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HomeMy WebLinkAboutpitkin.bldg.273513400028 (4)DOCUMENT LAYOUT Certificate of Occupancy or Letter of Completion (most recent project) Permits Final Inspections Any Supporting Documents Site Plans (no architectural plans) If there are previous projects they will follow in the same order. 130 S. Galena ~ ~ - ASPEN PITKIN COMMUNITYbEVELOPMENTDEPA~TMENT General Aspen, CO'81611 PERMIT APPLICATION Permit 970/020-5090 920-54481nspectionline PITKiNCOUNTY ^ CITY OF ASPEN 0 ~y/ _p,/;, Applicant to complete numbered spaces only. NO. lam' L-r' 1 7"h/'y~~ `~ V JOB ADDRESS ""' 1~ 237 Aspen Mountain Road B~ LEGAL 2 LOT NO. BLOCK TRACTOR SUBDMSION (^SEE ATTACHED SHEET) CO . Desc. Aspen Mountain (Little Ne11) _ OWNER MA1l ADDRESS - 21P PHONE DE 3• City of Aspen 130 S. Galena Street, Aspen, CO 81611 920-5110 FD CONTMCTOR MAILAODRE55 PHONE LICENSE NO ~ 4. M & M Tank & Tower P.O. Box 759, Greele CO 80632 970-356-7438 ... FN ARCHITECT OR ENGINEER OF RECORD "' "' MAIL ADDRESB - "PHONE LICENSE NO MH 5. N/A M.S DESIGNER MAIL ADDRESS ~ pHONE LICENSE NO 6 . N/A ~ CLASS OF WORK 7 ENERG CO ~ USETAX CENSUS CODE . ^ NEW ^ ADDITION ^ ALTERATION ^REPAIR [~ Remove ~ USE OF BUILDING 8 PLAN CHECKF '- PERMIT FEE 20NING FEE . Water storage tank Af VALUATION OF WORK SOUAREPOOfAGE ~ ' 9. $ 20,000 10. 2,228 Type of Consimction Occupancy Group Lot Area 11. Is there food service in this building ^ YES ~ No sae pr ewminqq Np. prsmdes ooo. Leaa (TOSeI Square Ft.) 12. Is LPG used? ^ vES ~ No ` NO.OFBEDROOMS Use Zone Fire Sprinklers Repaired? ^Yes ^No 13. Remarks Removal of a 500,000 allon Water IXISTING ADDED tank made of steel Alarm System gequiredl ^Ves ^No No. of Dwelling Units OFFSTREEf PARKING SPACES I Covered Uncoveretl nnn ,! tX~ SPECIAL APPROVALS "'" q O D AUTHOR( DBV A E ZONI H.P.C. PARK DEDICATION PREEUBMITTAL APPL ATIONA EPTED PLANS CHECKED gpPgO FORISRUANCE ENVIRO. HEALTH "' I" ` ENGINEERING ev BY Y BY PARKS D ~ / , G•' ~ t5, 98 FIRE MARSHAL HATE DATE DATE ! T W ) A ER TAP / NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL PLUMBING' H N ~ ASPEN CONSOL. SAN. DIST. , EATI G; VENTILATINGOR AIR CONDITIONING. orHEq THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION- , OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ppyMENT OFpITKIN COUNTYUSE TAX ANY TIME AFTER WORKIS COMMENCED. ^ MONTHLY OR QUARTERLY RETURNS WILL BESUBMITTED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMMED THIS APPCICAT70N AND ` KNOW THE SAME TO BE TRUE AND OORRECT. ACCPROVISIONS OF LAWS ^ DEPOSIT METHOD 