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Home My WebLink AboutBURWELL ST., 2406 ,.. ~, BR,E MER TO N B U I L DIN G PERM I T DE P AR T MEN T , '" >. .. <.. . . '. . , , , . , . .' ======~~===========~==~===~~~~======~.~=~=~=====~====~======~==~~===.==. 'Applicati~nDate J s.sue Da fe , . Assessor Acct # Si.te Location Owner - LastN~me .:.. street - Ci ty " . .,- P;hone Tenant's Name Agent's Name Architect's Name [X).Building. [ ] Mechanical [ ] Plumbing 03/25/1993 ' , 03/25/1993 2406 BURWELL STREET JEFFERSON &J bu C{' 660 'REDWGOO COURT BRE~ERTON .' (206) 698-2584 Application Number 93AP06423 Permit Numher 14491 Project 'Group ',First ANN . . state WA Zip 98310-_ Phone(206) Phone(206) Ml [ '] Grading [ ] Sign. [ ] Mpve But 1 ding . [, ]l;3urning [ ] ,M,o:bi-l e Home,' (]Land Clear ,[ ] Paving [ ] Underground [ ) Demolition ~----~--~~~------'---~~~--------,--~------~-~------------------------~-. 'Buil ding Contractor: l Work wiil b~ ,completed by owner. Nature .of Work: 13 squares composition. Building Valuation . .. . ~--~------~--~------~--~~~~----~.~-~-----------'--~----~---~-,-----'----- $1755.00 Council District 7 Census Tract Construction Sq Feet 'Inspections Type . Requi red . Residence [X] ,Zoning Foundation [ ] Business [ ] Type Framing ( ] Other [ ] In~mlation . [ ] New [ .'.] Plumbing [ ] Repa;i;r' [X] status Mechanical [ ] Remodel [ ] Code Wallboard I ] Addition [ J 5 Final [X] . , , . ---~-------~----------------~-~---~~----~--'-----~~-----.--,-------~---- Received BY:~' '.' PJ' . ." '. . Approved BY:. I' i 1 n '\ ,{, . ~ ... . .,\..,./ ~ ~ ~ .1-:::> ====== = = == == =~ - ====,=~= = ===,====== = == = = ======== ;;4=== == = = = = ===== = ," '~'~"'-~'..'~j~~' , .,11; .~* .. tit."," , <'<":\' H R p: 14 E R 'I' () N REler.; l' p....f 1t OgS7SS . ? ".'<r,!" ,,," 13 'tJ J 1. n 1 14 (~ D E P ~ R T M F N T *. 'rhi~ 1s Not A Pfr.'rnd,t 1{ Mar. ') " .e,,) , 1993 ,..."..."'" ~ ..........,'~~ ...-'....---.,~......,...~ '.~~.'" ~.,~,~.-~......._,~"...,' ~ ,.............----._ -"_'~~"-,_,, ._,".......~-_.., ~~.....-._. .___l>~q.""'.........',__.,__,..-,,_"_.._"'.., -~ """~ " .Rui.lding 62-322.1001 Perm! t: .F'~ee $ 41. 00 1\nlO un t. P.a t d $ 41, 00 Plan Cheok t"e€>$ Amount Paid ~~~~===~~~=~=~~~~=~~,~~= 1 I other F.~e9 Zonin9 Fees $ .O(J 62-.345.8300 $ ,00 \ , \ ~i ,,;:, G~m r)<'lym~J t Qt tie r Fees Enen:H Gh,;\rge , state sic: fl43-/<,\1 ,13 Total Fees A:n~u:l~ Pa~ d .. ~ p.r.1.0t: Payment ,,7' \,:1' ~, Eahtrlce 'OU,f/c ,. S $ 4.50 .00 $ $ 4.50 ;;~::t ::.~:-;::~;::;::-;;.:;; s 45.50 45.50 .00 ~::~~=~:t;~~'1~ .00 ~2~~~~~=~=~:~=:==~=:'%~~ $. 41. 