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Home My WebLink About2215 VISTA CHAPARRAL; ; CB110973; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-02-2012 Patio/Deck Permit Permit No: CB110973 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2215 VISTA CHAPARRAL CBAD PATIO Lot#: 0 2552530700 $13,011.00 Construction Type: NEW TAMS RES 12 FT HIGH FIREPLACE, GAS/ELEC TO Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Plan Check#: ISSUED 05/10/2011 KG 07/14/2011 07/14/2011 MC MARIBEL MALDONADO CHYTRAUS&TAMS REVOCABLE TRUST 09-22-00 PO BOX 189 VISTA 92085 760-908-3443 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Strong Motion Fee Green Bldg Standards (SB1473) Fee Renewal Fee Add'I Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES 2215 VISTA CHAPARRAL CARLSBAD CA 92009 $154.21 $0.00 $100.24 $0.00 $1 .30 $1 .00 $0.00 $0.00 $47.00 $0.00 $303.75 Total Fees: $303.75 Total Payments To Date: $303. 75 Balance Due: FINAL APPROVAL Inspector: M· ~s Date: -z. Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the 'Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as 'fees/exactions.' You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any f I f whi h I n iv n N Tl imil r hi r w i h h f limi i n h i City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07-28-2011 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW110305 Job Address: Permit Type: Parcel No: Reference #: CB#: Project Title: 2215 VISTA CHAPARRAL CBAD SWPPP 2552530700 Lot #: 11-973 TAMS RESIDENCE Solid roof patio in rear yard and 151 sf of Priority: L 63 Applicant: Owner: Status: Applied: Entered By: Issued: Inspect Area: Tier: ISSUED 07/28/2011 LO 07/28/2011 LOS CABOS POOLS CHYTRAUS&TAMS REVOCABLE TRUST 09-22-00 253 WOODLAND DR VISTA CA 92083 +ea e+s 1s2fl'""-''"~~ Emergency Contact: JAVIER MALDONADO 760 521-6731 SWPPP Plan Check SWPPP Inspections Additional Fees TOTAL PERMIT FEES Total Fees: $99.00 2215 VISTA CHAPARRAL CARLSBAD CA 92009 $45.00 $54.00 $0.00 $99.00 Total Payments To Date: $99 .00 Balance Due: FINAL APPROVAL DATE04, l9j I?: CLEARANCE. __ _ SIGNATURE f1/1-~s $0.00 ~~ Building Permit Application Plan Check No.C • -, ~-0 t1 ~ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value C ITY OF T .7< _,g-760-602-2717 / 271812719 Plan Ck. Deposit V• CARLSBAD Fax 760-602-8558 Date -~ .._,, l)-Tl !sWPPly) la www.cartsbadcagov JOB ADDRESS 2215 Vtst01 Ch01p0lrrol SUITE#/SPACE#/UNIT# lAPN25"5-253 -07 -00 CT/PROJECT # ILOT# r !A.5E # I# Of UNITS I" BE~ #BATHROOMS I TENANT BIJSINESS NAME ICONSTR. """ I """'GROUP DESCRIPTION OF WORK: Include .squ_.. Feet of Affected Area(s) 3V-I itJ CCA bei. r-. ~ .f ir-t-p (~c.e l 2., J+,[/1 tJ O qS BBQ .5{)..s. ~,..,o( ekc-/-rt'<-1 -ft-t ·i,og fl/ pa--h O c.o ve.-r Of.e,,n --rv.Q_.//,, P ff -~1 i 0.-, +-e J JjOo e..k.cfvic-i-hl 151 ¢, re+.k)((I 1 w/en~1~er111,ry ,2ftf~ EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE ' AIR CONDmoNING IFIRE SPRINKLERS YES[)# NcCJ YES□No□ YES0 No0 CONTACT NAME (It Dltfwwnt Fom Applicant) APPLICANT NAME MARIBEL MALDONADO ADDRESS ADDRESS PO 80)( 1gq CITY STATE ZIP CITY VISTA STATE CA ZIP q208S PHONE IFAX (NE ~ IFAX 1,0 C:,08-344 ~ (7eo) 2q 4--8,44 EMAIL EMAJL PR~~OOERC~~TRAUS & SHERRI TAMS CONTRACTOR BUS. NAME LOS CABOS PooLS, INC, ADDR2 2. f s vist~ chap~rral ADDRESS Po Box J8q CITY Car\c;bad STATE CA ZIP q200Cll CflY VISTA STATE CA ZIP q2oss PHONE (.7"o) 635 .. 