEN Temporary Ede
WASHINGTON COUNTY /` / Sp /c
,I,UP1S5 '_(• '�� 7.,•7Sv (�
DEPARTMENT Of PLANNING�� ,-OC ALIT
THE SHUTTEI W! CNG DIVISION - Nat AREST
_'ROSS ST
MiiiiiiiiWiMMEMEEMBEEIMIMMEWMMIMErp(E NS A LAODE Ro
Ns uir Oup type pp s[ /T
FOR APPLICANT TO FILL IN i f r_L ICONS,
'WILDING STATISTICAL CLASiI►ICA TION ZO (_
ADo.[SS 9504 S.W. Washington Sq. Rd. —_
C. -_
NSS NO rot. UNITY
LEDAL Dt SCRIPI ION Shop J-2 located in t••1 ..ONDI• ..
Bldg. J, Washington Square •-
NO OI IL DOS D /7"
AREA O? 10' NOW OLO•
USE OP - N /—' TONING APPROVED IV AT[
\•.) otrN[RWASHINGTON SEQUA RE,I,jd`A 226-2692 .00 .PE or SANCTA T,ON DIS,
vADDRESS 900 S. W. 5th, WATER SUPPLY 015 T.
` SLOE $$$$$CR PROM
1 CITY Port land, Or. 97204 ',OOP ONE OP I I
APC"ITtc' op E.A.HarrIngtort L ZZb-Zb9Z 4.71.74. OI COWIN, $$$$$CO NIONO/AT + 'AID = Toru
I ENGINEER NO Nltyv,T j*IDM PROM C L _
Wet AT l nytvn 3• marc, fns• +
•005(115WI j.y -4.bRr•cr 1..wL-_� -
•TEL Kos or'Rats PROM
• \
l CON IRA C TO/ ,C0 Slot •NOP :III OP 1115(101
TVP( o• to/TING tt?tACR NISNRAV + Y•110 —D TOTAL
ADDRESS 015,4555 5,51. PCOM C L
CITY _ + =
DESCRIPTION OF WORK - coRNER c..Iro►► TES ❑ NO ❑
NEwj ADO ALTER REPAIR 01'1001,SN SEE REVERSE SIDE FOR SPECIAL APPROVALS
Sl PT 8c1 tt� NO OP NO OP
,t
t [ S
� .P•. !TONNES rAM,LIPS
NO. Or RO0M% Nn 01 PA'. . ..
us O,
so vc•I.,41- Retail - Camera ;hop -
N` O.' s., .I 6
t10N•TAOr `a' __
APPLICANT ` ty( .,. ,Ar - APPROv•‘S DATE IN•PECTOR'S SIGNATURE
VALUATIONS 8 1f -c .00 • ,(A•ION
' ' c o I I A-,01AC.
P L. p
P[[$2 M•c�.---• 7 i / , r i r $ 9'/ --._ _�_ T/Z'�'LC
Nt•t,T Ar1NOwltooe TNAr , N•vt *IAD •..• •PPUCAT10N
•NC STNS THAT THE A/051 't ccRatt? AND •G•tt TO roost, ,A . II AN1'
WITH ALL (0‘,11., 0RD'NANC(S 550 STAT, LAW• RtGL,I•T,Nf
•U'LDING CONSTR„CT,ON
SIGNATURE O/ III cossicT
►EIIMITT[E FIN 0 L *ED
.ODRf SR W}Ay/S?HTI N�i N Sx\.. D NC. ' or I ,•//.P° /
PLAN CHECI VALIDATION ..-,' NO VAIN PERMIT VALIDATIONJONN mc,
CASsi
• AI
..I I VT No. O// A / 03 R1c 11 T NO./// , a A T t/•' fila
I
N
1
ate,
Washington County
' ^ Fire District No. 1
7 \
14480 S W Jenkins Foeo
' Beaverton.Oregon P7005
Bureau of P".re Prevention
646-1101 Extension 245
Plans Examination Report No. ��,-, Fire 3tation •
'aunty ?len No. 0104
Run Distance
q_ y
Building, Thn rhi.0_tnrhiAci Occupancy F-2 l arL:3ntilIl Tire Zone
Address hn7 - "adk{ritnn Construction Type iii-
Architect/Designerh rL n Address 71 -nvcrlY '1 v._. Lor.. . noalas. Cs
Corner .r .r ' nr if It I nr• Address _ a h, pn r,a
Stories Main Area Lr-, /Basement Area nnnn Attic Height 20rS
/ tops nuns
True Walls t, :,-: Fire Escapes nr•r . Exits i. /Total Width 31st
Stairs, - /Enclosed Other Vertical Shafts ncn2 /Enclosed _ Sprinkler'
Area Covered - _ i,.- ,,,, Man. Alarm S.P. • Ext. r._ /Clue • /11.4 • __
Combustion Detection ,u /Type _ _ /Area Covered
Floor -ntr Ceiling nun&„^.rt.tilm Roof hunt un
Str. Members Wall Cover npull_ / nvn-hamld-
Exte ri or Interior
Heating System. Fuel - — Cooling System not_ z n"r
The plans for the above de ccr.bed structure were referred to this office
and reriewvd for conformity with State end District fire safety lave
end r- ,.alationa. The follov:ng itemized comments describe changes in the plans required
'or conformance with such laws and regulations and recommendations for enhancement for the
mineral fire safety of the occupancy.