00 ~ '> 4J.OO Re(;e:1.v,;;d FiCom~ (In, 03/'2.5/~1.~493 Ann Jefferson '1408 ~0r t91AP06f~~ -,'-~ ',-_.,".._*" "..-" .""~-"--~.~.."----,,. --_._-",--~,,--,._---,. 0" --,---,-._'. ..~' --.._._~ ~,~ '-':'~f.2:;:":::,-,~-,,,"~ .-- ,'. / ? .. ,~/ ,.f. \,." \, " '\.. 'I, , i i ,._\J., ~ J_" ~ )... '" i \ ; ; BRBIllERTON BWLDING DEPARTMENT ,inspection Report Scope of won: 13 squares composition Ad.....: 2406 BURWELL. STREET OWner: ANN J1:'.d:"l"lliSON Contrador: SELF Pennit Nmnber: 14491 Phone: Phone: COMMENTS: FOUNDATION FOOTINGS APPROVED: WALlS APPROVED: COMMENTS: line uiml 10' APPROVED: Insolation: r COMMENTS: UNDER FLOOR/FOUNDATION INSUlATION APPROVED: WAlL INSUlATION APPROVED: CEILING INSUlATION APPROVED: MECHANICAL ....coated ~ hearth. COMMENTS: GAS PIPING APPROVED: FURNACE APPROVED: OTHERAPPUANCES APPROVED: COMMENTS: PLUMBING GROUNDWORK APPROVED: PLUMBING ROUGH-IN APPROVED 81l1S1SJ:KOCK aired) COMMENTS: SHEETROCK APPROVED: aired aired COMMENTS: FINAL APPROVED: ~/~ / ~~?> 73 C-~ ~-:I' _. \ "-" 1:- . '. . . ,', ';' <i[.~: .', . ,"~:' \;.~ ,B.f;;;,'f:: i'1.F~.:F: T C) ,N '. H UI L D 1..1,) C Og'~ A.R T M EN T P r'l? n' r 'I" ,,- ..... ::::: ::'::: ::::::::: ::::.:::::: ..".. ;:;.; ::;..:; ::::' ,,~. ::::: ::::: ::::: :::;,:~: ::~ ;;-;: ;:;.;;<::;:-::;: :::::::::; ::::: ,:;.::::::.::::: ::::: j';:: :,0::: ::::.:; :::::;.:-~,:: :;::: :;::: :.::;; l:~: :'!:: :::.:: :.::~ ;:;: ;:~:: :.;:~:::.-: ;,:;: :;:i~ :;-...: ::;;:; .:::: =:.: ~.;~ :~~~ ~;,.:.:::~:i: ::::: ::.:::::-.:: :;:':: ::::: :d ::::; :::: :;;'::;:'''"':': :.-::: . l~ork t.\J'l11 240{~ BUPI"h:LL p(~t~:~~EL.L '. ' '),:1,('),,;,. "r:3! JI;)t,If::' I l' . "),,...~. ,"'" "I. ,,", [, ,..... ",~ "";:',,:.lfII",-~ ' nr'Etvi''''p T'{~lK1_' '. ;;~ .:~ "':Ji;~~7 ,> . t, ,:,t,; c';' ,,)/ ,;'; ('PI~ t:i. cat t 01'\ f;~iJmbe'( 'P8r'rn<1 t Ni:lmbd,( . .. " 'r , ,Q""".j i';;' f': t'. r>.~ r'l i'r. J . , ' . t ,.1 ,) >"'" , A I .,) 'O'!" ?O(;jP();';;:'?O L 11 4::17 "~lr;.f~) 1 j (' ""]', J' i'" Y:l' '\ ""t' ,:,,) ~ , j \', _, .~..~~,.., "....,.Jl: t,rCt. <.:...' J Sf;~UO 'bi'it~):), . (.I;:::,:S(:E~<::O:{,' Acet 4f " " ' ~::;'Jte L,c!cq't: Jon OvrClf':Y' . L,as,tNi:"lme :3t '( PE0t: .u,. C::ity "Ph(:)Y'lc '. 'Tenant"9 l..Jame , .figent "(~ Name Ar:ch:i t cf:.:t '~!} . '[ ']"',nu.ildinq Lx] . Mi)(:han [, ;:I.,' P}umbi J. 1".> 1 ''::I / J C<9() " . _' ,i -, ~..J J' < 7. c ...~ , J J/ 13/J?i7'O First nos f'11 2:1 p9B310 ) ....:., P<'i\}J n9 unJlmd " li.t:ton . HtJ J 1 eli "r19 . r-"Cl' '(""'" :(" V' tJ (~,t . 'I; (".) f':' . ,~J.. t '..')" ~! '.' . .; ,t TYPf;. \ . . ," Inspect j CHIS', , Requ 5: Y' f:;d PCS i clenGf; Bus i nf~~3f::;: Ot hE),( , . NC~v.J I:~f.