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97-102662 CITY OF FEDERAL WAY PERMIT NO: I3L.D97-0438 33530 Fi rst Way South ,�!" idh,,,,J01..,II!,. E...,.,11 A., .. 110.11!li wl!' I %C Pt 1114 I '1P ISSUED: 08/21/97 Federal Way , WA 98003 Building Inspection Requests 253-661-4140 BY: FC 253-661--4000 EXPIRES: 02/17/98 ADDRESS: 33114 47TH AVE SW NO. : 189890--0100 PROJECT DESCRIPTION:NSF- Including plumbing and mechanical Seville BASIC#97-1OO9-v94 -= OWNER __-=___== TCONTRACTOR _ .. _...... _ = t LENDER .. LEBARON HOMES INC f LEBARON HOMES INC CONTINENTAL MORTGAGE CO. 25710 212TH AVE SE i 25710 212TH AVE SE I. 11555 SE 8TH ST., #110 MAPLE VALLEY WA 98038 I MAPLE VALLEY WA 98038 f BELLEVUE WA 98004 S 425-432-9124 432-9124 LEBARHI099LZ *_; CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.2% *** BLD?:X MEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 s COMP PLAN -UREA , FEES: TYPE OF WORK:NEW USE:RES 1ST.: 0: 1431:sf STORIES 2 9 REQUIRED PARKING..: 2 SPRINKLERS' I PLAN CHECK FEE $ 100.00 CENSUS CATEGORY •101 2ND.: 0: O:sf HEIGHT • 36.00 ft HAZARD CLASS •' PUB WKS PLCK(SF),.93 $ 80.00 OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION REQUIRED SETBACKS FIRE FLOW 0 gpm BUILDING PERMIT...,* $ 874.00 { :R3 :U1 :? :? OTHR: 0: O:sf EXIST..$: 0 FRONT • 20.00 ft Mechanical Permit* $ 54.00 TYPE OF CONSTRUCTION BSMT: 0: 839:sf PROP...$: 166493 SIDE • 5.00 ft WATER SERVICE..:FED J SBCC SURCHARGE * $ 4.50 :5N :5N :? :? : DECK: 0: O:sf s REAR • 5.O0:ft SEWER SERVICE..:FED SCH IMPACT (SFR)NEW $ 2372.00 OCCUPANT LOAD GAR.: 0: 631:sf RECEIVED.:07/21/97 PLUMBING FIXT....93* $ 98.00 5: 0: 0: 0: TOTL: 0: 29O1:sf IMPERV SURFACE: 2342 Sf SENSITIVE AREAS?.:Y -- ------------ FUEL TYPES.:GAS GAS FANS • 4 BOILERS/COMPRESSORS WATER CLOSETS • 3 URINALS . 0 TOTAL FEES $ 3582.50 GAS PIPING.: 100 ft HOOD • 1 0-3 TON • 0 BATH TUBS • 2 DRINKING FOUNT.: 0 ID FURN<1O0K..: 1 DUCT WORK • 1 3-15 TON 0 ; SHOWERS . 1 SUMPS • 0 GAS HWT • 1 WOOD STOVES...: 0 15-30 TON...: 0 Ig LAVATORIES • 4 VAC BREAKERS...: 0 CONY BURNER: 0 FURN>10OK • 0 30-50 TON...: 0 i SINKS • 1 DRAINS • 0 BBQ • 0 MISC • 0 50+ TON • 0 DISH WASHERS - 1 LAWN SPRINKLERS: 0 GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS 3 ELEC WTR HEATERS.,.: 1 OTHER FIXTURES.: 0 RANGE • 1 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 1 GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 --- - .._._ __-_ ___ __ I -- _ _ - - ...._=a PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARVED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFORMATION FURNISHED BY M IS TRUEANDCORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET. OWNER OR AGENT ect1444 = /"...ca .-, DATE F'tti _ _._.... FILE COPY • BUILDING DIVISION �°; r 33530 First Way South VV FEY RECEIVED Federal Way,WA 98003 (206)661-4000 Fax(206)661-4129c JUL 1 7 1997, 45.r`c 9 7�/00?- ►may APPLICATION FOR BUILDINGARtiRMIT Sevdi or¢38 PLEASE PR/NT APPLICATION # IS t�O 9 7 - f;,)71- ��#<3> Address w..,,:.. 