1. it hooting, cooking, ventilation and electrical a uipment end app1tnncec Ire
rouuired to be approved by Underwriter& Laboratories Inc. or other nationally
recognized testing 'Nancy on ; inetallad in conformity with the tasting aycncyrs
specifications.
(ref: ,ec. 502 U.J.G. 197u Volume I1;
Consld E. McEvoy
Fire Mar ,1/. /
Plane Examine
cot .`ssh. c ., l r1,. opt.
Ine;r.ctor 3uttn
Cd Harrington
Form 900/3
Rev imed 3/13 FIRE PREVENTION DOES NOT COST—IT PAYS
7.
door finish hardware, i.e. locks/latch.., arm requ`red to have no provici ons
for locking against egress, being upenable from the inside a* nll times fur
immediate exit without the use of keys, spacial knowlsdgc or effort.
(ref: ac. 3703 U.8.C. 197-1
3. Notification of this office for inspection of construction is required:
') orin- ".o drywall cover
b) prior to occupancy of the r1.:ra
(ref r.ec. 1.271 Uniform Firs Code 1971)
4. crior to occupancy of the 'tors a "Certificate of :,ccupancy" ie required frog
tnu ...:L yin;ton ;:Dunt y dept.
' - L. _i_.T ,IL1 The oxit referroc ;_c, abnvn i throtnh the roar of
the store. Thr, main entrance is served by n roil
up grill. For intwrior Wet standaiau locations
alsass refer to the fire suppression synt:sn plans
for the Mall hoots area.
9.504 Sir Washington Square Rd
1S1 26C
camera shop
4 #30355
( Shutter Bug)
4110
- Amorsint
a' Y�
�H / / g WHITS Inrmecte Copy
3 0 3 5 5 5/ I r R r✓ N Q YELLOW Perm.ffee
v PINK Coihler
FqM" N° APPLICATION FOR BUILDING PERMITGREENTemporay Filo
ernes e//Sf/. 5p /CU_
WASHINGTON COUNTS ADDRESS ) NI
DEPARTMENT OF PLANNING
,OCALITr
Bg DIN DIVISION NEAREST —`
it6l
THE SHUTTER CROSS ST
r SMENNIMY CENBL A LANG ,sr GROUP TYPE PR SE1� By
_FOR APPLICANT TO FILL IN `pj'jf `OC rr L CONST C
BU STATISTICAL CLASSIFICATION ZON
ADDRESS 9504 S.W. Washington Sq. Rd. ----
NO '� DWELL ()NITS
LEGAL ok SC tiP,,ON Shop J-2 Iocated in SPECIAL CONDITIONS
Bldg. J, Washington Square ,i
AREA Or LOT NO OI RLOFF /i z y17-4,
NOW ON LOT ��7//// 4 -�
USC OF TONING APPROVED BY / ATE
\ OWNER
WASH INGT ON SQUARE.IK". 226-2692 -YFE OF SANITATION / D151. r
Y ADORE55 900 S• W. 5th/ RATER SUPPLY DIS T.