~p;:.di . 'f:? ""ml""/J,,, J .,t;. "H.:.. (H:ld:i. t :i. Cll',) . f', "I /" ..l 'r l . [' ] (J [ .1 ' [ J [ J ',", Status Code .-.-i.,. ,F'oundp.t:l on { '" " , F{a'mi flU "" t: J , .'IrH':i(rl;'1tion>[ 1 ,,, '\Plumbiri9 C J ., Necha,n 1. Gi'd [){J '. ~Ja 11 boa'rd [: J r,;:'~ TV'''' 1" rX'l .,,, "', ,..,.,-J -.. -.., .,...... -.. -.- .-.., <.0:::'" ........-- ' ~ . , -. . , ' . , . . , , -:'" ..... .,,,. '--;' ..... -., _'.. ...., ..... ,~,. _... "". ,.... ._ .....: ..... '"'f' 'M'_ _._ ._. ~"_,,:, _...... .._....... "':"_ ...~ ,....'~.., ...,_ '"_. _~_ '{:)pp~'(wed ~.' ~ . ~.' " "', "~-~.., t ,"' /C"~ -.".,-..':"::',.., " "-""..~,,.. - ..;,.. ...... ._-~ ..::::..:: .."LL ,-J.:::-i.'.~-f""~ I "\ -......._ _.. ...... =..... ~..~.~. .......... _4 .__~" h_ ~~...__~_.", H'"'' _l.,.~.", ...._.~.. _. ..,1_ f.:.: ~ , " . , pr~ ,_T-,"'",::" '~.t':r:-~' .~; ;r,V"'I"'I""";".1<"D"'<,or',:~" B e/f:""'Kl ,EF: T Of'J 8, U I L DIN <,6 DFf;) f-l h: T1'1 C N, f < 1,\, ') <, " ," ';:"<, , ,,' , " ,'".,,:::'~:~t~i:~~'[:~~t~:r,'~::,:".:.,r.".",~.~,:~:;,:."~~:.,:~:.~.~J,~'~'''~~":~'" .' ] ,'(lr,1p], :1. cali en t~urnbe!- 90F~PO:?7{)t , Corrt '['act 0:( Street ," City F;horle F<ep're1:,>e;rit a,t i'v'f) r'i" -, 'l" "0, I: j ". ''', '(' .:,,:'~ .1+ .':::. ,,' <::! " c ,":' ',l:..'t::' \,,?jt::. 'Jr' ': CH::/ ,I... i c~e~nHe '1::'("('jt'lC-JM"', ("'I.,\r:'F." "1-M:C:;"f" "" '''''',' t, ' j ,,') L, ,..", L, f"l.". 4020 CLLFf'..! LANE " 131?EJlf:='T(rON ' < { '~'l"-J/ \_ ,,~.~. .J {iI'JD , rrrB " ,.,~~.,;. ". " , '" , , ' , , ,\,.. c " ' 'r.~ .~- ,.' ,~. .11 :. ,~rl ." "':;;:, /,_~'.~".~.)' ....;..';(,; i~'.(t:c''''-, >:\;:,U-::', ''';-:i\P~~;""'",,...;;<'''.,,';g.:- ;"1';'::-f/'i~ .':~.ot: ~"o ".<d,~~',u '. ~[, " 'c" ~,_-'; '_~'~ '::i ;~y"::;~~~'.:' ,";::1:.', .:;.A_~\-'t'~"J,:-".....,'i';t, ~"::,'i'". INSPECTION RECORD CARD . .- " , - CITY OF BREMERTQN BUllDINGDEP ARMNT. ADDRESS O'NNER CONTRACTOR. 2406 BURWELL BOB PARNELL ECONOMY SHEEI'METAL 11437 PERMIT NUMBER PHONE PHONE 377-6697 1 FOUNDA liON 1. PERMIT ON SITE 2. CHECK PLANS TO PERMIT 3. CHECK SETBACKS 4. PROPf:RTY STAKES . 5. FOOTING WIDTH & DEPTH 6. SOIL BEARING O.K. 7. CHECK FOR RLL 8. REQUIRED STEEL IN PLACE 9. CHECK FIREPLACE FOOTING 10. ANCOR BOLTS 11. FOUNDA TlON VENTS 12. CRAWL ACCESS . COMMENTS: FOUNDATION. INSPECTION APPROVED BY: 2A FRAMING 20. FIREBLOCKING STAIRS DROP CEILINGS TUBS OR SHOWERS ROOF & CEILING LINES FURRED OUT AREAS FIREPLACE AT CEILINGS HOLES PLUGGED TOP 8. BOTTOM LID IN VOIDS 21. WINDOWS MEETS ENERGY CODE CLASS . SAFETY GLAZING ' REQUIRED FIRE EXITS WINDOW SILL HEIGHT 22. CEILING HEIGHTS 