33//y y7 Yet Atv. 5, 0, ederg U)"' i gs'��� Tenant(if known) Lot # /.z, Asses Tax#9Y7'9 Building O er's Name ,_i____. Address �c'/I. iQ 5 f-f?L. 267/0 2J ii • S F City !Y I Ct , 1Q15 � . I State Zip 90 Phone ,Zj /� / 73 93�Ila K Nature of Work 5L1.L e: linf(e etj ui Re sidece_, V Name (F,M,L) (5a t:- Address =Address City State 2(p Conte arson Din,t.r I-1pyay Phone Other Pho a Fax Company Name Address City State Zip Contact Person /Airk Contractor's #(card rrYust be presented) Expiration Dat Verified 0`Yes 0 No 1, fficRHL D99Z. z b/Y/i5 Name Address City State Zip Contact Person Phone Fax f. LEGAL DESCRIPTION _�/ c 4o4.- /6, P/ 0f ad ,/ 4 (5-7117e roti J Plan en rmmriles#, Dn,,nron Q:.l.. III . III Existing Use �..CI ..:. ..... _ h a� Proposed Use !v et.C� /4e��e Permit includes: l Building p Plumbing p Mechanical 0 Other Type of Work: tt. Residential El New 0 Remodel 0 Number of Units f 0 Deck 0 Commercial 0 Addition pr!Garage 0 Shed 0 Other Enter 1st Floor / r4 sq ft 2nd Floor sq ft 3rd Floor t_' .t Yy ,,,..sq ft Existing Floor Area sq ft Area Basement 'sq ft Decks sq ft Garage -rt—� : sq ft Proposed Total Area t" sq ft Water Availability 0 Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation $ Zoning I Lot Size /%7) 7711 j,) Existing Bldg Valuation $ _ tENDEREEMEUgnaiMainiMiMg ................................. Name CO n/ +n,0_./kik 4 'g r C co( Address 1 City B e.' I o e_-- State tI1 iii- Zip 7 vl _ � cf t Ni. Contractor Name Address City State Zap • Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No Contractor Name Address City State Zap Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No sIziit'AftCU1ttt:E3ti IX RE Cf#UN1T»Mi!` >'` Water Closets .3 Sinks / Urinals Lawn Sprinklers Bathtubs 0/ Dish Washers / Drinking Fountains Other Showers / Electric Water Heaters Sumps Lavatories fri 'Washing Machine Drains »>:::;:"3> 'z:3i:'>< � < z< z` 7ofa1'' Erxture Count :.::::.......... .;;:. ......:..,� •fa�;�;i$i:::i:i::':iiii::::::i:::::::::::::::i<isisisi?< 'riii>�i%i:i>::rii> C># :> Nt i:ea.rals<:i<'iii`i::<<:<i<ii': MECHANICAL EVALUATION ONLY $ Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons Length of Gas Piping Ranger Air Handling > = 10,000 CFM 30-50 Tons Furn <100K BTUs \. Gas Log 1 Unit Heater 50+ Tons Furn >100 BTUs Fans 7 Miscellaneous Fuel Tanks Gas Hwt . Hood / Boilers Above Ground Cony Burner Duct Work •/ 0-3 Tons Underground BBC's Wood Stoves 3-15 Tons 'fot I:11ntt:�aunt>>s�><i::<;>; >; ?> i DISCLAIMER:I certify under penalty of penury that the information furnished by me is true and correct to the best of my knowledge,and further,that-I am authorized by the owner of the above premises to perform the work for which permit application is made.I further agree to save harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim arises out of the reliance of the city,including��� its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. Owner/Agent: &.