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Home My WebLink About7003 Cedarbough Loop_BLD90365_2025r / \\ Permit N 6 3 r Date Called42 Time Called s By ' 1 N 1p" 11 N NOTICE and -fn'spectrdn Report Addresses f Contractor Owner TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Plumb GW ❑ Roof Diaphragm ❑ Footing ❑ Framing Foundation ❑ Drywall Nailing ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Shear Wall ❑ Furnace 1 APPROVAL VIOLATION ❑ Insulation ❑ Gas Piping ❑ Woodstove ❑ Final ❑ Reinspection ❑ Other Fj PARTIAL APPROVAL CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. t"4- Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. c^ 774/ ❑ CALL 435--FOR REINSPECTION — 24 hour notice required. W Inspector ,/Kty! r Date I was present during this inspection. Perry eity of I .I L I N 11IF, "41 NOTICE and Inspection Report Date Called —� /C� Address Time Called / Contractor L �� By Owner Requested by (® TYPE OF INSPECTION REQUESTED Ij ❑ Setback ❑ Reroof ❑ Insulation Plumb GW ❑ Roof Diaphragm ❑ Gas Piping Footing ❑ Framing ❑ Woodstove oundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. e, 714 ❑ CALL 4354M FOR REINSPECTION — 24 hour notice required. 1 Inspector Date I was present during this inspection. Permit No. 7� Date Called IZA-2-190 Time Called /L%OU By NOTICE and Inspection Report Address�� - Contractor' Owner Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing [Final ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION )K CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to pe0orm inspection. CALL 43 OR REINSPECTION — 24 hour notice required. Inspector Date I was present during this inspection. Permit No. -- Date Called ?— Time Called By 061 r,6 S It I "N4; r 4P iv NOTICE and Inspectrdn Report Address Contractor Owner �- /6) Requested by-,,c11 TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other g APPROVAL ❑ PARTIAL APPROVAL /❑ VIOLATION ❑ CORRECTION REQUIRED Corrections listed below MUST BE MADE before work can be approved. IQ --Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perjorm inspection. �i� ❑ CALL 435 OR REINSPECTION — 24 hour notice required. / t� � =... / . ��/�` .aim _ _ -�. �� :. ►- �it'/ r Inspector 4 Date I was present during this inspection. Permit No.' — Date Called Time Called By `d D —l0 ❑ Setback ❑ Plumb GW ❑ Footing ❑ Foundation ❑ Concrete Slab ❑ Shear Wall cil,, ol! IL It ,1, N Ir' "11N NOTICE and Inspection Report Address Contractor Owner TYPE OF INSPECTION REQUESTED ❑ Reroof Insulation ❑ Roof Diaphragm ❑ Gas Piping ❑ Framing ❑ Woodstove ❑ Drywall Nailing ❑ Final ❑ Rough -In Plumbing ❑ Reinspection ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 43 5�R REINSPECTION — 24 hour notice required. Inspector / Date �L D ✓+v I was present during this inspection. Permit No I <_ City l! A IM I N WrO 1 NOTICE and Irco-peci-rdn Report Date Called Address 7703 Time Called c3.s� Contractor By Owner ( ,-1 Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other ;;�-APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to periprm inspection. ❑ CALL 43AWOR RE INSPECTION — 24 hour notice required. Inspector ` Date K-4-5 I was present during this inspection. Permit —S //22)] NOTICE and -Inspect on Report Date Called tVrV/" Address Time Called Contractor By Owner r-, 7 / � Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing �aming ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In Plumbing inspection ❑ Shear Wall ❑ Furnace ❑ Other ,,0'APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. —e--w-ork listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perfprm inspection. ❑ CALL 434 OR REINSPECTION — 24 hour notice required. Inspector Date was present during this inspection. Permit h _ �.