HomeMy WebLinkAbout4060 Brentwood StreetA i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
IN. P CTIQN NOTICE
Inspection Type:'�j
Job Address:
Permit Number:
7�
❑ No one available for inspection: Timed AM/P
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date:` Inspector:
-
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: ,
f
Job Address:
Permit Number: gym'
.a�
❑ No one available for inspection:
M
Re -Inspection required: Ye No
When corrections have been mad , call to re-inspectio . -234-5 3
Date: ` .2` Inspec r
DO NOT REI 0VE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address:�'t��Permit Number:.
Number:.
❑ No one available for inspection Time l � AM6-MV'
Re -Inspection required: Yes No --- _ _
When corrections have been made, call for re -inspection at 303-234-5933
Date:{, Inspector:
DO NOT REMOVE THIS NOTICE
> i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
za
Job Address:
Permit Number:
❑ No one available for inspection: Tim fc
'-
Re -Inspection required: Yeses- N
When corrections have been made call re -ins ection at 303 -234 -
Date: -6-(4—'LGA(
Inspecto .
DO NOT RE VE THIS NOTICE
SI
i CITY OF WHEAT RIDGE
_1�9�Build! ft1rispection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office-* (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: � �u
Job Address: LAO U 0�
Permit Number: C �C,\ C\ (�C\\ Ck
❑ No one available for inspection: Time
Re -Inspection required: Yes e ,',��)
When corrections have been made, call for re -inspection at 303-234-
Date:-
03-234-
Date:C> Ips Inspector:
DO NOT REMOVE THIS NOTICE
�!' i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
,r,w n p
Inspection Type:-.�
Job Address:
Permit Number:
❑ No one available for inspection: Tim 1PM
Re -Inspection required:�,k Yews No
When corrections have been ade, ca e -inspection at 303 -234 -
Date: Inspect'
if
DO NOT REMOM6 THIS NOTICE
s_ CITY OF WHEAT RIDGE
_:�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office ® (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: ( v� % V t )`j
Job Address: `-4 DUO boe F YN � U OL> C_
Permit Number: v2 V � C,
[� �
\ n\ fK L,�
ij
�i�, r C U h f' f C F ��
_i.Z
i1
s a
-,t
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: 15 ,70 1 i Inspector
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Homeowner Basement Finish PERMIT - 201900998
PERMIT NO: 201900998 ISSUED: 05/22/2019
JOB ADDRESS: 4060 Brentwood St EXPIRES: 05/21/2020
JOB DESCRIPTION: SWO Remove old paneling and install drywall; open up existing wall and
install french door; build 2 new walls in unfinished area; bathroom remodel
with new tile, toilet, vanity, shower pan; create egress bathroom - 1,165
sq ft total'
*** CONTACTS ***
OWNER (720)261-5341 ANDERSON GRETCHEN S
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY ***
Total Valuation
Plan Review Fee
Use Tax
Permit Fee
Investigative Fees
** TOTAL **
*** COMMENTS ***
ESTIMATED PROJECT VALUATION:
FEES
0.00
406.93
858.11
626.05
626.05
2,517.14
40,862.50
*** CONDITIONS ***
All roughs to be done at Framing Inspection.
I, the property owner, by my signature, attest that I currently reside at the project
property, intend to reside at the property for a period of one year after completion of the
project, and am personally performing all work, without the assistance of hired or
professional workers. If professionals are hired, those contractors are licensed with the
City of Wheat Ridge and are listed on the permit. Consultations and inspections will only
be performed with the homeowner of record present.
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
City of Wheat Ridge
{
Homeowner Basement Finish PERMIT - 201900998
PERMIT NO: 201900998 ISSUED: 05/22/2019
JOB ADDRESS: 4060 Brentwood St EXPIRES: 05/21/2020
JOB DESCRIPTION: SWO Remove old paneling and install drywall; open up existing wall and
install french door; build 2 new walls in unfinished area; bathroom remodel
with new tile, toilet, vanity, shower pan; create egress bathroom - 1,165
sq ft total
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,permit. I further attest that I am legally 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 changeof 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 required
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, an violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City Of
�W heat R,
MUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 2911 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: Permits(a)ci.wheatridge.co.us
I FOR OFFICE USE ONLY I
Date: T511�
Plan/Permit # 'Hoo q7�
Plan Review Fe q
fAA1 g
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:
Property Owner
Property Owner Email:
Tenant Name (Commercial Projects Only) N /
Property Owner Mailing Address: (if different than property address)
Address: 1-61D '1Q .