'''\
- SLOE $$$$$CK /ROM
1 C,Tr Portland, Or.
.9lnT9]^74 TOONT POOP LINE OP I
AIECNITEC! OR E.A.Harr Cgtol'L ZZb-Zb92 TYPE OP (SISTINE FFTSACE NISUWAT + TARO = TOTAL
I ENGINEER NU 515555N WIOTN FROM C I.
ADDRESS MeaDhl,, tell �tTuESre .
, !gm-. _
U 9OD S.W. Sth,TEL +
uof irT•AcI reoM
CONTRACTOR NO 5,0E PROP LIN( OP I L
,\ TTP( Or i[s1ST lose SETBACK III NIENw•r S. NANO =. TOTAL
•005e55 NIeNw•r w10TN rROM -
C ITT +
DESCRIPTION OF W-)RK CORNER CUTOFF TES u NO 3.
,NIESTj Apr ALTER REPAIR DrMOLIsa SEE REVERSE SIDE FOR SPECIAL APPROVALS
SOFT NO OF NO OP
812E 85o S.F. STORIES FAMILIES
NO. et DROOMS NO. Or PATNPOO-
VIE OP -
S TRUCTURE Retail - Camera shop
NO. Or FMP•_OTEES 6
SIGNATURE OP/44y L _ _
APPLICANT1, .♦ 4L '!' •PPROVA,.S * F 0. T TI 0••,,,•1
v•L U•TIONS .00 I':1iUNDATION I JLA TION
F RMS MATERIALS
P C IV _. -_ �� PM' (TT/ •R BRACING BOLTS
7#1;)-4i7-1410d
PEES 2.0 •-•(.."' /JC i FEE$ � PIRFPLACF
Nr.(BY •CNNOWLEOO( Twit I H•VE RISC TH!F APPLICATION ,
ARC STATE THAT THE •110V( TB CORRECT •ND AGREE TO COMPLY WALE BOARD
WITH ALL COUNT, ORDIN•NCEI AND STATE LAWS REGULATING _
_
•UILOING CONSTRUCTION
SIGNATURE OP I/IIl1SE NIIMRFR f.,V 4,N 1 �
PERMITTEE AND POSTED
ADOWFSi lirA HTNUON SQUARE/--'NC.-----
- �fA Li T>FT� >o^C�tp�. �. FINAL �l�-9�� / f%
PLAN CHECK VALIDATION r _ i.e rsPH PERMIT VALIDATION/ (�,,. N„
RE CE,t•1 NO. ../6 A)�/ DATS#y. 4//1 II, , , .., NO/U.,/o/ DATE/// `, %2.4
M'n
WaPtlington County
_ .J �•
Fire District No. I
1448u S.W Jenkins Road
Eeevenon, Oregon P7005
p N.
-� Bureau of F_re Prevention
646-1101 Rzterwri on 245
Plans Lamination Report. No. ^r-, Fire Station _;•
'aunty Plan No. 0104 Run Distance
Building Thr' rhit+trrhur Occupancy I_2 Mercantile Tire Zone ',
Address ha2 'mrd i n 'ry,rn Construction Type
Architect/Designer i .hr..•t Lnrmr+n Address ' ,;,,-1715/ `1 r.'., LDL 'iletlea. re
Owner + r ar i f i r inu Addreea_ 9�,^� * _ JL; nn icuL1 a
Stories Main Area cram /Basement Area rant Attic Height ls, /Stops, nous
Fire Walls Fire iscapes nnnv Exits ;. /Total Width T, ft
Stairs , /Enclosed _ Other Vertical Shafts nL: /Enclosed Sprinklers
Area Covered Man. Alarm nn S.P. s 1�:Xt. n_ _ /Class /No.
Combustion Detection /Type - /Area Covered
Floor :nen rnt.a Ceiling mrn,l_nrt_Li1n Roof triy.uL wo
Str. Members Wall Cover nose / n p..h,inrd
Exterior Interior
Heating 3ystesi Fuel - Cooling System not. a:Iola
The plans for the above described structure were referred to this office
z.nd reviewed for conformity with State and District fire safety laws
end regulations. The following itemized cement:: describe changes in the plans requ!.red
'or conformance with yeah laws and .regulations and recommendations for enhancement for the
peneral fire safety of the occupancy.