-..-)ex.1774,14.�. ..,16 �„`P� L / f` t/`� Date: wu,...�.AR (J Rcv.o 11/11/98 DISTRICT OFFICIAL USE • LAKEHA EN UTILITY P.O. Box 4249 •31627-1st Avenue South • Federal Way,Washington 98063 APPL# Seattle:941-1516 •Tacoma:927-2922• Engineering:941-2288 PERMIT# DATE BK# APPLICATION FOR A SIDE SEWER PERMIT A/C# S/N # SITE PLAN IS REQUIRED FOR ALL APPLICATIONS TYPE OR PRINT LEGIBLY OWNER kr= . C re 1/1. YYL.t PHONE (yz5-) PROPERTY ADDRESS 3 3//y '�7 ,ve, 5. 61, jCec efc�� o/,(� .-�!�� LvrT 9ree,3 BILLING ADDRESS Z..S✓7/0-2/a-14`PT��e- 5- €, fflt.pIE' ()CP�t�t�' t. �"YY LL/b 901-75 AT rr CITY t/ STATE ZIP LEGAL DESCRIPTION: NPLAME S & 12re0 Lt' Dash. e tom - LOT i( BLK / �/' (IF APPLICABLE) OTHER LEGAL DESCRIPTION i� S&. OI vtt- AUTHORIZED SIDE SEWER CONTRACTOR �1 PHONE BLDG. IDENTIFICATION /?c'S tete-1076U NO. OF UNITS PER BLDG. WAS BLDG. PREVIOUSLY CONNECTED? YES ❑ NO IF YES, ACCOUNT # IS BLDG. CONNECTED TO WATER? YES ❑ NO [ IF YES, ACCOUNT # RESIDENTIAL X APT/CONDO/MOBILE HOME NON-RESIDENTIAL WITHIN ULID TYPE OF BUSINESS ( BE SPECIFIC) SQUARE FOOTAGE OF NON-RESIDENTIAL BLDG. SQ. FT. PROPERTY AREA SQ. FT. (MULTIPLEX AND NON-RESIDENTIAL ONLY) 1 REGULATIONS AND REQUIREMENTS ARE SET FORTH ON REVERSE SIDE OF THIS APPLICATION J FOR DISTRICT USE ONLY IN LIEU OF ASSESSMENT CONNECTION FEES BILLING TYPE RESIDENTIAL 0 FRONT FOOTAGE $ NO.OF ERU NON-RESIDENTIAL 0 OTHER FACILITIES $ CFC/CIC $ SIC GROUP DEVELOPER PAYBACK $ AREA CHARGE $ APT/CONDO/MH 0 SUB TOTAL $ — BASIC PERMIT $ PUB AUTH 0 RIGHT OF WAY $ DISTRICT IN 0 OUT❑ WATER DISTRICT PRETREATMENT $ LIFT STATION SUB TOTAL $ ULID TOTAL $ PLANT 1/4SEC BOOK D.P. INPUT COPY 0 Resicitial Sewer Use Certifican (To be completed for all new sewer connections, reconnections, or change K„:cor�rr p of use of existing connections. This form does not apply to repairs or replacements of existing sewer connections.) Pursuant to King County Ordinance No. 11034, all sewer customers who establish a new service which uses metropolitan sewage facilities after February 1, 1990 shall be subject to a capacity charge. The amount of the charge is established annually by the King County Council but is limited by state law to$10.50 per month per residential customer or residential customer equivalent for a period of fifteen years.The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers.The charge is collected semi-annually.All future billings can be prepaid at a discounted amount. Questions regarding the capacity charge on this form should be referred to King County Wastewater Treatment Division at 684-1740. (Please print or type) / Owner's Name te.�a-ro nNe me 5, T-i2 c _ For King County use: (Last,First,Middle Initial)�1 H Account# Property Tax I.D. Number 1k? 'q1' 0/`` L` Property Legal Address: Monthly Rate Subdivision Name 3-it)vie roBk Subdiv. # Six Month Due Lot# 0 Block # Building Name (if applicable) Property Street Address . 