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HomeMy WebLinkAbout7265 W. 34th Avenue� ► � i City of Wheat Ridge -.A Residential Mechanical PERMIT - 202101193 PERMIT NO: 202101193 ISSUED: 06/04/2021 JOB ADDRESS: 7265 W 34th Ave EXPIRES: 06/04/2022 JOB DESCRIPTION: New 2 Ton AC unit installation in backyard - 14 SEER Electrical need for re -hook *** CONTACTS *** OWNER (303)232-4734 LANE ELIZABETH A SUB (303)421-3572 WILLIAM BURAS 017865 LAKESIDE HEATING & A/C SUB (303)885-8555 MIKE VINCENT 202103 PERFECTION ELECTRIC LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 21600.00 FEES Total Valuation 0.00 Use Tax 54.60 Permit Fee 93.35 ** TOTAL ** 147.95 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section 134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of which require a building permit, occurs or where one or more rooms lawfully used for sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. 1* � 4 41' PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Mechanical PERMIT - 202101193 202101193 7265 W 34th Ave ISSUED: 06/04/2021 EXPIRES: 06/04/2022 New 2 Ton AC unit installation in backyard - 14 SEER Electrical need for re -hook I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this�permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This.permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any �pplicabje code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. 06/04/2021 Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alci.wheatridae.m. us To: CommDev Pets Subject: Online Form Submittal: Air Conditioner/Evaporative Cooler Permit Application Date: Friday, June 4, 20217:02:37 AM Air Conditioner/Evaporative Cooler Permit Application This application is exclusively for AIR CONDITIONER OR EVAPORATIVE COOLER. YOU MUST ATTACH THE ELECTRONIC PAYMENT FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. PROPERTY INFORMATION Is this a new install or New Unit Installation replacement for an existing AC unit? Is this Residential or Residential Commercial? Property Address 7265 W 34th Ave. Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Margee Feehan Property Owner Email Field not completed. Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" Credit Card Authorization Form .odf CONTRACTOR INFORMATION Contractor Business Lakeside Heating & AC Name Contractor's License 017865 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-421-3572 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email becky.b@lakesideheating.com Address Retype Contractor becky.b@lakesideheating.com Email Address DESCRIPTION OF WORK What type of Air Conditioner replacement unit are you installing? How many tons is the 2 unit? For AC - what is the 14 SEER? For Evaporative Coolers, what is the CFMs? Where is the unit backyard located (for example, rooftop, backyard on ground etc)? Is electrical needed for Yes re -hook? Provide Electrical E202103 Contractor's Wheat Ridge License No. Project Value (contract 2600 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Rebecca Buras Permit Email not displaying correctly? View it in your browser. 14 CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line —%� (303) 235 -2855 Office * (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type �si��r7�vavG Job Address 4!u9 Permit Number ❑ No one available for inspection: Time Re- Inspection required: Yes No F When corrections have been made. call for re- insnection at 303- 234 -5933 '- IS NOTICE City of Wheat Ridge j� Residential Roofing PERMIT - 102247 PERMIT NO: 102247 ISSUED: 09/23/2010 JOB ADDRESS: 7265 W 34TH AVE EXPIRES: 09/23/2011 DESCRIPTION: Reroof and redeck 26 sqs with 30 yr GAF /ELK shingles * ** CONTACTS * ** owner Beth & Jon Lane sub 303/548 -5000 02 -1001 Roof Corp. ** PARCEL INFO ** ZONE CODE: UA SUBDIVISION: 0548 USE: UA BLOCK /LOT #: 0/ ** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 15,300.00 FEES Permit Fee 299.40 Total Valuation .00 Use Tax 275.40 ** TOTAL ** 574.80 Conditions: Both front and back of permit need to be posted on job site. If one or the other is not present, INSPECTION WILL NOT BE PERFORMED. 