1. All heating, cooking, ventilation and alecttiaa1 o' utnnont anti appli:,n;;or rrt
required to bo approved by Undsrwriterc Laboratories Inc. or other nationally
recognized testing wormy and installed in conformity with the tasting cyoncy's
epeciticetione.
(ref: Fee. 502 U.U.C. 1g7U Volumy II)
.3onald L. NoIvC
fire Mar
IL .r - rA /' -
•lens .
sos .7sh.(o.%11dq.Dept.
Inspector Butts
Ld Ilarrinnton
Form
Revised 3/ FIRE PREVENTION DOES NOT COST--IT PAYS
3/73
?. Door finish hardware, i.e. locks/latches, are required to have no provisions
for locking against ogress, being openable from the inside at all timer, fur
immediate exit without the use of keys, special knowledge or. effort.
(ref: ''sc. 330Z U.F3.: 197
3. Notification of thio office for inspection of c:nstruction is required:
ii) nrior to drywall cover
o) prior to occupancy of the store
(ref• Sec. 1.207 Uniform firm Code 1971)
4. Prior to occupancy of tho store s "Certificate of Occupancy" is required from
the uc,iir,;,ton County �uiJ din;, Uept.
liali y1I::,1itICT INS, PECTOORRs The exit referred to abc:vo ie through the roar of
the store. The main entrance is served by a roll
up grill.. for Interior wet standpipe locations
:Tease refer t.0 the fire suppression ryotem plans
for the Mall hone area.
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DriVELOPMENT SERVICES nIVISION
150 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, trigp717: INSPECTION REQUESTS: 503/640-3561
NONE: 503/648.8761
•
OREGO 5 .
Page : 1 of 1 3
Date : 02/02/90
Time : 12:4J
Permit Type : Commercial Electrical Permit Permit # : 05007905
Pettnit Status : APPROVED Applied : 01/31/90
Situs Address : 95t.4 SW WASHINGTON SQUARE RD TI issued : 02/02/90
Permit Title : HEALTH WAY/WASHINGTON SQ Completed :
Permit Descr , To Expire : 08/01/90
Project Title : HEALTH WAY/WASHINGTON SQ Project # : P0006021
Project Descr . • * EROSION *
Parcel Number Land Use Di,ttict :
Valuation0
Legal Uesct . •
Owner Construction : OTH
Applicant Name : RURAL ELECTRIC Classification : 900
Applicant Addr . : HCR 61 BOX 76-K Oc-_upaucy •
BANKS OR 97106 Validated by : VU
Applicant Phone: b4 .-bti9b Inspector Area :
Fee description Units Fee/Unit Ext fee Data
Two* New Circuit Alter . or Extend 1 ,00 32 . 00 3z, 00
Subtotal Electrical Fees : 32. 00
State Surcharge of 54: 1 . 60
Total Electrical Fees : 33.60
*** Fees Required *** *** Fees Collected a Credits ** *
Receipt No. Date PaymHrt
02/02/90 43,60
Fees: 3.1.60
Adjustments : .00 Total Credits: . u0
Irotal Fees: 33.60 Total Payments:
34 .60
Balance Due: ,00
NOTICE. 'r his permit becomes null and void If the work or construction for which itis Issued is not commence.,within 180 days. Once construction has started,
the penntt becomes null and void If construction Is Interrur red for a period of 180 days. I certify than the information presented by the applicant and
his agent or agents In support of this permits true and correct to the best of our knowledge. I acknowledge.hat the Building Department's r ehance
upon false and misleading Information may invalidate this permit All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be complied with whether or not specified on the plans or noted/M1 the plans correction sheets I acknowledge that
the granting of a permit does not grant authorby to access private property or to use easements I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for inspections at various times during the process of conatruction and the building
inspection staff verifying compliance with the various codes. Use or occupancy of the bulldina or structure permitted pt Mr to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements aro satisfied and
approval is given by the Building Official I further acknowledge that a lien may be placed on the IRIa of the properly upon which the permit is issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements.