� 01,j n� i P �� , �� i, �� NOTICE and Inspection Report Date Called — Address &4A� Time Called 5/.csZ> Contractor ESL / By Owner Requested by /( TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing eFraming ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION F' CORRECTION REQUIRED Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to peoorm inspection. ❑ CALL 435 FOR RE INSPECTION — 24 hour notice required. Inspector Date) I was present during this inspection. Permit ,— `_ As'AdINl:""ItN NOTICE andInspect o Report Date Called Time Called By -� Address Contractor Owner Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION CORRECTION REQUIRED Corrections listed below MUST BE MADE before work can be approved. e ow as ed and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to pe orm inspection. CALL 435� MA FOR REINSPECTION — 24 hour notice required. Inspector ' Date I was present during this inspection. Permit No. �� 7City n� ■�� I % Ir m�� -� NOTICE and Inbpection Report Date Called Address Time Called Contractor By ( Owner ! Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete SlabJ4 Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to_9erform inspection. ❑ CALL 435 5 FOR REINSPECTION — 24 hour notice required. Inspector .Av/ f -F .0 Date I was present during this inspection. Permit No. Crty �� A t It Ii I N C N NOTICE and Inspection Report Date Called 2 P5— Address 2Ci01 i'Aa�,g, Time Called ''.r Contractor By Owner f / Requested by (::,.d _26 TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing Final ❑ Concrete Slab ❑ Rough -In Plumbing Reinspection ❑ Shear Wall ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ';�-A Work fisted below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to pe,06rm inspection. ❑ CALL 43 013 REINSPECTION — 24 hour notice required. Inspector s� Dat_L'/ � was present during this inspection. /� M (Fr ,'c4, (INSPECTION REPORT N O?'Q Permit No.: 01- 7Y50 Lot #: T Address: _70U3 S Q aaro ,41, Contractor:- -y O Omer: �a IN * Date: , C-, - z -r - u 7 If APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. r 1.' 5`L,- Inspector: Date: (9 �,;Ig-02 TYPE OF INSPECTION REQUESTED ❑ Under -floor ❑ Footing ❑ Foundation 6 Mechanical ❑ Wood Stove ❑ Masonry ❑ Other: ❑ Framing ❑ Gas Piping ❑ Drywall, Nailing ❑ Consultation ❑ Shear Nailing ❑ Groundwork ❑ Grid ❑ Struct. Slab ❑ Rough -in ❑ Final ❑ Drainage ❑ Insulation %- 25-C-7 c F04 �&o ctG N M`O O G,OIIF GouQS€ v � 1 i1+y ��•� Il,.r� Ctg ZZ3. 1�ou 5C AA, 1 r -M G�.w4ubP18w�S SCW,I- -- .A -LA- bv,-z--A-k , CATTY OF r RUNGTON 0 PRO D a ors _16-zi-c-7 sM _.._- ` PPR0VED BY i HE INSPECTOR E Fv P.,uA 44 ( A44txd 7 Q 1 I L=v k`1. L o,,V, . OFFICE 070.