23. SWAY BRACING 24. TRUSSES PROPERLY INSTALLED STAMPED PROPERLY BRACED 25. ATTIC ACCESS 26. RAFTER & JOIST SPAN 27. ROOFING, FLASHING, SHEATHING , 28. SIDING 1.WIRING APPROVED 2.FOUNDATlON VENTS 3. SHIELD UNDER POSTS 4. POSITIVE CONNECTIONS 5. SOIL TO WOOD CLEARANCE 6. BEAM SUPPORT' 7. TA. MAT. NEXT TO CONC. 8. WASHERS ON ANCHOR BOLTS 9. BEAMS PROPER SIZE 10. FLOOR JOIST SPAN , 1. NOTCHING 8.. DRILLING 12. STAIRS WIDTH RISE & RUN WINDERS LANDINGS . HEADROOM 13. ATTIC VENTILATION {upper & lower} 14. CHIMNEY STRAPS SECURED 15. FIREPLACE COMBUSTION AIR , 6. FANS VENTED TO QurSIDE 17. WATER CLOSET CLEARANCE , B. SMOKE DETECTOR , 9. SHEETROCK BACKING UNDER STAIRS '. ABOVE GARAGE DOCR HANGERS COMMENTS~ FRAMING INSPECTION APPROVED BY: ~ .. . ~V:-"<I 2B INSULA liON COMMENTS: 1. PROPEA A-VALUE 2. VAPOR BARRIER, 3. PROPER FASTENING INSULATION INSPECTION APPROVED BY: MECHAN1CAL 1. PERMIT ISSUED 2. FURNACE LOCATION 3. FURNACE CLEARANCE 4. 'BI VENT SIZING 5. 'B' VENT CLEARANCE 6. 'B' VENT SUPPORT 7. COMBUSTION AIR 8. DUCT SIZING 9. DUCT SUPPORT & JOINTS 10.GAS PIPING TEST 11. GAS PIPE SIZING 12. GAS PIPE SUPPORT COMMENTS: M .' HVAC APPROVED BY: 'U- GAS PIPING APPROVED BY: I (~3'/ft:? WDST 1. WOOD STOVE CLEARANCE 2. CHIMNEY CLEARANCE 3. HEARTH EXTENSION 4. CHIMNEY HEIGHT WDST APPROVED BY: P PLUMBING 1. PERMIT ISSUED 2. UNDER TEST 3. WATER PIPE SIZING 4. DYN SIZING 5. PROPER SUPPORT COMMENTS: 6. PROPER RTTINGS 7. REQUIRED CLEANOUTS 8. PROPER GRADE 9. HWT PRES. RELIEF VALVE & UNE 10. SEISMIC STRAP ROUGH-IN APPROVED BY: UNDERGROUND APPROVED BY: 3 WALLBOARD 6. ARE SEPARATION IN GARAGE 7. ATTIC ACCESS 8. DRAFT STOP IN ATTIC 9. PROPER CONST. OF FIRE WALLS 10. DROP CEILING & LIGHTING 1. LID OVER SIDES 2. NAILING 3. W/R AT TUB OR SHOWER 4.5/8 UNQER STAIRS ,5. FURNACE ENCLOSURE COMMENTS: WALLBOARD APPROVED BY: 1. HANDRAILS 2. GUARDRAILS HEIGHT INTERMEDIATE 3. EXHAUST FANS 4. WATERPROOFING IN SHOWERS 5. DISH'NASHER AlRGAP 6. FIRE DOORS, .' LABLED AS REQUIRED SELF CLOSING 7. FIRE DAMPERS INSTALLED ,8. PENETRATIONS IN FIRE WALLS . FINAL PLMB. APPR. (comm.) .~ FINAL MECH, APPR. ~omm.) FINAL BUILDING APPR. 4 FINAL 9. HOT WATER TANK PAL . . 10. OUTSIDE GRADE 11. SOIL TO SIDING CLEARANCE 12. SMOKE DETECTORS 13. FIREPLACE HEARTH 14. SAFETY GLAZING 15. INSULATION . WINDOWS MEET ENERGY CODE UNDERFLOOR & ATTICE INSUL. WATER PIPE & HEAT DUCTS 16. WOODSTOVE APPROVED 17.'WlNDOWS & DOORS CAULKED (~ COMMENTS: {1{('11ft:( ~ '. . ~/ .' .' . N(] 42601 /} ,:3 _ Fee $.uu.u..nm"'nnnn6.wn:~.'nn..,.,nwnn..'mnn' Receipt No. n......pnO~'.";':,g..