3 5 % OF25"/a OkTHE PERMIT VALUATION RAID' ' AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED AT ISSUANCE: A FINAL REPORYbN 70TACACTUAL COST MUST WITH WHETHER SPECIFIED HEREIN OR NOT THE~GRANTING ~OF A PERMIT BE FILED WrrH IN 90 D"AYS O"F SUBSTANTIAL COMPLETION OF DOES NOT PRESUME TO GIVEAUTHORITY TO VIOLATE OR CANCECTHE PRO- WORK AND/OR ISSUANCE OFTHE CERTIRCATE OFbCCUPANCY VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING"CONSTRUCTION . . OR THE PERFORMANCE OF CONISTRUCTION. ITISMY RESPONSIBILITY TO ^ EXEMPT. EXEMPT ORGANIZATION REVIE THE APPROVED PLANS AND ANY COMMENTS THAT ARE CONTAINED ~ T N A IAT THE STRUCTURE AND/OR PROJECT'IS BUIL7 IN ~ ^ RESALE: STATE&PITKIN COUNTRYRESALE NO LI N (CABLE CODES. . ' -L~ ANYONE WHO USES AND/OR CONSUMES BUILDING MATERIALS AND FIXTURES IN' cNAr of R (DgTE7 - PRKIN COUNTY fSSUBJECr YO THE S.5%USE TAX. _Z PROPERTY LIENS MAYBE PLACED ONTHE OWNER'S AND /OR THE CON- S NgTURE OF OWNER pF OwNERauILDEA) (OgTEt TRACTOR'S PROPERTY WHEN USE TAXISNOT PAID THIS FORM IS A PERMIT ONLY WHEN VALIDATED """ '~^ . ~ ~- N/ORk $mRTED WITH' Energy Code Valitlatiori Plan CFeck Validation Zonin Validation PermifValidatUYPERMITWYLL BB"DOUBLE FEE ' 9 ''ion " ~" ""35 % Use ~rax~`Deposk Valiiletion '~ ~~ h _. ;~::~a ELECTRICAL ~E~MIT d~`~~L~~ATION 3 130 South Galena ASPEN*PITKIN REGIONAL BUILDING DEPARTfvfEtVT Aspen,C081611 PITKIN COUNTY-^ CITY OF ASPEN ^° i '- 309/920.5440 PERMIT-N~:3-1 1 ((l,i <.. . ~ ,_.. ......,,W...., .... v, ,,,_:,.v, . :. JOB ADDRESS (#and street) ' '' // /9~~ ~/~S~" TJI.4W9...T - ~~ ~ ~ -~~ '~~-~ OWNER REPRESENTATIOE "-' '- PHONE " ELECTRICAL CONTRACTOR '" -' MAILING ADDRESS ZIP- 'PHONE COLO: LIC.~# - 'v~.w., ~.e.r(+cr' t. 5 os 5...17"' ' r~ '- " ELECTRICAL DESIGNER "- - REP ESENTATIVE ~-- PHONE .. ~ •..• •.. ~.",••", GENERACCONTRACTOR - ,.. _... _.. . REPRESENTATIVE PNONE ~M.IA..w ~ w O -. TT ~ ~. BUILDINGPERMIT#" '--" OCCUPANCY GROUP TYPECONSTRUCTION ~-~ - SOUAAE FOOTAGE ' ' USE OF BUILDING ' G fi t ~ 1 ELECT AL VALUATION ~ - le $ y ru - -- - DESCRIBE - ' -- CLASS OF WORK ^ ADDITION ^ ALTERATION'...,.." ~7NEw ^'OYF~ER ~ ...._..,.•, ~•. ~., :.,.•. ..'" ".. ' "`.. :."."" ., `~. ~_~.. ~. ..a..l.v«.... ...s.Aa» .eve. -r.'i+kWptti.clf VOLTS - PHASE' "WIRES AMPS ' SERVICE: ^ NEW ^ EXIST ^ CHANGE ^TEMP - - .. - ._ . -..,_ ._ _.. .. # C reuits - Feeder Sme PANELS: #Circeits Feetler Siie # C rcuits Feetler Size` - ,. r_ .,,<. .,.. , M<, # ClFcelts Feeder Size Service Feetlers - - - BrahctrCircuits - - 'TYPE WIRING SYSTEM - ,w._. .. ... ~ <., ..,., . -.... -,.,,. .... .