-Py= �= aq, q5-�. h 1 -, x 5� �, 4 Y °� RESIDENTIAL MECr1AHICAL � PERMIT APPLICATION �Jnt G�Ia Department of Community Development City of Arlington • 238 N Olympic Ave. • Arlington, WA 98223 • Phone (360) 403 3551 • FAX (360) 403 3447 THIS APPLICATION TO BE USED FOR ONE AND TWO DWELLING UNITS RESIDENTIAL STRUCTURES. THIS APPUCATION MUST BE ACCOMPANIED BY THREE (3) SETS OF CONSTRUCTION DRAWINGS, AND THREE (3) SETS OF WASHINGTON STATE ENERGY CODE APPLICATIONS. Type of Permit: Project Address: -- Lot #: Project Description: (Residential Project Valuation: -700 3 S CADA-A-RO-Jt-�161 1,vCP Subdivision: 45qoo Parcel ID #: Owner: 'a rT"y-A V' v I u'-"L/7_X Phone Number: Address: 7c-V3 ctmg-6w+ City: � State: WA- Zip Code: - Q&__M Contact Person: Phone Number: 36o 403 M( Cell Phone: Address: Please List quantity of fixtures Below: CLOTHES DRYER FURNACE OVER 100K APPL VENT /OTHER BOILER UP TO 4-15 HP BOILER 51 HP AND UP EVAL COOLER VENT HOOD ALL OTHER UNITS Fax: E-mail: City: State: Zip Code: y FURNACE UP TO 100K BTU 1 GAS OUTLETS FLR FURN INSTALL/RELOCATE SUSPENDED HTR/UNIT HTR\ APPLIANCE REPAIR BOILER UP TO 3 HP _ BOLIER UP TO 16-30 HP BOILER UP TO 31-50 HP _ AIR AHNDLING UP TO 10K CFM AIRHANDLING OVER 10K CFM VENTILATION FANS OTHER VENTILATION SYSTEM DOMESTIC INCINERATOR COWIND INCINERATOR FREESTANDING STOVE FIREPLACE INSERT Contractor: Phone Number: 77 1 251 Address: ? t (o 5 W `i City/K"d-iZAte W WA- Zip Code: 9609B Contractor's License NumberU -'X- 6)q-7 Expiration: I hereby the above information is correct and that the construction on, and the occupancy and the use of the above- d ff property be in accordance with the laws, rules and regulation of the State of Washington. Appliea�ts Signature Print Applicants Name Date UI 2) 2037 �� ♦ '?-s A;iq fir♦ * r_ FOR STAFF USE ONLY Permit # Accepted By Amount Received Receipt # Date Reoahed WEB Forms -42 Page 1 of 1 3/07 dwa CITY OF ARLINGTON CONSTRUCTION PERMIT ® COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.00365 OWNER MAIL ADDRESS CITY ZIP PHONE Woodhaven Homes P.O. Box 1032 Lynnwood, WA 98046 546-3969 ARCHITECT OR DESIGNER MAIL ADDRESS CI'I Y ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N Same as Owner WOODHH17408 MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE L CLASS OF WORK K] NLW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION VALUATION OF WORK ; 90,000 DESCRIBE WORK Naw C'nn�i-ra�r�#-i rxn PROPO51 D USL OF BUILDING Sin le Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE GRANTING OFA PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE NTRACTO. OR AUTHORIZED AGENT DATE A l C4 LEGAL DESCRIPT ION DI PROPERTY ISHOWN BELOW OR ATTACK FOUR COPIES) LDF C-lQjLOCK OF Woodlands Sector 1 TAX ID NUMBER jOB ADDRLSS 7003 Cedarbough Loop (OFFICE USE ONLY) PLUMBING NICAL NO. TYPE OF FIXTURE FEE TYPE OF EQUIPMENT FEE WATER CLOSET (TOILEI) jtNO, AIR COND UNITS — H P EA BAIfiIUB REFRIGERATION UNITS — H P EA LAVATORY (WASH BASIN) 0BOILERS — H.P. EA SHOWER GAS FIRED A.C. UNITS — TONNAGE EA KI ICHEN SINK & DISP. 2 00 1 FORCED AIR SYSTEMS — B T U MEA 1 DISHWASHER 2 00 WALL HEATERS - B.T U M LAUNDRY 1 RAY UNIT HEATERS - B.T U M CLOTHES WASHER 2 00 EVAPORATIVE COOLERS WAIER HEATLR CLOTHES DRYERS URINAL VENTILATICN FAN 18 DRINKING FOUN I AIN RANGE HOOD COMMERCIAL FLUOR DRAIN AIR HANDLING UNIT - CPM 2 VACUUM BREAKERS 4 00 STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE & CHIMNEY SINK (SERVICE - BAR, ETC.) 1 WATER HEATER 6 2 1 GAS PIPING SUBTOTAL $ 26 100 SUBTOTAL $ PERMIT $ 15 100 PERMIT f TOTAL FEE $ 41100 1 TOTAL FEE ; SIDL YARD SE [BACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER 4-23-90 PLAN FEE 445.25 CHECK FEE RECEIPT NO USE ZONE R7200 LOT AREA 7824 VACANT SITE ®YES ❑NO FEES VALUATION FEE PLAN CHECKING NG 386.43 (5 8 82 TYPE OF CONST VN OCCUPANCY GROUP R3 & M NO OF DWELLING UNITS 1 BUILDING $ SIZE OF BLDG 2849 NO, OF STORIES 2 MAX OCC, LOAD 8 PLUMBING 41 00 FIRE SPRINKLERS REQUIRED ❑ YES E*NO MECHANICAL 51 50 COMMENTS STATE BLDG. CODE ENERGY CODE SURCHARGE 4 50 PENALTY U.B C. SEC. 303(a) WATER/SEWER FEES 1305 00 TOTAL 1978 18 PERMIT VALIDATION WHEN PROPERLY VALIDATED TIN THIS SPACE) THI 15 YO R PERMIT & CEI PAID ' CR# BY cc: ASSESSQR. APPLICANT, TREASURER, BLDG. DEPT. B N'GOFFl tAL DATE RECO DS COPY . " CITY OF-ARLINGTON CONSTRUCTION PERMIT •` ® COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ - - - PLUMBING ❑ SIGN PERMIT NO. owAliR MAIL.ADORES3 '« CITY sit nIaNE Amoulto Oq PtAIGNim ; MAIL ADDRESS CITY 11P IKINE N RAL C0741 RAC ILIAMAIL ADDRESS ^'E" Ell 11P MANSE 'Ih�aQ Auk &J �Cm gS ?, O . �a iQ � z 4 (,,,,u vtveJ., �r �o fro —CiEY sY6- 3y6 oc>1��Ifll ?Yo8 14(.14ANICALCONITlAC1OR MAIL ADDRESS 11P PIKXIE LVLENS!/ PLVMBINUCONIRACIOA MAIL ADDRESS CITY » 11P a 1' PiIONE LICLNS1I CLASS O1 WORK NI ❑AIIUILION ❑ALTERATION ❑REPAIR ❑ LIE MOLIIION ❑BUILDINGRELOCAIION — /VALUAIWWOf WORK DLSLRIBE WORK iR SEJi.Y3r UILOING �'. I HEREBY CERTIFY THAT I HrjVE READ AND EXAMINED 11-115 APPLIC1- 5 IION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PRUVI- L AL L►ES[.RI I KlN IN PNOP►R N &kLOW OR ATTACH 1QUA CGPIESj $IONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE CIF WORK Lul C. BLOCK OF WO AI WILL BE COMPLIED WITH WHETHER SPECIFIED j-IFRi d OR NOT. TI IE • GRANTING 6F A PERMIT DOES NOT PRESUME 10 GIVE AU I I IQRI1Y TO VIOLATE OIL CANCEL THE 9ROVISIONS OF ANY OIFIER STATE OR TAX 10 NUMBER LOCAL LAW gEGULATING CONSI RUCTION OF TI IE PERFORMANCE OF CONSTRUCTION.. PERMIT EXPIRES I YEAR FROM DATE Of ISSUANCE. SCAfAIURiOfC(*dIRAC1OR04AU11400VZLZLOACANT DAIS 109AuuRtSs • x 1 Zeo tOFFIC:E USE ONLY) 161ECIIANICALIN NO. TYPE OF FIXTURE FEE NO, TYPE OF EQUIPMENT FEE WAILR CLOSEI IIUILLT j Off- AIR GOND. UNI IS - II.P. EA. - BAIIIIUS LAVAIURY IWASII BASIN) SIIOW'LK REf6LIGLRAIION UNITS - II.P, EA. BOIL(RS - ILP. EA t;AS TIRED A-C. UNITS.- TONNAGE EA. --i-- kl ICIILN SINK i 015P. UISIIWASi1LR EgM D AIR SYSTEMS --1 T.U. MEA WALL-IIEAIERS -B.F. . M ----#�-- LAUNURY TRAY UNI) IEAIERS-B.1.U• M CLUIIILS WASIILR EVAPORAIIVE COOLERS NAILR IILAILR I CLOIIIES UP YERS URINAL VLNIILAIION FAN URINkINU i OUNIAIN I RANQE IIUUU COMMERCIAL I LOUR URAIN AIR IIANULINL UNIT - . CPM VACUUM BREAKERS KULII )TRAINS - RAINLEAUERS SII)V '• MEIAL FIREPLACE A CIIIMNEY SINI. RVICE - BAR, EIC.I WATER HEATER GAS APING SUBTOTAL' 1 y'•' 1- SUBTOTAL 1 36 PERMIT 1 t1 E PERMIT I $ IOIAL FEE 1 oC� •'-TOTAL FEE 3 5101.. Y ARD St 15^LA ) s-/ G-!:-T- /r I COMMENTS 10IRRL1 HGROUPRO. LO1 AALAVACANNT Vit21, VYES ❑ NO Inir[LWANfOf DWELLING UN ITS•• FIRE SPRINKLE ❑ YES Cc: ASSESSOR, APPLICANT, TREASURER, BLDG. DEPT. FEE � � �Er'., RECEIPT NO. fEES I YALUAIION •` FE PLAN CHECKING VO BUILDING �' 1 it �- PLUMBING 1 RED MECI (MICAL - r • STATE BLDG. CQOf ENERGY CODE IURGIARGE h PENALTY y U.B.0i SEE omal WAIERISEWERIEES (� •� TOTAL /ERMIT VALIDATION Val PROPERLY VALIDATED ON 1105 SPACE! LENS a YOUR fERAYT i RECEIPT , r PAID CRB BY :I 1 T, ° BURT7W.0FM1AL DATE • REGARDS COPY' •