3//y- L/7i9-de., n5, ii. , City, State, Zip redpX ct/ I�kyr 11 Owners Mailing {U/ Address 1S-7/U` ,2 aft- /JtJY'_.. S� (If different from �/J/� l n above) ALP le V t! /yr FQ3 Owner's Phone Number( 2,--9f Property Contact Phone Number ( Party to be Billed (if different from owner) Party's Mailing Address (if different from above) City or Sewer District Lake-h tc(ems � s Date of Connection: Side Sewer Permit#_ Residential Customer Please check appropriate box: Equivalent (RCE) Single-family 1.0 Duplex (0.8 RCE per unit) 1.6 I I 3-Plex (0.8 RCE per unit) 2.4 4-Plex (0.8 RCE per unit) 3.2 5 or more (0.64 RCE per unit) No. of Units x 0.64 = Mobile home space (1.0 RCE per space) No. of Spaces x 1.0 = For condominiums, please fill out Supplemental Form A in addition to this form. I certify that the information given is correct. I understand that the capacity charge levied will be based on this information and any deviation will require resubmission corrected d to or determination of a revised capacity charge. Signature of Owner/RepresentativeetDate ?^/) -'') Print Name of Owner/Representative Q,l,/ }n CU” i pry 1 de_ 1057(Rev.11/96) White-King County Yellow-Local Sewer Agency Pink-Sewer Customer .0•00 111"11111111."" (LE13ARON HAES INC 1,.."::. . - 'WT.,-Irl'A''' .'t RAY MARKLEY- PRES. PHONE: 2� 4 �1 �: J�{. _ : 43 912 � . b(... --1 - :-fi/ t LEGAL: (-Pigs)/ Poi NTS) 01-M ________ _I-QZ iQ__--._ 5TO 13RooK__ - -_Pagc4L_ 189884- o i a o 1- - L01 SIZE : 7/3Y = 7/ M " iq/ 777 Std. FT, ± _ ; 29 5- RECEIVED CovEkRGE `M �__ _.._.._._- M 2cfo OCT 2 8 1997 HOUSE_ ilz& ± N 'N GR R ‘, )&, :t. 11, Z CIBUILD NG DEPT. AY li 1-21-12 ± .;-: N `:' /8'0 �, Z N REVISION DATE OCT 2 8 1997 �N SOOpR � , • M C F FEDkEV�. 287 6 - 1 DEPT.OF COMMUNITY i �}L p E R \ = 47 c BUILDING SECTION 6 Rov ✓ APPROVED_p ,, . AS CORRE D P.E: _ - - t SUBJECT TO FIELD N.G._ _ - __ 28 d r - . 3 lij , ,,,,„,,..,.., OVERSIGHT OR VIOLA��f�MOHI� - ` - " rl y Dr---- a -�` CI !RDINANCES ARE g JI4 /� 25 2S ' 4 36 ,% CA pR i - 9 FRaNT .. w/ r��N iz-902 y8-4'/z.x Liz- to.., 2 w EST C 36 DiA 6y-LIT& t' ,i"\I2.1P o ELEVATION a 2.0 Si oul- \I► N cis •r, • 01,/ Oki 57TI:7 ` Pi-..411,1 --7----.--- - OXY �T N N N / `/-...__iz:...1.,...--:::�G_- 20 S (v V' �E Sy,� ..y_. 2N ToC.f., (TY?) 33114 14-27 )/E/ S, w, PLOT PLAN 1" =30' NORT1-i --.--- 1 01 ( 1 o. a 1-i� ; ►.� TY. OOrF L,111.1,f;1 ' 11141, :sr:{ Fir - t I .,., U....40 .. : 1$.1. PIK'! ie f:.At I t A,/, t-h t .,m)�Lt1F., t:i l t=ai c1,1 I r' ' ' 6'61 4000 s , I / I)r 1rt`. 1'. .:: 3'3J 1 t ! 1 1Z (IV/ ' (A) 4 0 I,U9890' }t i.�_}t.i a - ROJI}: 1 Ns(.;g:F?.11'1 I 011.NSF- 1ncI Mt rig pluabin9 and lechanii.al ',16,504448 I14SI(197-104W-04 Capri'! 2b) I LEBARON HOW LIN. i LEBARON HOMES IHt rON1INltrtAt m0R1Gt9GL co. i 25710 212111 AVE S€. 