~m, ,. _.... .~. ,+..~.H„... ~. _ DESCRIBE WORK'IN DETAIL (FOR ADDITIONS, ALTERATIONS INDICATE NPE. NUMBER AND LOCATfON bF SOUYtCE`OR G~IfiC"UiTS)""~ s ere a restaixrant inNth ui ding? ~.. .._. ' : ~~ ~ , -. Cu.~. w.u ©f- w. a,- Yes ND Ga ,R.-s ~ ~ Q,.v I,A .. 't'- ,@,l - 'T L 'Tt ' Ll .5'-e liL• -~~t.a,cl.na ` 1~ ~ - ra zwrw+au .x.e :f'du`na'3G:d4eYP _ ...~.,u..n,na.+<. ws.v. gn ueYw vsAF[e " dN3 SELECTION OF METHOD FOR PAYMENT"OF fYSE'TA7T '~ ' - ^ DEPOSIT METHOD 3Y OF 25°I O'F 1tERf~YIT'VALLSYION TAI ~fIGGJIS`SmGAPJ"CE`. ^ MONTHLY OR OUARTERLYRETURNS WILL BE SUBMITTEd: ~ "" FINAL REPORT ON WTAL ACTUAC'MATERYALS' COST rtAU$T"$E"t'IC°Eb"WITNYN g6" '" ~ DAYS AFTER COMPLETfON OF WbRK" GENERill. CONTRACTb'RS CHUOS7NG"TIYIS ~.EXEMPE STATE 8 PITKIN COUNTY RESALE O METHOD MUST REPORT"ANFYHRMIT`TAX FbR ALL SUBCbNT AC ' ' R TORS fHATbO NOT ~ V q~ OBTAIN THEIR~CSWN P~R7G1K '" ~~ ~~ ~ . EXEMPT ORGANIZATION '~ 1 P ^DOUBLE-ERMITFEE ~ ` ,. N~T~CE "` USETAX PERMITF~ For all work tlone under this permit the permlttee accepts full responsibll ty for compliance w th the Na6opxl ~w,W..,, yp ..., ....., ,. .... Electric Cade, the C ty of Aspah oMlnances, antl all oMeY croonty Yesolution~s, ciYy~oltlmanCe9 state`laws Q `I' , ~ ~~-- , whichever applies Perms subject to revocation orauspensron for violation f n l w . ,,,\ y o a a s governing same An aaeptep final electncal Inspection shall be obtalnetl prior to using tfie electrical sysCem Alinal electrical In "-- . BUI "PARTME~IT ACCEPTANCE" . .. a spection shell be requested wit67n 48 h6UF~'atter completing an ele'ctnce7installa0e}i "' . . . . APProv BY ' - - ate ~/r 93 ' - ERMIT VALIDATION _~~ ATE RECEIPT#- ~ ~ L TgOTA SIGN,II flE OFAPPIICANT - - DATE ~~ 3' ~ / ~ -~-~~ $ V - --~---- --.. ~---•• ~~~_»~~ ~ ~~~y rain-ewmmy vepermlem mlq Goia-GU§lomer's Copy Green-Finance .,,;._> ... 'nos.-. ,kf »x:. e? ;T""' 4am w'.. '. pEPAFtTMENT GI~NAL' BUILDING rJ440 303/920" ASPEN ~pITK)-v RE Aspan, coiorado e~ 6~ ~ ~ 30 South Galena / ~j/ O\ J K LIST C-/--~_ Inspection _------ ^ STEEL (REBAR) ~- Footings ~ I Cassions -~ Wall Wall Gores -- Struc. Slabs --- Pads piers Bond Beam INSPECTION CHEC BUILDING ~~ per d No. 't11LDING partial ._----`'_ ~ - ^ MECHANICAL s nspection ------- ~ PLUMBING R_Frame ELECTRIC Rough Insulation -'- -- Underground - -" Flue(s) ~ -- Drywall Constr. Service -- - Vent --- Waste & - Fp_ Flue(s) " - - Special round - Underg - Water Pipe Combust. Air - -- _ Mobile Home Rough " Gas, Pipe - ~ Final - Final Perm. Service -' Final Air.'Cpnd. Final • Fire Sprinklers --- Kitch. Hoi?a -- Bonding - -- Special ' ~ -- ro ress. ~-~-_" ection Fee $ ----------' which is now in P g ~~ Noted d ^ Reihsp _..,,..rrnns on the c onstruction ^.,.