APPLICANT'S SIGNATURE
AIII% WASHINGTON COUNTY
DEPARTMENT OF LAND USE AND TRANSPORTATION PERMIT NO. O S
11 . LAND DEVELOPMENT SERVICES DIVISION
ELECTRICAL INSPECTION SECTION TEMP. PERMIT NO
1150 NORTH FIRST AVENUE DATE ( 3(j %
HILLSOORO. OREGON 97124 640-3470 ISSUED BY
LABEL NO.
ELECTRICAL PERMIT APPLICATION
RURAL F.UCI'RIC,_INC. HCR 61 Box 76-K, Banks, OR 97106-- 545-66_94
NAMENA� OR FIRM PLEASE PRINT MAILING ADDRESS TELEPHONE •
Or. al ELECTRICAL CONTRACTOR LICENSE NUMBER 34-82C I AM REGISTERED WITH THE BUILDER S BOARD
ORS 701.055 REGISTRATION M4747E EXPR.DATE SIGNATURE OF
SUPERVISOR LICENSE 1/--1710-5 --
H.LE i NE N
Li
PROPFPTY OWNER I HEREBY CERTIFY THAT I AM THE OWNER OF THE PROPERTY DESCRIBED BELOW. AT WHICH LOCA ION I PRCPOSE
TO MAKE AN ELECTRICAL INSTAL LATION FOR MY OWN USE AND THIS PROPERTY IS NOT BEING CONSTRUCTED FOR SALE LEASE OR
RENT FOR THIS REASON, I AM EXEMPT r-ROM BUILDER'S BOARD REGISTRATION UNDER ORS 701 055 THE ACTUAL INSTALLATION WILL
BE MADE BY ME OR BY WHO ISA MEMBER OF MY FAMILY
REL ATIC NSHIP OWNFR'SSIGNATURE
OWNER'S NAME _ CITv -' \ SuN}v
LOCATION OF INSTALLATION _ RF ., �, ��.
AD RT
DIRECTIONS �4.� kLJ.2L 1/ 4 �5c �
FEE
RESIDENTIAL RESIDENCE WIRING LESS THAN 1000 SO FT ____ W S 32.00 ________
RESIDENCE WIRING LESS THAN 2000 SO FT _-__ @ S 53.35
RESIDENCE WIRING OVER 2001 SO FT @ S 74.70
ELECTRIC HEAT INSTALLATION IN EXISTING RESIDENCE @$ 21.34
SERVICES TEMPORARY SERVICE -- @$ 21.34 I
SERVICE. CHANGE ONLY IN AN EXISTING RESIDENCE @S 21.34 _ 1
SERVICE NOT OVCR 100 AMIERES @ 5 32.00 ^- _
100 AMPERES BUT NOT MORE THAN 200 AMPERES _+ @ 5 53.35
OVER 700 AMPERES BUT NOT MORE THAN 400 AMPERES _ @S 74.70
OVER 400 AMPERES BUT NO1 MORE THAN 600 AMPERES @$ 106.70
SERVICE OVER 600 AMPERES @ 5 138.70 _
SERVICE OVER 600 VOLTS @S 320.10
FEEDERS INSTALLATION, NOT MORE THAN 100 AMPERES @!; 21.34
Al TFRATI�IN OR RFI()CATION OVER 100 AMPERES BUT NOT MORE THAN 200 AMPERES ,_-__- (°'S 3?.0U __
nvi H 7110 AMI'I RES HUT NOT MOH, THAN 400 AMPERES __,___ 0,5 .1 r II,
OVER 400 AMPERES __- (°IS 64.01
FEEDER OVER 600 VOLTS@ S 85.36
MIS. t. ANF 011S MOBILE HOME SERVICE _ (AS 21.34
MOBILE HOME FEEDER *S 21.34
EACH IRRIGATION PUMP@ 5 21.34
EACH ELECTRI,SIG?.UR OUTLINE LIGHTING (0'$ 21.34
EACH RESIDENTIAL SWIMMING POOL @S 21.34 __,
ONE NEIA',;IRCUIT ALTLRATION OR ExTENSION Co$ 1.34 �_
` TWO OR MORE NEW CIRCUITS ALTERATIONS OR EXTENSIONS _ @ S 12,00 _., _
OTHER NOT LISTED ABOVE (ta5
I WSPECTK)N FEE S 3')-,---
O
FOR/SECTIONS CALL 640-3611, 2 5%STATE TAX $
24 HOUR IECORDEFZ OPE WORK PIG DAY __
PI ADVANCE OF NEED, 1 3. PLANS CHECK FEE S_
(1+2+3/ TOTAL CHARGE $ •33--
" THIS PERMIT BECOMES NULL AND VOID IF THE WORK AUTHORIZED BY THE PERMIT IS NOT COMMENCED WITHIN 180 DAYS FROM ()ATE OF
ISSUANCE OF SUCH PERMIT OR IF THE WORK AUTHORIZED IS SUSPENDED OR ABANDONED AT ANY TIME AFTER WORK IS COMMENCED FOR A
PERIOD OF IRO DAYS ELECTRICAL PERMITS ARE NON REFUNDABLE &NON TRANSFERABLE
GLUTILD6 E-001 /- K a W 6/
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
150 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561 (24 hours)
OREGON PHONE 503/640-3470
1!