25110 212TH AVE SL 11555 >€ 8111 SI., 11110 1111iMAPLE WOW( WA 48OI8 MAPLE VALLEY WA 98038 8ECLEVUE WA 98004 9 I 4,'5-431' 432-9124 1 1 pp , .,._n CONIRACIOLIS; 'Yt1AtSf Kt t Ir.A11HM tilt 1;32 04'1,4 ztr =.t.46 SALES 1Alf fOR PROJECTS MINN 111Ci iY 01 EFO1RAE HAY. fAX RAl11 - 8.1'#1 t:t x. < a}z:ty}a.h yfbYY'A ^,sctacsusaasYc.:Mmx.a .. 1 Rt D.':, `'�Y`' PLS":wk F LR L;1 ��0P C '1`r ,'_t 'iF?I I , r "r}MAP PLAN,. ...:+If bA FEES: 1 1 TYPF OF Wogs W USE:RES 1ST ,40 143 y1i, S'1tri! ! N}rttPF.Tt ,AREIW;. " SPr'IRMV?,_.,.. 0 PLAN CHECK FEE / 110.00 1 1 CENSUS 014$1_,..:101 'T1t� 5 fILl. :,,i..«^.. 1".,.at}1 " }vi:,:" +.,-,'. .,,,,,ti, PUB WKS PLCK(SII..93 $ 80.00 1 ' ;„,,,,—(1);,.„-, 3 U; w " I f;1 ,''*10 ....: ' 0 WA IL.1E PERMIT..,.+ $ 574-00 1 OCCUPANCY GRp:,. �, ItA1 �T1Ct1i 1 r r�,:aita€� �.L1krs�.i. f :R3 :01 .::'. :2 ,Ing: On 4 , E1+1 .1. , „r,; t 20.00 it J Mechanical Permit* $ 54.00 j 1 TYPE OF CONSIRI ,1!411 b NT: 39• , ON.. t- T6„ot :11}' 5.00 ft WRIER SLtV10E..:1LD J SBCC SURCHARGE.._..* $ 4.50 3 I :SN :5N :? :, : DEC; 0• O:s 1 REn) • 5.00:11 SEWER SERVICE..:IED 5(0 IMPACT (SFRINEW $ 2312.00 1 OCCUPANT LOAD--- ------- GAR.: r, 3L:sl }L'_LIVtp.:U' .AI T PLUMBING 11XI,,..93x $ 98.00 I •• 5 0: }T: 0: 1011 2 IMPERV SURFACE: 2342 sf SENSITIVE AREAS'.:Y m mar .,.,«.'..eta43r s•sr.._cevcq::;l�s,ra:.„;�,:-,...se..:: rax tr:..n ,rr:r. FUEL TYPES.:GAS GAS CANS.. • 4 B0ILERS/CO$PRESSORS WATER CLOSETS • 3 URINALS,.,,.,..: 0 1 IOTAL FEES $ 1582,50 ! GAS PTPING,: 100 ft HOOD . 1 0-3 TON • 0 BATH TUBS...,....,.: 2 T)RINflt4 fOUNT.: 0 1 i FURN-:.100i..: 1 00(1 WORK,•,,.: I .1-15 TON • 0 I SH0WERS.....,. • 1 SUMPS • 0 1 1 GAS H01 • 1 WOOD STOVES : 0 15-10 101...: 0 IAYAIORIIS.... .,..: 4 VAC BREAKERS...: 0 If CONY BURNER: a FUR11 100K , 0 30-50 TON...: 0 SINKS 1 DRAIN!, 0 j BRO ,: 0 MISE `'' • 0 501 TOW 0 PESO WASHERS • 1 LAWN '.10RIN11FRS:: 0 1 d GAS OPYFF..: O AIR HANDLING UNITS ' FOEL TARRS-.. ._-- LLEC WIR H£AIERS...: 1 GIHER FIXTURES.: 0 \\\I 1 , AUG[, • 1 . 10,000 GM: Er ABOVE. GROUND: 0 LAUH WSHR 0011.15...: 1 r GAS LOGS...: 1 10,000 CFM: 0 UNDERGROUND) 0 (1 ,..t L':' ..1.,....C.1C¢"..+&X.,.,.:...F..:Ar...hA'l i9,.'.:k 1.t2...'d._.:'G.9.«.%:;.Ri.X::w..;.5.7..4.:...•ttS:N�--' PEIlfflfS EIREkt IOU DAIS Ar AN ISSUANCE IF NO WOKE I S1ARIEP. RESIDE0114 ANA GIMPING PERA115 EXPIRE OWE YEAR ACM PAff Of ISSOANCE. 11 I C RIIl1 INAI lilt IIff 11011 TURN*SNIS I 10IO CORKICI to I'rt. 111.'.1 01 AIV tWOVELDGL A00 111 APPLICAAL.L l.ITY Of f1DAtNAl PAY KIQ111RINIMI3 1111+ 94 t1 OWI ,! OR AGENT kc4tJ . /,�^ 1rI+ �C 1{ FIELD COPY 1 • • r1 rSETBAOKS&FOOTINGS Date r , (B —1 y 2 Pp;1JNDATl N WALLS _. . : • :.;:.) Date// >7 // /'.:By::::>:�j — 3 PLl71iABING ROUNDWORI( : Date By ................................................................................................ 