~'2~=nm...,wnnw' B U I LD I N G P.E R M I T CITY OF BREMERTON BUILDING DEPARTMENT F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36 7/ Owner's Value Bldg. Dept. f" .~7) $ ~.;).. Value DESOuPTION: Lot Block Additions Address on Job _;f~~~ _~_ __ - - _ _ _{"~1~,~~~,,~~!~!d?' _m~_ __ __ _ __ ___ _.. __ _ _ _ _ _ __ _ _ __ _ _ _ __ ___ _. __ _. _ _ __ . Date __!:~='f.. ~ _~ g.c...;': ~:'!. _ ____ _ u _.._ _ _. Building h__mm__m_ X ___m__hm__. and _m...._.h.... stories __m_m____mh___.._ basement. Lot ....___.mm._ x m_~__...______ Front Yard .h_..__h__h__..__.___ Rear Yard ~..__m____.m.______. Side Yard .mh__..__.___________ Garage .___mC___m__m.____h._h Occupancy _ __ ___ _. - - _.__ __"~.__ _._ __.__ __ __ __' _ _ _. _ _",_ _ __ _ _ __. _ _. _..__ _ _h _ _h_.. __ _.._ _ _h _ _. __ _. _ _ __. _. __ __ .... Zone . ___ _____ u_ ___ _. .__ __ __.. ___ __ _ _ __ __._.__ Owner m_..A.j;.1':_:..._.L0t:~~:...____Ld~~4..:________. Address _________. '_,_' ..___._________,___________... Phone __.._____________ Contractor __ ___ __ _ _. _ _ _ _ _ __ _ _ _ _ _ _ _. _. _... _.. _._... _ _.. _. _ __ _ _ __. _ _ _. _ _.... _ _ _._ Address __ _. _ _ _ __ _ _ __ _. __. _ __... _..._ _ _ _ _ _ _ __ __ __ _. _ Phone _ _ _._..._ _ _ _ _ _ ___ This permit is issued for: ;;. . ___,:.~i _~_ =-:__:~jt'__ _. __~;~i_!il~_~!_ _u u__ ~~~-L~~M:~._ _ _ :.0-~(t='~;:~~&:_~,_'!! _u .'__ _ _ __ __ __ _ _ ___'. _ _. _ _ __ u_ _ ___ _ _._ __ __ __ _ _ __ ___ uu_ _ __ _._ __ ___ un un _u_ u_ ___ - -'- - -:~ ~~- -. -- -._ - _ m _ _ __ _{ _ __ __ _h _ _. _ ___/_ _.. _ _. __ __._ _ _ __,~_ __. _ __ __ _h_ _ _. __ ~=. _ __... __ _. __ _..__ __ _ _ _. __ __~ _ ___ __ _, _ _ __..._ _ _ _ __ m __ ___ __' __ _. _ _.__ _ ___ .___ __.._. ..~._-:.t",~:f': _~;:.,"" _~; "",";:'2__ _ "_h _ _.. _... .._.. __ _..__ ___ _ _ _ _ _ _ __ _ _. __ ___ _ _ __ _ _ __ _..h __ ._ _ _.. _ _.. __ _. __ __. __', _ __ _ _ __ _ _ _. _ _ _ __ _ _ h _ _.. .__..._ __ _ _ _ __. _ _ ___ _ __ _.._ _ _ _. __ ,_ __ _h_' J:'~- - All work to/conform to all applicable building ordinances and amendments.. Please note the following special instructions and requirements. DETACH HERE AND POST THIS SECTION ON JOB INSPECTION - Reinforcing steel ,must be inspected after placing and before covering. FORMS shall be inspected and approved before pouring. All plumbing, wiring a,nd the frame of all buildings must be inspected and approved before covering. Wood preservati~e to be used on all wood against masonry. Ventila,te foundation and attic. Sepa- rate permits required for plumbing, wiring and heating. See City Engineer before working on streets or sidewalks. -- --- -- ..