75qq 'FAX p(7~o\ ctos-3443 (1_ 1,0 ') 2q 4 -8 b44- EMAIL Emaril,el @ loscabos pools. C.om ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE LIC.# 08~8" 5 lc-s,/c-1':;"BUS.i-i '2 37 B c, .. WOfMff' Compensation Oeclaration: / hereby a/frrm under penalty of ooe of the following declarallons: 0 I hl'le and will maintain a cenlflcatt of consent to se!l-lnsurw for workers' compensation as provided by Sec1ion 3700 of lhe Labor Code, for the pelfonnaooe of the work for which this permit is issued. 0'i have and will maintain worl<ers' compensation, as reQllired by Section 3700 of the Labor Code. for lhe pelformance of the work for which this permit is Issued. My wor1(ers' compensalion i~::, and policy numberare:lnsuranceCo 'SPAR.TA INSURANCE co. Poicy t«>. 003WKo,soi ExpirationDale \O~U,2011 l]lm.section need not be compleled t the pem,it is lorone hundsed dollars ($100) orless. LJ Certificate of Exompllon: I certify that in the pertoonance of the """1< for which this pennil is isSIJ8d, I shall not employ any person in any manner so as to become subject to the Wotl<ers' Compensation Laws of California. WARNING: Failure to aecure wllf1un' compensation coverage is unlawful, and sh.Ill subject an employer to criminal penaltln and civil fines up to on, hundrld thousand dollars (&100,000), In addition to the cost of compensation, damagn II provided for In Section 3706 of the Labor code, lntenst and attorney's, __ _g CONTRACTOR SIGNATURE □AGENT DATE 05.oq.2011 I hereby affirm fhlll I am exampl from Contractor's LJcense Law for the following 198son: D I, as oWfl8f of the property or my employees with wages as their sole ~lion, wiH do the work and the structure is not inlended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or .,..,.-oves thereon, and who does such work himself or through his own employees, provided that such improvemen1S are nol intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving thal he did not build or improve for the purpose of sale). D I, as owner of the property, am exclusively contrading with licensed conlr.lcto,s to ronstruct the project (Sec. 7044, Business and Professions Code: The Conlraclor's License law does nol apply lo an r:,wner ol property who builds or impro.es lheleon, and conlrads for such projects with contractOl(s) licensed pursuanl to the Contractor's Uoense law). □ I am e~ under Section ___ _,Business and Professions Code for this reasoo: 1. I personally plan to provide the major labor and materials for conslruclion of the proposed property improYement O ves Qlo 2. I (have/ have nol) signed an application for a buildlng permil for the proposed wor1\. 3. I have contracied with the following person (firm) lo provide the proposed ronslruclion (include name address/ phone I conlraciols' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work [include name/ address/ phone I contractors' license nun-bet'): 5. I will provide some of the """1<, but I have contracted (hired) the following persons to provide the work indicated Onclude name I address I phone I type of work): _g PROPERTY OWNER SIGNATURE □AGENT DATE Is the applicant 0< future building ooc:upant requiled lo submit a business~ hazardous matsrials mgislration fonn 0< risk management and prevention program under Sec1ions 25505, 25533 0< 25534 of the Presley-T snner Hazardous Substance Account Act? D Yes 1::::JNo Is the applicant or fulUte building oocupaol required lo obtain a perm~ from the air pollution conlrol.Jl§.trict 0< alt.9!!ali!