__--==--- the You are ordered to make Marshal for further sprinkler Decks -- actor: ""--- Carport ------ Family nstructigns tq lnsP pet. _------'~ Dining -- Liwng Garage: Att..--~ Kitchen ~ gtdrage _- Laundry - # Levels ---- s~, Baths _-'~2 Baths _-- DESCRIPTION: Fup Baths _--- SolariumlGreenhouse -- Entry Foyer _-Bedrooms _-- Ezerase Rm. - Breakfast Nook ___------- Library -- OfficelrvSludy --- Den _---~--'"- Media Room - Sitting Rodm _------'-'"'--"_ _____----'-- Model # Mud Rdbm _---- Gas Appliance: Make .---'-- Other:.---~- Model # _------"--- Fireplace: Make _,_------~'-- ,/ _ Cohtact Phone r~ME / !/ ~ uV/ ~ ~~ / Request Recd. p e Tir s((// T TFI F A. Addres Request for inspector Subdivision Date Ihsp. r Contractor ~ `. S Owner __.----L :.. -,..;t,~_ : , <, ~ . . , v ~~~ P ~ ,__ _ .. 506 Eeat Main street BUILDINGPERMdT APPLICATION `~ Ge Aspen, Colorado 81611 ASPEN pITKIN CoriStrP neral 303/925-5973 * ction REGIONAL BUILDING DEP;4RTMENT errrmit~+ JurisdictioD of ~-5~-~ Np, 11 ~ V y Applicant to comp/ate numbered spaces dnly. JOB AODRE55 _ .. _ _ •,•• ••, •>: •,• 1 ~ ~'. .»...nxr.m.^n. . LEGgL LOT NO. BLOCH. TRACT OR SUBDIVISION "'-" ~ ~~ (lJ SEEATTACHED SHEET) Z DESC R. .. OWNER MAIL ADDREBS 21P PHONE 3. C ~ ~ F ~ fit/ /~ CONTRgCTO 'MAIL PO EGB PHONE ' 4 y )~ n LICENSE NO. Q Ii SQ /JN CG ~G ~ Z Y . / Y ( 2 ~ / L ~ U .. I gRCHITECT OR DE SIGNER MgIL ADDREBS~ PHONE LICENSE NO " . / ._....,rA ,..a.k..~.,~ .~K. ,., ENGINEER MgIL gODRE55 PHONE LICENSE NO .. _ , ,. ...,,. ,,. ,.., , ~,,~4s USE OF BUILDING '/A=J/ /' M ~ e~+.+. 7. ~U ~/ /~VS~ ~ ~~N '~-' g Class of work: ^NEW ^ ADDITION ^ ALTERATION ^, REPAIR ^ MOVE ~Vyg CK `21~.~ ~ g. Change of use from Change of use to PLgN CHECK FEE PERMI EE ~ i ~_ ~ TOTAL FEE (~ 0 1 O Valuation of work: S ~ o Tvpe o(construction occuoanev Grouo LotArea 11. REMARKS: ~~ size or awitlmq No. or 5roaes Max. OCC. LOdtl (r0[aI SO Vare F(. NO. OF BE DROO'S- use zone q•e Sprinklers ReOUl.ea EXISTING A ED ^ vas ^ No No. or Dwelling Ubits OFFSTREE P ING SP E S' o.e,ea ree ' ~' $pecidl ApprOVals REQUIR AUTHORIZED BV DATE , ,... .._..,..