City, State, Zip:
Architect/Engineer E-mail:
Contractor Name:
City of Wheat Ridge License #:
Contractor E-mail Address:
For Plan Review Questions & Comments (please
CONTACT NAME (please print) .n 1r
Phone:
Phone:
CONTACT EMAIL(p/ease print):7"rt!_FZrv� Cd t'I
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL 'RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
I-Cl-kOVe Atl PIAICS:�,�) - repic,cc-- &,-)-'+t ')Dy - i'c6,,,;0 c)LQ crooi,�L 1v,41(
13Lk<l 2 Acs 1,41
b -,H rC 4 A-),-, ) '�'
", 64r� cz-F wrs —
d� r
eJZ- -dor-- L-0 — bLi & Gov-/'
Sq. FULF �S;- — BTUs _
Gallons
P PG &':-,-, ,ic
3 'd -Zr5
Amps Squares For Solar: KIN # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ Mcc --ds rc�i', -mss lJt�tS mgr L�ha2
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 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 applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ON (OWNER) CONTRACTOR) or AUT ORIZEDREPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name5-/7C;4-1C-
):� <.a -z— i,j� DATE: Zell,
Printed Name: J / CyyC' A
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE,
Reviewer:
BUILDING DEPAaWENTXOMMEI`JT$:
Reviewer: _
PUBLIC WORKS COMMENTS:
Reviewer:
Building Division Valuation: 410 1(/c
City of
s Wheat j_1 e
COMMUNITY DEVELOPMENT
Official Certification of Property Owner Permit
THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently
reside at the project property, or intend to reside at the property for a period of one year after
completion of the project, and am personally performing all work, without the assistance of
hired or professional workers, or, if hiring sub -contractors, list them on the permit.
Consultations and inspections will only be performed with the homeowner of record present at
the Droiect Droaerty.
Property Own
Project Prope
Project Type:
Notariofi signature of Applicant
State of Colorado }
County of Te 1'iorss
4N'
The foregoing instrument was acknowledged by me this /S day of _�no,,,/ 20_.17 by
U
A D ODEANRY PUBLICF COLORADO ID 20164015481 EXPIRES APRIL 22'20 20
My Commission Expires Y /oZZ /20_2d
Notary Public
TAS PROFESSIONAL ENGINEERING SERVICES
13844 SHILOH DRIVE CONIFER, CO. 80433
ENGINEERING LLC Ph: 303-807-8991
May 20, 2019
Steven Trefz:
This letter is being written to indicate that TAS Engineering LLC has performed an inspection of
an egress window installation located at 4060 Brentwood St. Wheat Ridge, Co. 80033.
The new egress window was installed in the North basement wall of the residence. The
inspection found that the window and installation meet the requirement of the governing building
code.
It is my determination that the window and the installation meet the standard of care for
residential construction and complies with the governing building code.
Please give me a call if you have any questions.
Thank You
Sincerely,
om Stratford
Professional Engineer
TAS ENGINEERING LLC
303-807-8991 1 tstratforda-taseng.net
♦ " . Ir
City of
'� W%e at �ge
COMMUNI TY 01V I i f �rn11 r+ I
APPROVED
Review for Code Compliance
s'Z1.II
Plan E aminer Date
of rm : The Wuance of o permit or opproml of pkns specifkotrons
and computations shall not be a pernvt fbr, or on approval of, any violation to
any of the provisions of the building code or of any City ofd nonces. Hermits
presuming to give outhorit y to violate or cancel the provisions of the Yui fq
COM or other ort/inOnces of the CHy shall not be valid
Page I I
Cf�ity of
'�Whardge
COMMUNI IY :)f I tt ,IAI N
APPROVED
All new and existing smoke alarms
shall be interconnected so the
R vieNNed for Code Compliance actuation of one alarm will activate all
of the alarms per 2012 IRC R314.5.