Permit 0: 05007905 Project # : UuO Ul i n Status : APPROVED Page 1 of .
Issued : 02/02/90 Expires Valuation: 0 03/05/90 08: 34 '
I CONEL&C
r Permit Title r?EALTH. WAY/WASHINGTON SO
Description A EROSION *
Job Address 9504 SW WASHINGTON SQUARE RD TI
Parcel number
Owner Name .
Applicant Name : RURAL ELECTRIC
Applicant Addr : HCR 61 BOX 76--K
. BANKS OR 97106
Phone number 645--6696
APPROVED /i NOT APPROVED ,_ APPROVED _ _ STOP WORK UNTIL __�____
[Repair as Listed] [Construction May Proceed]
[And Re-Inspect ] [However Note Below. . . . ]
I
Inspection Requested:
* Final Inspection
03/02/30 RI EMC AM PLEASE
' 03/03/90 DN KP NEED ACCESA TO COMPRESSOR CEIL
03/05/90 RI LMH
Inspection History Summary :
* Underground
02/01/90 CC LMH POURING TODAY/JUST CALLED IN
* Cover & Service
02/09/90 AP HS WALLS ONLY
02/20/90 AP' KP
I
inspector Comments:
Inspected by : Date:.
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON 150NNOR H F RST, 1III SBORO, ORivISION 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561 (24 hours)
-\0 OREGON PHONE: 503/640-3470
Permit #1 05007905 Project #1 P0006021 Statue APPROVED Page l of 1
Issued 1 02/02/90 Expire`. 1 08/08/90 Valuation: 0 02/15/90 07126
• COMELEC
Permit Title 1 HEALTH WAY/WASHINGTON SQ
Description
Job' Addres 9504 SW WASHINGTON SQUARE RD TI
Parcel number
Owner Name 1
Applicant Name = RURAL ELECTRUM
Applicant Addr 1 HCR 61 BOX 76•-K
1 BANKS OR 97106
Phone number 6q5-6696
APPROVED NOT APPROVED APPROVED _ STOP WORK UNTIL ._
[Repair as ii : d] [Con=_.traction May Proceed]
[Arid Re-Inspect ] [However Note Below , , . . ]
I
I
Inspection Requested:
* Cover & Service
02/09/90 RI LME{ AM PLEASE
02/09/90 AP HS WALLS ONLY
V2/15/90 RI EMC CEILING COVER
Ir .pection History Summarys
* Underground
02//01/70 CO LMHQ POURING, TODAY//►J-USST CALLED IN
zere e•--'-'744:0 C-
f.
iii)tlr-
4
,t ate,PC, 1 dic„)._, �e 1.4,, ' ' ,te .��
7-j4 r)4,,,,c4, 14d640/ ,152kter erffitte- 401 rvoc
7,,,./ 1(,‹.
7-444: 7:4444" ,
(�// •t, 7411
Inspe•ctor Comment.. 7-/ Y -1-4f-e-
1/ mea &
Ins•p e c t f by: ___ � Date' '