6 nails per shingle is required. Ice dam membrane is required from eave edge to 2' inside exterior walls. Board sheathing with any gap greater than 1/2" requires panel sheathing overlay on entire roof. Sheathing inspection is required prior to covering. Midroof inspection is not required on permits purchased after 4/18/10. Contractor shall provide ladder for inspections. Scheduled inspections that cannot be performed due to inclement weather must be cancelled prior to 8:30 a.m. on the day of inspection or a re- inspection fee will be assessed. I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to field inspection. Signature of contractor /owner date 1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of wheat Ridge, Colorado or any other applicable ordinances of the City. 2. This permit shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration date. An extension may be granted at the discretion of the Building Official. 3. If this permit expires, a new permit may be acquired for a fee of one -half the amount normally required, provided no changes have been or will be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. 4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem. 5. Contractor shall notify the Building Inspector twenty -four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceeding with successive phases of the job. 6. The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation. All plan vi 's subject to field inspections. Signatur o ief Building Official date INSP TION REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855 REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. INSPECTION RECORD Occupancy /Type INSPECTION LINE: (303) 234 -5933 Inspections will not be made unless this card is posted on the building site Call by 3:00 PM to receive inspection the following business day. NSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS .JOB TION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS: Caissons 102247 l / (CEG) Concrete Ground WLIne Permit Fee 299.40 ng or Monolithic 275.40 INSPECTIONS TO BE SIGNED PRIOR TO PRO( CITY OF WHEAT RIME 09/23/10 2:04 PM cdba Alan Parkes - roof / French Drain Rough Plumbing PAYMENT RECEIVED Gas Piping rvice Lines Rough Mechanical 574.80 ABOVE rvice Lines Insulation 02965D L H6V VC 11HJ bttlV JlliNtU CONCRETE S LAB FLOOR Electrical (Underground) Plumbing (Underground) Heating (Underground) ROUGHS Sheathing RNUUNI FINALS BPSP Reroof and redeck 26 Lath / Wall tie 102247 Mid -Roof Permit Fee 299.40 Electrical Service 275.40 INSPECTIONS TO BE SIGNED PRIOR TO PRO( CITY OF WHEAT RIME 09/23/10 2:04 PM cdba Alan Parkes Rough Electric Rough Plumbing PAYMENT RECEIVED Gas Piping Mechanical Rough Mechanical 574.80 ABOVE Framing Insulation 02965D Drywall Screw Building Final Fire Department -- -- R.O.W &Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLIC WORKS SHOULD Parking & LandSCaping BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. "NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER KtLtLPI NUMI)HUODU U RNUUNI FINALS BPSP Reroof and redeck 26 574.80 102247 Electrical Permit Fee 299.40 Use Tax 275.40 Plumbing PAYMENT RECEIVED AMOUNT Mechanical MC 4321 574.80 Roof Aoth Code: 02965D Building Final TOTAL 574.80 Fire Department -- -- R.O.W &Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLIC WORKS SHOULD Parking & LandSCaping BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. "NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER City Of Wheat f4-d e [7m C ITV DEVEtOPM�NT g `1 r Building Dlv/sion 7500 W. 29' Ave., Wheat Ridge, CO 80033 Office: 303 -235 -2855' Fax: 303 - 237 -8929 Inspection Line; 303 - 2345933 Facsimile Building Permit Application Property Address: 7A65 kv 3 K Pk Property Owner (please prin jj ije s vi + �oli L. .. Phone: Mailing Addrass: ptditferent than praperry address) Address: Contractor: Use of Bpace (deacrlpoon): DescNptlon of work: Tact O ��ruslas iie., M14-n C1G� Co -4rr 1 1t•�, Zt, d + Plan Review fdueat H i ma oraubruftb: O WNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGPOEMENT 1 heresy cenity that Me setback distance$ ppr�oposed by this permB application are accurate, and do not vioisM appicabte ardlnancea, allegations rdee or ns rnaaade o o oaths 4Ny that I have e Q* or covenania, easements or rosbicttona of record; that all meeeuromer" shown, and p g o a n tions m are accurate; that l have read and apran to abide ppyy all oondmcrrs printed On INS eppllcatlon and that I assume full t Ifty for compllarroe with the Wheat Ridge Building Code (1.8.C) and all other applicable Whaat Rldga OW Inancea, for work rMar t parmlt. Ptaral subject to Yard tnspaoleon, CMLCEONE:: (OWNER) (CO TRA� or PERSONAL REPRESr TATIVE of (OWNER) (CONTRATOR) PRI ,Y NAME: _ /�I;C _ SIGNATURE: Dale: 2 ONgta COMMENrar DEPARTMENT USE ONLY Zoning: Revie PuHLIC WORK$ COMMENTS: Reviewer, e1k1.DING DEPARTMENT OOMaENTS: Reviewer. OCCUPANCY: FIRe "PARTWkrr -: 0 ■pproved w/ oonrmeMa ❑ disapproved 0 M review required Bldg Valuation: S Credit Card Pay ent: L listed an Credlt card on file. pate: m Print nae: Aa P / 4 es Signature: ! 