}:_managemenl district? []ves ~ Is the facility to be construded within 1,000 feet of the outer boundary of a school site? LJYes l.d1'lo If AHY OF THE ANSWERS ARE YES, A FINAL CERT FICA TE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EllERGEHCY SERVICES AND THE AIR POLLUTlON CONTROL DISTRICT. of the wonc this pennit is issued (Sec. 3097 (il Civil Code). Lender's Address I certify that I have read the applicallon and slate that the 8bowe lnformlllion is OOIR!CI and that Ille lnbmation on the plans is acauate. I ~ID oomplyllilll al QIYOlllinancesand S1ate laws relaling ID building OOll5trucllon. I hereby aulhorizerepresentativeof lheCily rl Garlsbaltoenterupon the alxll'e men1kJned p-operty forlnspedion PIJPOS8S. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY~ CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN A~ WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: AA OSHA penrit is recµred for excavations over 5'0' deep axl dem:lliliorl or aristnx:1ion of slrudlJres over 3 smes in height EXPIRATION: EYel'f permit issued bylhe Bu1ding Official underthepTNislonsof !Ns Code shall exµre by limtaion ax! booome null and ,,oo ilhe buiang orl'oOl1< atAtlorized by such permit is notoommenaJ:I will1fl 180 days from the date of such penrit orW the bo.ikling orl'oOl1< arthaizlld by such penrit is suspended 0< abandooed al ;yiy tirTe alerlhe l'oOl1< is cxmnerced b' a J:8lod of 180 days (Seclioo 100.4.4 Uniform Bulding Code}. ,l:f APPLICANT'S SIGNATURE DATE os .oq.20" Inspection List Permit#: CB110973 Type: PATIO TAMS RES 12 FT HIGH FIREPLACE, GAS/ELEC TO B Date Inspection Item Inspector Act Comments 06/19/2012 19 Final Structural RI 12-1 PM IS PERMIT OK TO FINAL? 06/19/2012 19 Final Structural MC Fl NO PATIO COVERS 06/19/2012 29 Final Plumbing MC Fl 06/19/2012 39 Final Electrical MC Fl 02/06/2012 89 Final Combo MC co SEE BACK OF CARD 02/01/2012 92 Compliance Investigation MC PA MIKE WENT TO CHECK JOB BECAUSE H.O. SAID ABANDON. FIREPLACE IS ALREADY BUILT. 09/19/2011 62 Steel/Bond Beam MC WC 09/19/2011 66 Grout MC PA RET. WALL AT SIDE YARD & 1ST LIFT AT FIREPLACE 09/07/2011 61 Footing MC AP FTG & STEEL FOR RET. WALL & FIRE PLACE 08/15/2011 11 Ftg/Foundation/Piers MC co 1147 F3, AT RET WALL 08/15/2011 23 GasrresURepairs MC AP METER TO BBQ & FIREPLACE 08/15/2011 31 Underground/Conduit-Wirin MC AP CONDUIT ONLY, METER TO BBQ, FIREPLACE & SPA 08/15/2011 62 Steel/Bond Beam MC WC 07/26/2011 12 Steel/Bond Beam MC co 2ND STOP, 4 OF 6 COLUMN FTGS & STEEL ONLY, NOTICE FOR RET WALL 07/26/2011 12 Steel/Bond Beam MC co 1ST STOP, COMPLETE ALL STEEL Tuesday, June 19, 2012 Page 1 of 1 Carlsbad 11-0973 05/24/11 [DO NOT PAY -THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PREPARED BY: Ray Fuller PLAN CHECK NO.: 11-0973 DATE: 05/24/11 BUILDING ADDRESS: 2215 Vista Chaparral BUILDING OCCUPANCY: U TYPE OF CONSTRUCTION: VB BUILDING AREA Valuation PORTION ( Sq. Ft.) Multiplier Cabana 324 13.17 Trellis 208 9.59 Masonary FP 1 3,855.98 Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code cb By Ordinance Bldg. Permit Fee by Ordinance I • I Plan Check Fee by Ordinance I ,.. I Type of Review: 0 Complete Review D Repetitive Fee· =8 Repeats Comments: D Other D Hourly EsGII Fee Reg. VALUE Mod. D Structural Only ($) 4,267 1,995 3,856 10,118 $126.91 I $82.491 Sheet 1 of 1 macvalue.doc + «,~ ~ CITY OF CARLSBAD BUILDING PLANCHECK Pool/Retaining Wall CHECKLIST E-37 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov ENGINEERING Plan Check for CB 11-973 Review# 1 Date: July 22 Project Address: 2215 Vista Chaparral APN: 255-253-07-00 Project Description: Solid roof patio in rear yard and retaining wall in side yard (151 sf of retaining wall) Valuation: 13,011 ENGINEERING Contact : Linda Ontiveros Phone: 760-602-2773 Email: linda.ontiveros@carlsbadca.gov Fax: 760-602-1052 Any outstanding issues will be marked with [ XJ . Please make the necessary corrections to the plans or specifications for compliance with applicable codes • and standards. Submit corrected plans and/or specification to the Building division for resubmittal to the Engineering Division. Items that conform to permit requirements are marked with l I ATTACHMENTS: r I Engineering Application ~' J Storm Water Forms [_J Right-of-Way Application/Info. Sheet l ] Reference Docu ments r ··-··-··-··-··-··-··-··-··-··-··-··-··-··-··-··-··-··-··1 OFFICIAL USE ONLY ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT BY: DATE: REMARKS: Notification of Engineering APPROVAL has been sent to via on E-36 Page 1 of 4 REV 5/23/11 CB 11-973 Review# 1 E-37 1. SITE PLAN Provide a fully dimensioned site plan drawn to scale. Show: LJ ~ North arrow D W Existing & proposed structures [ ] m Property lines (show all dimensions) n l✓ ] Easements Show on site plan: L I I D n l 7 Drainage patterns r✓l Existing & proposed slopes Lf 7 Existing topography [Zl Retaining Walls (location and height) CJ L Indicate what will happen with soil excavated from pool area. Include on title sheet: [ =-i ✓ Site address D W Assessor's parcel number n [7J Legal description/lot number C--] [7 Grading: Quantities of Cut L_J Fill lmportL J Exportl 7 D l 77 Project does not comply with the following engineering conditions of approval for project no: ] L Conditions were complies with by: Lot / Map No.: LOT 63/Map 13385 Subdivision/Tract : CT 88-03-01 Reference No(s): DWG 322-1A/PE 2.91.16 Page 2 of 4 Date: REV 5/23/11 CB 11-973 Review# 1 E-37 2. GRADING PERMIT REQUIREMENTS The conditions that require a grading permit are found in Section 11.06.030 of the Municipal Code. D n Inadequate information available on site plan to make a determination on grading requirements. Include accurate grading quantities in cubic yards (cut, fill, import, export and remedial). This information must be included on the plans. If no grading is proposed write: "NO GRADING" n D Grading Permit required. NOTE: The grading permit must be issued and rough grading approval obtained prior to issuance of a building permit. A separate grading plan prepared a registered civil engineer must be submitted together with the completed application form attached . LJ L J A grading permit has been applied for: DWG n [ I: No grading permit required. 