„. ZONING gPPLICATIONACCEPTED PLgNS CHECKED ~A'PP 'E'p"POh'S ~~ E HEALTH DEPT. Bv~ ev SOIL REPORT DATE DgTE DATE PARK DEDICATION WATER TAP NOTICE SEPARATE PERMITS A`RE"A EQUIRED FOR ELECTf2 ICA L~ PLIYM~BIPI'~, ~ ENG. DEPT. _ HEATING, VENTILATING OR AIR CONDIT ION7NG" ~ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONST7tU'CT'fON FIREMARSHALL AUTHORIZED fS NOT CbMM=EnTC'Eb°lNIT'FYY`t~ f`YO"'~A"`C''S""O`R"(F'2''p(~'$"I'~'(f~ OTHER ($PECIFVI , TION Oft WORK IS SUSPEND ED OR ABAND E R ' ~ ° " ON D OR A PE1iIOD OF 7 IO ~; DAVS AT ANV TIME AFTER WORK I$COIGfM=EN'C'ED'"'"" ~. ~~i D EXAMIN Ed~ THf5 `"APPL'iC~'A~'~10N I ' AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PfiDV15Y0'N$ b'F"`L~AIRIS N H AND ORDINA CE S GOVERNING T S TYPE ~ P 'YJORK WILI'BE COMPCI ED'Mfll'H WHETHER SPECIFIED HEREiN Ori NDT TH E'U1lANTING OF'A YER dA`rT DO`E"S=fSbT PRESUME TO GIVE AUTHORITY VY A R " ' `" ' ' ' = ' o } y THIJ FARM IS A PCRMI'f ONLY WfL'F YY 11''77 CCTV AL ~ATE~ TO OL 60 CANCE L Tr~ E P ttD GISIO ~IS 6 ~ V ANV or R STATE OR LocA~ LAw REG AT(N'G cDN$TRUCnoN bR'Y7+''E PE'R"- FOR WORK STgRTE'DW/~'HOUT PEN'MYT W%LL~$E D'OUBC M OF CONS UC IO . E E V _ .. ,.. ~ RE HORIZED gGENT (DATE) g T O U iO ?~ SIGNgTU OF OWNER i c n wO OC Ui nc~. 44 s / ~~y~g VALIDATION ~ ~-/ k ~-^~ PERMIT VALIDATION CK.~ M.Q. ^ CASH ^ -PLAN CHECK"V'A=L°IDA'R(bNy CK. Orr M.O. ~O ~ CASH ^ WHITE-INSPECTOR'S COPY YELLOW- '~*: r ._ .~ ~.~,,. a's a». "'( ~ t ~G. _ • ~ , _.., ;may= ar ASSESSO R'SC6pV PINK-BUiLD1N D'EPARY''W%'E~"'FICE GOLD CUST3.,,O~NERSaCOPY f°~'1LDING~1'NSP~~`TI~O'1~1 tSEPiCAT'IANT CITY OF ASPEN Cf1UN7Y OF PIT'Kl~l^, COLORADO ~~~~ ADDRESS d ~-` ELECTRICAL OF JO! ~/ ~ , G. `~ ~ ~/I,Q~ ~ ~U~1 PERMIT ~' WHEF n1GNED AnYb VALIDATEO'BY SOtID(N'G IN5dECYlON bEPA~2TMENT THIS PERMIT AUTNORI2E$ THE WORYC DESCh'I BEb BECO"CV°~" '"'" ' CLASS OF WORK: NEW',;ly ADDITION O ,,.,,,. ALTERATION.O REPAIRO MOVE C~ WRECK O OWNER ~ NAME , ADDRESS _ ," _, ,. _ ", PH,ONE_. } LICENSE ll`C~E~i~SE'W ' p •` J NAME (AS LICENSED) CLASS- ~- NU/v(6ER S7 ADDRESS ! • ®_ PHONE,,,. ` O SUPERVISOR V FOR THIS 106 NAME _. _,pA7E CERTIFIED _. NO. OF UNITS DESCRIP TIO'N OF WORK _ NO. OF UNITS DESCRIPTION( OI"~ORI~ ,/~ TEMPORARY METER V TRANSFORMERS & RECT IFIERS' NEW SERVICE ENTRANCE - WIRING MOTORS & CO N7ROLS t~ NO. AMPS_ ~~~ ~~®~ NO. OF OIL BURNERS STOKERS, . FORCEDAIR SYSTEkAf CHANGE SERVICE ENTRANCE OTHER NO AMPS __~,~_ MOTOR$ >~G' ~~~_~ J~p {~ ,CIRCUITS SIGNS ~++~, -- LIGHTING NEON EXT'R SIGN & i TRANSFORMER HEATING NEON INT'R SIGN & I°7RANSFORTv1ER" " POWER SUB-CIRCU175- ~ ADDITIONAL TRANSFORfvY'ERS; "~~ EXT. OR iNT UTILITY (RANGE DISPOSER COOLER, FAN,DRYER, WATER HEATER) ,-..,,- NO OF INCANDESCENT ~LIGHTS'~ OTHER _ FIRE DETECTION-ALAR/v1 SYS'M ' FIXTURES ~.,~: OTHER REMARKS ,~' lj'°"'' AGENCY AUTHORIZED DATE .w BY PUBLIC _.,. ::..,. .. ,.