2'd LL0099LEOE dH00jDDH WULS:11 O102 62 dos DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 4741 ' BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date : 3/20197 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner : Property Address: 7265 34TH AV Phone: 232-4734 Contractor License No. : Company: Phone: 4,. OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value : $1,618.00 I hereby certify that the setback distances proposed by this permit application are accurate, PBfillit FB2 : $55.00 and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or . covenants, easements or restrictions of record; that all measurements shown, and allegations plan RevleW Fee : $0.00 made are accurete; that I have read and agree to abide by all conditions printed on this application, and that I assume full responsibility for compliance with the Wheat Ridge Building Use Tax : $32.36 Code (U.B.C.) and all other applira eat idge ordma .for work under this ermit. ~ ~ (OWNER)(CONTRACTOR) SIGNE DAT Total: $87.36 Description : INSTALL Electrical License No : Plumbing License No : Mechanical License No : Company : Company : Company : Expiration Date : Expiration Date : Expiration Date : Approval : Appro,val : Approval : (1) This pertnit was issued in accordance wi[h the provisions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zonin9 Regulations and Buildin~ Code of Wheat Ritlge, Coloredo or any other applicable ordinances of the City. (2) This permit shall expire if (A) the work authorized is not commenced within siMy (60) days from issue da[e or (B) the builtling authorizetl is suspended or abandoned for a period of 720 days. (3) If this permit expires, a new permi[ may be acquired for a fee of onrhalf the amount normally requiretl, pmvitled no changes have been or will be'matle in the ori9inal plans and specifications antl any suspension or abandonment has not exceeded one (7) year. If changes are made or if suspension or abandonment exceeds one (i) year, full fees shall be paid for a new permit . (4) No work of any manner shall he done thatwill change the natural flow oFwater causing a tlreinage problem (5) Contrector shall notiry the Builtling Inspecror hvenry-four (24) hours in advance for all inspections and shall receive written approval on inspectign card before proceediing with successrve phases oFthejob. ; (6) The iuance of a permit or the approval of tlrawings and specifcafions shall not be consVUed to be a pertnit for, nor an approval of, any violation of the provisions of th uiltli y codes or ~yo ther ordin ce, law, ru e or regulalion. - I CJ / l l!N ` i Building Inspector HIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Building Permit Number : Dete : Property Owner : j-, , 1,, PropertyAddress:7z65S iiJ Contractor License No. Company : - Phone : 3 ,33-~7 3:.>,°Y73 y Phone : OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT f hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application, and that I assume full responsibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit. (OWNER)(CONTRACTOR) SIGN D ~ DATE'~ Description S~c~ l C~~ ~ N\ BUILDING DEPARTMENT USE ONLY SIC : Sq. Ft. : Approval : Zoning : Bu~~ingY,~omments: Approval : Approval : Occupancy : Walls : Roof : Stories : Residential Units : Electrical License No : Plumbing License No : Mechanical License No : Company: Company: Company: Expiration Date : Expiration Date : Expiration Date : Approval : Approval : Approval : ~Pla~" s B~'q~tre In ~PI~n~Re~ified WWRW~ .