3. MISCELLANEOUS PERMITS LJ [ ✓ J RIGHT-OF-WAY PERMIT is required to do work in city right-of-way and/or private work adjacent to the public right-of-way. [ 1 l A separate right-of-way issued by the engineering division is required for the following: LJ Please complete attached right-of-way application form and return to the engineering department together with the requirements on the attached right-of-way checklist, at the time of resubmittal. Right-of-way permit and pool permit will be issued simultaneously. Page 3 of 4 REV 5/23/11 CB 11-973 PLEASE FILL OUT COMPLETE A NEW FORM: B-24 AND E-29 E-37 Review# 1 4. STORM WATER Construction Compliance [_gJ CJ Project Threat Assessment Form complete. C j L] Enclosed Project Threat Assessment Form incomplete/incorrect. Please make corrections, re-sign a new form and resubmit with next submittal. LX D Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form and return (SW 11-305 ) Post-Development (SUSMP) Compliance D [ZJ Storm Water Standards Questionnaire complete. D ["] Storm Water Standards Questionnaire incomplete. Please make the corrections, re-sign the questionnaire and resubmit with next submittal. D [ZJ Project is subject to Standard Storm Water Requirements. See city Standard Urban Storm Water Management Plan (SUSMP) for reference. http://www.carlsbadca.gov/business/building/Documents/EngStandsw-stds-vol4-ch2.pdf LJ W Disconnect discharges per SUS MP. Do not connect runoff from impervious surfaces to storm drains without first discharging water over landscape areas. See SUSMP 7 I ] Minimize use of impervious surfaces per SUS MP. Redesign to reduce the excessive use of impervious area (pavement) on project. Use a balanced design of pervious surfaces (landscape area, planters, etc.) and impervious surfaces. See SUSMP 5. ADDITIONAL COMMENTS Page 4 of 4 REV 5123/11 PLANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST Plan Check No. CB110973 Address 2215 VISTA CHAPARRAL Planner GI NA RUIZ Phone '-'(7--=6-=-0.,_) 6-=-0=2=----'4=6-'--7 5=---------- APN: 255-253-07-00 Type of Project & Use: FIREPLACE/CABANA/TRELLIS COVER Net Project Density: Zoning: __ General Plan: __ Facilities Management Zone: __ CFO (in/out) #_Date of participation: __ Remaining net dev acres: __ DU/AC Circle One (For non-residential development: Type of land used created by this permit: ) Legend: c;;;J Item Complete@tem Incomplete -Needs your action Environmental Review Required: YES D NO ~ TYPE DATE OF COMPLETION: Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval: Discretionary Action Required: APPROVAURESO. NO. PROJECT NO. OTHER RELATED CASES: DATE YES O NO ~ TYPE __ Compliance with conditions or approval? If not, state conditions which require action. Conditions of Approval: __ Coastal Zone Assessment/Compliance Project site located in Coastal Zone? YES D NO ~ CA Coastal Commission Authority? YES D NO ~ If California Coastal Commission Authority: Contact them at -7575 Metropolitan Drive, Suite 103, San Diego, CA 92108-4402; (619) 767-2370 Determine status (Coastal Permit Required or Exempt): Habitat Management Plan Data Entry Completed? YES O NO ~ If property has Habitat Type identified in Table 11 of HMP, complete HMP Permit application and assess fees in Permits Plus (A/P/Ds, Activity Maintenance, enter CB#, toolbar, Screens, HMP Fees, Enter