~ ,.: ,,. ~ :.,, ... , . WORKS NOTES TO A"P'P`LI~A`~l' ~~ VALUATION FOR INSPECTIONS OR7NFORNfA170N'CALL 9°255973 '~~ '~~ ~""°"` """ `""~" THE V " C~ ~ J ~ OF WOR~C' ~ ~"• ALUATION OF EACH OF THE ABOVE UNITS StSk('LL `e`E°PNC`~."t5'"1~1 Tl~i'~`'~°~.' I N ~ ` ' ' ~ ^~ FOR AlL WORK DONE UNbER 7i~1T PFB'TJCY~"T'F~'E ~ O e OR '~'"• COMPLIANCE WITH TN!'r!'.~`Yfb~i"~Y F:L'9"C~'R7`C'%iC"C"~'"'~"j"7'p"~"'"q"$p~*'I~°"^Qµ'Yjj°~'E'S' i T " "' PLAN T P FILED ~ TOTAL FEE 1 J D ALl OTHER COUNTY RE`$O"I'Tl`j'I`~'$~" CI`f~d~51~"i1 ~ ~ $ '''Y A ' " t C F S7A E L VA S WHICHE~FR A PP1IE$ PE ` ° ` "' W ' ` RMIT SUBJECT TO RFVO C X Yfr~N dR ~I SSP~SfON ` fO~t fifdCliTl°()FI"OFY"!CN'Vn'CS (i"O°GE~2~!°7~S"G°"`3A'°M°"E. REQUIRED INSPECTIONS`YNAL"C""B`Elt`E Q G" '1'A"'V'YfT A" °V" " ` °"` ""'"`""'""`" DOUBLE CHECK B~ `~•~ $ t D A N C~ I '" ' "' FEE ~ CASH ~ (~ wF NAC INSPECnoN SNkiI iBE li&DE ~ OR WER'wICL"BE --' "~ _ ~' RELEASED, AND'BEFORE THE BUILDING M OCCUPIED 'BUTCDING-b E"P"AR'YM~N'"T""` ~ "" `~ _ . SIGNATURE' "' ~" ~,.. ~ ./' ~ f~~~~~~ '. ?LICANT: (. ,. >. APPROVAL 8Y' ~jLJ r~i../ OATE l c THIS FORM IS A PLR~T ONLY "_"" " "" " E 'CFlIV11 DATE PERMIT NO. LICENSE # RECEIPTS CLASS AMOUNT D y`"=~:~ WHEN VALIDATE ~ ' ~~// ~ f{l OG WHITE-INSPECTOR'S COPY YELLOW-ASSESSO A$PEN'~P1~~IN REGION, 606 F_awti" Main Streei Aspen, ,. BUILDfNG INSPECTION CFfPCK LIST` Inspebtion ~~"~~ Reinspectwn Partial Complete ~- Permit No: GC Steel Electric ~"'-Plumbing Heating' Building Footings Temp Underground Rough R-Frame. Caissons Underground--.; Waste&Vent .Flue Insul. Wall Swim Pool, _,_ Water Pipe F. P. Flue Drywall _ 8truct Slabs T Rough Gas Gtass Door Special _ Damp Proof Service Fihal Combust Air Mobile Hdme _ Foun.lnsul. Final /' Fire Sprinklers Final Final Found: Drain Stove Type Zoning _ FIRE UFE & SAFETY Kitch Hood Accepted ~ /" Rejected Reinspection Fee $30.00 Yes No I No. Bdrms. (You are _...., .r .,.. ~ w ,, ,'~ s Instructions to Inspector- FContractor ./C--~~ G°~1'iG. Owner !G/'_S9.S~~G~IJ%~' Inspected Date': Rev. 4/86 MM., -xr wG .. ~.,..,. ~wa.,ww.~wxro.wwwwi~.,>„.e.. Kitchen..- Tub _ Shower- Lav. _,_, Cx7.C.=Ice _ W"~ar ' '~'I u~/`S`~i"pwer_ Jacuzzi _ Bidet-Hose Bib-Laurid ,,._ e. ~_ :~ ~,.,~..~.~~~w,.,~...,:;,. ry._ C7otfies VVas~ier`" I-fo4"TuK """'" "'"6'~V. ~ ''" ""'" acJ~"'u"i ~ul~hower - ~ _. -. City-County- Time of ArnJal'.;,~~ Time of Departure `~ dT ~~~--,,~ v ....... . .... ..~ Addfess6~~_~~~ ~,%9/as//`1 PhoheJob Office Subdivision Reque§t Reb'd ~//~1.~i> /~~,~ I Inspector --. ~ ..... .. ,..v. 'o+. ....xh' ~..».ry pan 4~[ ~/ u'.. v JrYtidi a., n .. ... .. .. d..h... ~ .~wxl xy