(1) . This pertni[ was issued in accordance wilh the provisions set forth in yopur application and is sub'ecl to the laws of the Slate of Colo2do antl to the Zoning Regulations and Buildiny Code of Wheat Ridge, Cobrado or any olher applica6le ordinances of t~e City. (2) This pertnit shall expire if (A) the work authonzed is not commencetl within sizry (60) days Gom issue date or (B) the buildin9 authonzed is suspended or abandonetl for a penod of 720 daya (3) If this permit expires, a new permit may be acquired for a fee o( one-half the amount normally required, provitletl no changes have been or will be made in the original plans and specificalions and any suspension or abandonment has not exceeded one (i) year. If changes are made or if suspension or a6andonment exceetls one (1) year, NII tees shall be paid for a new permit. (4) No work of any manner shall be tlone that will change the naWral Flow of water causing a tlreina9e problem. (5) ConVactor shall nolify the Building Inspedor lwenty-tour (24) hours in atlvance For all inspections and shall receive written approval on inspeclion card 6efore proceediing wilh successive phases of the job. (6) The issuance of a pertnit or ihe approval of d2wings and specificalions shall not be wnstrued to be a permit for, nor an approval of, any violation of the provisions of the builtling codes or any other ordinance, law, rule or regulaUoa . Construction value : j g 00 0 Permit Fee : Plan Review Fee : Use Tax : Total : Chief Building Inspector For Mayor THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 95-1216 3UILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date :6/14/95 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner Property Address Contractor License No. Company FARLEY JON L 7265 34TH AV 18023 Schroeder Roofing Metro Phone: 232-9734 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of rewrd; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application, and that I assume full responsibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all other applirable Wheat Ridge ordinances, for work under this permit. (OWNER)(CONTRACTOR) SIGNE DATE/a Description : REROOF Phone: 444 3538 Construction Value : $2,800.00 Permit Fee : $54.00 Use Tax : $42.00 Total: $96.00 (1) This permitwas issued in accordance with the provisions set forth in yopur application and is sub7'ect to the laws of the State of Coloratlo and to the Zoning Regulations and Building Code of Wheat Ridge, Colorado or any o[her applicable ordinances of ihe City. (2) This permit shall expire if (A) the work au[horized is not commenced within sizTy (60) tlays from issue date or (B) the building authorized is suspended or abandoned for a periotl oF 720 days. (3) If this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be matle in the original plans and specifcations and any suspension or abandonment has not exceeded one (i) year. If chan9es are made or if suspension or abandonment exceetls one (1) year, full fees shall be paid for a new permit. (4) No work of any manner shall be done that will change the natural flow of water causing a tlraina9e problem. (5) Contractor shall notify the Building Inspecior hventy-four (24) hours in advance for all inspedions and shall receive written approval on inspection card before pmceediing with successive phases of the job. (6) The issuance of permit or the approval of drdwin95 and specifcations shall not be construed to he a permit for, nor an approval of, any violation of the provisions of ihe buildindes or any other ordinance, law, rule or regula[ion. Chief @Lilding Inspector THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION S SUN-12-45 MON 02:53 PM SCHROEDER 303 344 0922 P.05 Propnity Owner : t'roperty Address : Gantrocior ur.ense No. : Company : Bu1LCING OWNEIt40NT1tAC1 Oli SIGNATURE OF UNDERSTANDIN6 AND AGRE6MFNT ~ ~..w...~w.~, w.n. e aia..c emoo:eA bv 1MS acimil iOWkoti°^_ ue KCutall. oswme WMt ip Yoning, Approval• Approval Nncne : 2.37 - _ q 70 r Phone : Conskucti0n Velu*'~Cj Permit F00 : 5 c~, rrv Use Tpx c ~Fd o-~✓ Tolat: USE ONLY Wails : Roof Liconsc No' Plumbinq li GOmpdnV ~ pale Staies : No:_ 4 Expuatwn Date ~ . qpproval. ~ J 5P!a2!5V1R!qu~k2M aasidentiW uNts: bleclwnWLioemie No Company:., ~XpfiWn DilO' • Approval : A rammoom n+s PMmq ri) ~t{YM n K,(.pG RlyMild~i aM tlmkhnp Goda t Tns prn~w yyu r~pnd d(A) Vr w rw^aanaa ia a pcnw d i» a, n ~A1 p"mq e,a~es. a new pdn .'.tecUfAanc (1~[Y~fW kC~ No Mb4 ~8 dM nu~wi a!W Ir {:14111.II IIM y1A11'uYO,fir (ly*lo {~nfMJnny w-m SVLSR{twS i~W4ML11M1-1Aj 1M'ilwql ' li NM NirYINq . 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