4 SLAB..INSIiLATIGI�I'.. ::«:::: »>:::<:€:::.;::>::>:::.»::>::::.: .....:.......................... .............................................................. ............................... .............................................................. Date By 5 FOOTING/DOWNSPOUT DRAINS Date i2,_,`Zr By C__,�-./ 6 UNDERFLOOR FRAMING Date (.. -is. ...By, ..:. :::,,,.:.. .i....;;;; ....^"' :::::::::::::::::: ::::::::::::::: :::::::::::::::::::::::::. ::: ir�k � . dAo16h vi'de a Y/- ci00.0-a. 7 SHE , .. .,...':':«_>>> »> >>:>::>':>[>>>>> >> ; Date Z--/3.. '9� By 6././ ...1 V ........................................................................................................................................................... ........l......:::i . . ............. . .. . . . 8 PLUMBING'ROUGH-IN <> : < < >> >€ Date —CC_ C/ ByT . ... ....................................................................................... .... .......................................................................................... ...... ......................................................................................... 9 AS''PIP1. mils >45_> <> > »> °« < < . >J>�> Date 9 By7if�J :. 10 IVEOHANICAL ROUQE[1141 ::... riminsmisilimmilmi 11 FRAIYII.NG ..............:... Date 7, - B 12 1000. TIQN`'':' .. Date L/— /— c -By C c.J ................................................................................................. ............................................................................................ ............................................................................................... 13 Date By ....................................................................... 14 t3iWO :AND1AAVIIii.... Date By 1S.....UU......S....................P........E.....D..........C.......E..IL......I...N................ . . .:.:.:. . ..<.. .:..:.:.:.:.:.. ... . ... .... ........ ..:. .............. I .< > :..:>:.:: ..:>.::::..: <:.>:::..:::...:.: .:.>. . .: . ............................................................................................... Date By .............................................................................. . . ___..-.. .............................................................................................. 16 '.P .tl 1!! 4 ::»:::»»>>::>:»>:»:<»»:«>:>»>»»::»:»:» .......................................... ........... .... .......... . ......... ................................................................................................. Date By ...................................................................... ....... . ... .. ......... 17 PL10WORKS.:FINAL;: Date By .:;.;:.:..:::.;:.;::.;:.::..:.;:.;:.;::.:................::.::.::. 118 FIE`P'INA < >:>:[:>:•:::::><:> >g>»[ >> Date By . ....................... ... ......................................................... ............................... .. .. ....................... ............ .. ........ .. 19 BUILDING RINAL Date 5-: z " J rBy C__,CN ...................................................... . 20 OTHER :; . Date By CD0193(Rev 4/97)