-- ---- ---- --- -- -- ---- --.. -- --- -- --_.... -:::.. ---- -- -- -_.. --...... --.... -------;. --.. ----...... --- ----........ --........ --_.... -_........ -- --.... --_.......... -_.... --.. --........ --.... -- --...... --.. ------ -- ---- ---------.. ---------------------------------------------------------'".._-------------------------------------------------------------------------------------------------------------------- ...... --- --- -- ----.. -.. --- -- ..-- ---.... --.... --.... -- -- ---.......... -_......-.... -_.....;_.. ---.... --.. - -- - - -..- ---_.... -- --........ --.... --.... -- ---............ --.... -- -- ---.. -- -- --- --.... --- --........ --.... --...... --.. -- -- --.... ------...... ...... --.. --- -- ---- -- ~ --- -- -- -- ---- --- - -- -- -'-- - - -- -- - - - -- -- -- -.. - - - - ~- - - -- -- - - - - - - - --- - - -- ~- - - - -- - - - --- ~ -- - - -- - - -- - - - - -.. - - - - --- _..-- --- - - - -- --- - ~ -- - - - -- -.. -- - -- - - -- - - -- - - --- ..--- --- --- - -- -- - --- -- - - - - - - ~ - -- - - -- - - -- - - -- - -..- - - .-- - --- - --- - -- - - - -- -- - -..:.- - - -- -- - -- - ---' - - -- - -- ~ - - - - - - - -. ---.. - -- - - -- - -.. - - -.. - - -- - - -- - - --- - -- - - --- -- -- - -- -- - - - - - - -- --- - --- - --- - - --.. --------- - -- -- - --- -- -- -- -- ~ - -- -- - - -- - - - --- -- -- - - - -- --...- - -- -- -- - - - -- -- -- - -- - - -- -- - -- - -- - - -- - - -- ~- - - - - - - - - -- -.. - - - - - -- - - - - - - - - -- - - - -- - - -- - - - -- - -- -- - - - -.. -- --- - - - - - - -- -- -- - - -- -- -- -- -- - - .---- - -.. -..- - -- - - - - -- -- ~- -- - - - -.. - -- - - _.- - -- - - - - - - -..- -- - - - -- - - --- -- - - - -- -'- -- -- -- - - - - - - -- - - --..-.. - - - - -- - -- - ~ - - - - -- -- - -- - - - - - - - -. -.. - - -- - - - - - - - - - - -.. -- -.. -.. -.. -.... - - - -- - - -- - - -- -.. -- - - -- - --- --- -----------------..--------------------------..-----------....--------------------------..-- ---------------------------------------------------.----...----..---------------..------.-- ----.._-----------..-..--------------._--------~-----._-------------------------- -------._- ------------------------------------------- ------- -..----------------- -------------..----- - -- -- - - -- -- - - - - - -.. - - - - - - - - --- - - - - - - -- -- - -- -.. ~ -...- -.. - - - - - - - - - - - - -- - - --- - -- - - -- - - -- - - - -.. -- - - - - - -- ---.. - - - - - - - - -- - - -.. - - - - - - -- -- --.. - -- - - - -- - - -- -- -- ---- - -- -- _...