Itr-,
9 LVIA "11411,10 S-/4 Plans AM iner Date
1 AMRv of mnnN: istuana o/ o penrrtt oropprovor o/prons spec frrodl
rrm,t p,, or on app►ovaf of Orr/ vWroban to
+g code or of ony City Plrr
;a& w canal the prowslam sbns of tel7as t MiMewl**
/q
ry seari nW be voNd,
q L>
Z
/.1-3/---�
0,tj
F, c" CA
`Nx,eatRid9e
INSPECTION RECORD
'V*INSPECTioN LINE: (M) 234-6933
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.
INSPECTOR MUST SIGN ALL SPACES PERTAINING To THIS JOB
F01,1NDATION INSPECTI IKSPEC'OR
W-k
COMMENTS'
T —
-----
Stemwafl I (CEG) Concrete
Fircased Ground
Ret"fo-cing or Monolithic
I French
Sewer SeriCe Lines
PqyaN;3q6NcKerr-,NTiLA
. . .... ....
CONCRETE EILAU FLOOR
PILPIldng (UndQr9rOUrXJ)
Heating (UndarqrtPandi
DONOT POUR FL a Mr «MIN
Srjeathing
L ltn i 'Vail lie
VO-NOOt
I
S —
f;4c1! Jr IYYiQH
'buugh Eleccdc
ioul;;n P-Unlbing
3as
t(Xjgh MeChallC
j_
AacvE zNSPEC ER IN.
To as SIWED PRIOR To PA4
CM OF WEAT RIDGE
-r2n1jn9
911 13/11 ?;L7 Pp. cdbe
Diia
Scxerk
RECKK q3-.3P006370
P.ri-MT
MU uy cep SeTv"Ce enat
i 3 .3. 8.5
:INAL$
lecArROW
MOM
Peve Fee
USE iax
93.35
qurnbirng
AiAh Code;
jilaina Final
'OTAL
1 33.95
C.'7'18 f3r�raag
'
INSPECTIONS FOR PLANNING & ZONING, FIRE ANV PUB , ;C WORI(S SHOOLO
Pa.Klrg & BE CALLED AT LEAST ONE WEEK PRIOR TO MMAL 14SPECTZ.48.
'"NC�I Ad COMPLETED AND APPROVED BY PLANNING ANOZONING, BljiLDN' AND PU9UCWOqKS8EFbPFA
CER77FICATE OF OCCUPAMCY 4SISSUEC- Ffft. 1AfsviFcrirjN sy 7HE SU LVMG D10VON DOES NOT ( 0NS11 I J 7E 4 LITHIORf7A TION
OFACERTFICA.-E,'F OCCUPANCY NOPFERUfS.SIC)IV FAR OC,(,',JP
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUEO
PROTECT THIS CARD FROM THE WEATHER
_ a
CITY OF WHEAT RIDGE
Building Inspection Division
J (303) 234 -5933 Inspection line
(303) 235 -2855 Office * (303) 237 -8929 Fax
INSPECTION NOTICE
Inspection Type <
Job Address S'?'
Permit Number id/09'1
tions Time AM
" 1 City of Wheat Ridge
�r
Faxed Elec. Permit PERMIT - 111093
PERMIT NO: 111093 ISSUED: 09/13/2011
JOB ADDRESS: 4060 BRENTWOOD ST EXPIRES: 09/12/2012
DESCRIPTION: 200 amp service change- no new circuits
* ** CONTACTS * **
owner 303/320 -0332 Gus Dallagia Coma
sub 303/425 -0852 Andrew R. Dina 01 -8351 D & S Electric Contractors, In
** PARCEL INFO
**
ZONE CODE:
UA
USE:
UA
SUBDIVISION:
0336
BLOCK /LOT #:
0/
** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 2,250.00
FEES
Permit Fee 93.35
Total Valuation .00
Use Tax 40.50
** TOTAL ** 133.85
Conditions:
Must comply w/ 2006 IRC & 2005 NEC. Subject to field inspection.