Acres of Habitat Type impacted/taken, UPDATE!) lnclusionary Housing Fee required: YES D NO ~ (Effective date of lnclusionary Housing Ordinance -May 21, 1993.) Data Entry Completed? YES O NO 0 (A/P/Ds, Activity Maintenance, enter CB#, toolbar, Screens, Housing Fees, Construct Housing Y/N , Enter Fee, UPDATE!) H:\ADMIN\Template\Building Plancheck Review Checklist.doc Rev 4/08 Site Plan: [8J □ □ [8J □ □ [8J □ □ [8J □ □ [8J □ □ [8J □ □ [8J □ □ Pro'✓ide a fully dimensional site plan drawn to scale. Show: North arrow, property lines, easements, EOOStmg and proposed structures, streets, existing street improvements, right of way width, dimensional setbacks and existing topographical lines (including all side and rear yard slopes). Pro'✓ide legal description of property and assessor's parcel number. Policy 44 -Neighborhood Architectural Design Guidelines 1. Applicability: YES O NO C8J 2. Project complies: YES D NOD Zoning: SEE ACCESSORY STRUCTURE SETBACKS BELOW 1. Setbacks: Front: Interior Side: Street Side: Rear: Top of slope: Required __ Shown __ Required __ Shown __ Required __ Shown __ Required __ Shown __ Required __ Shown __ 2. Accessory structure setbacks: Front: Required 20' Shown 23' Interior Side: Required 7.3' Shown 23' Street Side: Required ~ Shown 29.5' Rear: Required 5' Shown .1£ Structure separation: Required N/A (PUD) Shown NIA 3. Lot Coverage: Required 40% MAX Shown NOT SHOWN 4. Height: Required 14' (WITH 3:12 ROOF PITCH) Shown 12.6' {4:12 PITCH SHOWN) 5. Parking: Spaces Required 2, Shown 2, (breakdown by uses for commercial and industrial projects required) Residential Guest Spaces Required __ Shown __ i2(' Additional Comments #1. PLEASE INCLUDE THE TOTAL LOT COVERAGE IN A PERCENTAGE (15r FLOOR ONLY FOOTPRINT OF THE HOUSE, PLUS ALL NEW STRUCTURES (PATIO COVER, CABANA, & FIREPLACE) DIVIDED BY THE TOTAL LOT AREA) ON THE PLANS. ~tttl~ i-2 : SAM~ OVUM W1S 1 I. I/, OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER G~ DATE~(' H:\ADMIN\Template\Building Plancheck Review Checklist.doc Rev 4/08 CB110973 2215 VISTA CHAPARRAL TAMS RES c 10~11-au~!/f:/J:;;1o P4 5/11 I II ~ LA'--'~\., SI ;;itt ( H 0&, L c,,(.,rr-,. &/;;.3/11 ~~-~ ~ "[J:"-~/L w/,e,~'TC-'4<-Cb ~1~1 I I ~ :zr: ~re, ]_;(-// iy{ C&~:k ·; /4 (1 I CvJ1.. 1J # 7Tf ~ -rl!f m /o 1-//-//- 1( 1J[tr ~-~ W-fe U[tc_ w/~ S+v14 ~ f-4Jtuc.! ~ /ctUM ttyJJ£f~- ~rr--tv ~ of-/=<!_ - .l.Ll.. Approved I \ f\J\Jlt../ Date BUILDING I I ) \~~ 7/11/ll PLANNING y ·f-i) ,-J / ENGINEERING /77a FIRE Expedite? y N '/ HazMat APCD Health Forms/Fees Sent Rec'd Encina Fire HazHealthAPCD PE&M School Sewer Stormwater Special Inspection ,r;Jdlf'/1 I e.-,. L CFO: y N LandUse: Density: lmpArea: FY: Annex: PFF: y N Comments Date Date Date Building 5~/,, rl-!-1( Planning slui11 l,/;)J./-/11 Engineering Fire Need1 II ~ I~/ t1[A.) /-JIL oXJ-0 vJ4r,..._ ieTT □CV Bv /J/ L 1A /i:r; '//~ Due? By y N y N y N y N y N y N y N y N Factor: Date ✓ ~one 7(/Lf(rr -7-ssu60 ,I/., I V> )/) ,,_ frA-MIJf A"II\ ()L A-11 ( I ~Done 7 / u,,/(1 -p(;.,y ;'/\Jsrdt, v _ r<',.;k,,;, NJ /,Udl ,6.e., /// 6 u ✓-If . v/tiA p ~'ch.c/~c::( klj rev-L , //,Pp/ /Ve' ~0 ~ 4: do<_ SW ,~ --&_ f?_M ff1'f )'" ,ratJ R, I I ~ • {jJ& sef-rol,lf,ed b ?l/flvY-f:u,7 , -rees voJ1,,/JeuJlJ€/JlforearJ CJ) er- I 7 -'□ Done □Done □Done ~;) t l03a5' □ Issued