- --- - - -- - - -- -- - - -- --.. -- -- - - - - - ---- - - - - -- -- --- - ------- --- -- ---- -- - -- ~- - -- - -- - - - - - - - - - - - --- - --- - - - - - -- - - -- - - --- - - - -.. -- - _..- - - - - - - - - - - - - - - - - - - - -- - -- -.. -- - - - - - - -- - - - - - - - -- - - - - - -.. -- -... - - -- - - -- - --- - - - - - - - - - -- -----------------..-..-----------------------....--------------____.________________________ __________"._________________.__....______________________________.._____________________M_ - - -_ __ ___ _ _ __ _ _.._ _ _ ~_ _ M .__ ___ __ ~ __ ___ _ _ __ _ M _.. _ _ _ _ _ _ __ M _ _ _ _ _ _ _ _ _ __ _ _ __ _ _.._ _ _ _ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _.. _ _ _ __ _ _ _ _ _ _ __ _ _ __ _ _ _ _ ~ _ __ _ _ __ _ _ _ __ _ _ _ _ _ __ __ __ __ ___ ____ ___ _ ____ _ _ __ _ _____ ---....---..---..----___....__________.._______..___.___.___..M_________________________________. __________.._.________________________.__________________________..___..___..___..M__________ ---..____________________________M___________.____________________________M__________M_____________.._________..________________..____________________________________M_.._M_.._._____ --;;...---------------------------------- ------~ ------------ -_ _________.._________ ______..___ M_______________________.._ ___________.___________._________..____..______.______M..____..__.. ---..---------- ------- ---------~------- - -- -- --------------- -------- --.......----- ----------- _..___________________________________M________ __________________.._______________________ -- -~----- -------------------------------- ------ -----------_______________ -- __ __ _________ _______________M________ _______ ______M_________ ___ _____________ ...____ __ ______________..M. ---..________________________.._M_..______.;;;.________M____---..-____..___________________________________M__________M_________________________________..__.____________________________ Owner's Signa ture__ _ ~ _ ,,_: ~ f... ~,: _,~:~.._ 2... .'_.:. _. :'.." :~~_~,. _r _~. ':'_: i,:~ ~', ~t. _. By _ _ _ _ _. _ _ _ _ _ __ _ _ __ _. _... _ _ _.. _ _ _. _ _ _ __ _ _ _ _. _. __ ___ __ _ __ _ __ _ _ _ __.. __.. __. _. _ ___ , , _ ""- -0' ':n~n , . His Authorized Agent ., ,,,,,. f'f"l. ~!"U " " Orr~Dr -'I' I'U,;1 R.\..2J,.\L B 'ld' g I t l',:'. .:':' '.5,,1,-_-..L.'_:'_ ____ vu~i . h'" UI In nspec or ___,________~___..____..__..__h.----.-----.------.---,.--------------.---..----00__ .,.,(:.",-,'1:"''1 B'u:l!'\"'G ) ~~onE G."''"' ec-, ,\,1", ." '''1\') B {.~ -,' rj ... i - ~I.;I 1& _ " ,/. ~_;j.-v i\ l;lh..l, Y .__________.___.____.__~_..________.________.___________oooo__ h...... ._____00..____.__.