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 permit. I further attest that I am legally 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.
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.
S. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy
of all required 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, any violation of
any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject
to fie l i e
Signatur f C f Building 0£fical Date
INS PE 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.
� o
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.
D I�0 th T 1 G
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS .IOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings /Caissons
Stemwall / (CEG) Concrete
Encased Ground
Reinforcing or Monolithic
Rough Electric
.Rough Plumbing
Gas Piping
Weatherproof / French Drain
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PR( CITY OF WHEAT RIBSE
Framing 09/13/11 2:17 PM Abe
Insulation
Andrew R Dina
Sewer Service Lines
FiFCEYF'T 40:311606370 Ai'u7UMT
BPSP 200 awv service char 133.85
FINALS 11109'3
Water Service Lines
Electrical _ Use Tax 40.50
Plumbing
PAYMENT RECEIVER AMOUNT
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
ROUGHS
Sheathing
_
Lath / Wall tie
Mid -Roof
Electrical Service
Rough Electric
.Rough Plumbing
Gas Piping
Rough Mechanical .
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PR( CITY OF WHEAT RIBSE
Framing 09/13/11 2:17 PM Abe
Insulation
Andrew R Dina
Drywall Screw
FiFCEYF'T 40:311606370 Ai'u7UMT
BPSP 200 awv service char 133.85
FINALS 11109'3
Pe'reit Fee 93.35
Electrical _ Use Tax 40.50
Plumbing
PAYMENT RECEIVER AMOUNT
Mechanical VS 3140 133.85
Roof Auth Cade:
081815
Building Final TOTAL 133.85
----------------------------------------
Fire Department
R.O.W & Drainage
INSPECTIONS FOR PLANNING & ZONING,. FIRE AND PUBLIC WORKS SHOULD
BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking & Landscaping
* "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
OFA CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
C
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
09/13/2011 14:30 3034676844 DSELECTRICALCONTR PAGE 02
Ve /IJ U1. 1JE 1D 44 PAX JU4 Q9 U ?L nano waY
City of
ea k--LPar,Nn' ,
J I ammmum D PMENT
Building Division
7500 W. 29" Ave., Wtww Ridge, CO 80033
Office: 303-235 -2855 a Fax: 303 - 237 -8929
Inspection Line, 303- 234 -5933
G¢ l Facs i mil e Building ` P � erm ii t . App l ication
PrOp�13'yAiidrbut): `�`��Jl�J
Property Owner (pfeass print): jCL
Address
A8aI11nrJ Addre$a; Of different Man property address)
:
City, State.
I _
Use of s (dascrlptianL) �t r �• -
p8ts??lRttn'+.T V �lC G� �G t f onat IQn value: t
n- a 12✓ jl 2' t o ffi1> i9 GerP Plan Re view (due at rkna WSr Wa;((aQ: S _
Sq. FL ti Ft eddad' Square* BTU'* Galan _ Amps—a-ap
O"MCOR70ACTOR SMATURE OF UNDERSTANDING AND AOREMENT
I hereby certify Iha! the setbar< dietartoe:. prepaaed by drla pe•mit epplicallan a,� aceurem, and da not violate eop rnerwb a ordinances
rule* or rsgulailorrs of the C'4y of Whet Rtdge a covenants, easemenn: or resMcdMe o} record; that as measurements shown, and
allegations made ere accurate: that I nave reed end agree to sbkle by all cond'Norre printed do this aapticatian
and that I assume full
msponslbilily.for camptlen� wile the WhnaY R' a euildtng Cede, (1.6.C) and a!I othtn appliceb(e Wharf Ridge Ordinances, for work o*
I underthla permit: Plans s tl ins ed�on.
CIRLCE ONE:= (OWN /,CONTRAC o PERSONAL REP/R/E�S�E�-N�T�A/J]7�-NL of tO 1� ) ; CONTRATORI cq�
eR NAME. I�NATURE:r _ ^_ ��'� — Data: 1,..1..JZ.
t d� n�'}yS �� >w���.k.:Sai^�,tTA�a� +fit ,�"`•
Contractor Ucense N; ( 4 Phorta: