HomeMy WebLinkAbout218 LILLIAN PL - Building Permits•
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. g%�.
•
UNIT NO. `, !!
{Tito. TRACT NO. LOT NO.• L/39�2(Z -O7 I /2
CITY OF COSTA MESA ETTR PERMIT A.P. zone
P,;ojt+ebP:ydress 212 L1 LltcO $r PL. tS? 3`d 1-42,• //&3 t s
^rt - S Main Building: I Accessory Building:
PP g ac156.9 VI� • A-CA-SO (,f) M. TYPE OF CONSTRUCTION U NEW U ADD LI ALTS•ATIQN LI REPAI• E Z
Applicant's Mallin Address C/ ../.�
l�� �/ ��,•�s�� -ICA. L6 I�CONVERSION -❑ DEMOLISH 0TH•• •___•_• - • L i T Front Q // qc4 ,e1 O
Own¢Ys Name "K-Y ll� y� CATHY FPhone!(R�- 8744 DESCRIPTION WOR USE F BLDG. 0 Aa. Ka.Ka B Rear 4 Z/ - N
Address :. .: • N/GI.EL CA�f -77 f exrayc a 1•o o ifp-Qw 0.."-, ,l. rtoowt • A - - I
TYPE OF PERMI • GRADING ❑ FOUNDATION ., STRUCTURAL I C Right f/, �/ - N
Arch/En . - License No. Left �.l(�- /
Addressg ❑ TENANT K.ELECTRICAL gj, PLUMBING ❑ MECHANICAL s': Q(/a,.4 e R
//�1 • ❑ OTHER I Ping. Ref.# ParkingRe /Provided E
Contractor's Name 0/A - Phone 3 q - D
PROJECT DESCRIPTION SQ. FT. 2-33 OCCUPANCY ( J�/
Address(mailing) - Planning Notes: 'C ed ZnaT r -ry✓t e'TP Gi Qr0.4''2 M
. CONSTRUCTION TYPE__ N VALUATION$ ' Ili (J ...11 e - T
City License No. - ZONE GRADING CU.YDS. ACRES to' JQV'Sf Co✓IC eat- 54r'.> TO Dad r'M
LICENSED CONTRACTOR DECLARATION Salt
• S'
I here affirm that-I am licensed under provisions of Charter 9 (commencing Remarks: / a .j/��,-.��{ j—.(}—'��fp•o �• QNcJ Rt fCt -e-0V C
with sect 0 of Division 3 of theBusinessand Professions Code, and Fre
too
.1,II PC IK V'r� A7• � sr• s Fp -
my license-is in ful orce ec . - ELECTRICAL - FEES
License Class License No: �t TENf70N G�iQH7�j�/� /7/70 _ `� L
Date Signature - - - �+.j� rise- ) #li//p/PLUMBING ,4_, FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATION /=' ! - - Construction Pole Sub. 0 50+ KW - •.
seby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink • , Showers 0 -
K,.Iorkers' Compensation Insurance, or a certified copy thereof (Section" Backflow Preventer • Service Sink Cooking Unit Meter ❑up to 100 amps
-+.-:"+---+ Lab Lab. C.) -
PbYicy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
U Certified copy Is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection •
•
• Date Applicant Fan Motors❑0.1 HP ❑1%-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors —
-
(This section need not be completed If the permit is for one hundred($100) F.A.U.'ornc.Solar 09.15 HP 016-15+
less). Dishwasher Solar Piping AU
I certify that in the performance of the work for which this permit Is issued, I
shall not employ any person in any manner s become subject to the Drinking Fountains Solar Tank / Fixtures Microwave
Workers' ompe tigg4aws of California.
Date 04 D•'( Signature Device Boxes Pole Light
9 Floor Drains Swimming Pool w/Spa 9
NOTICE:If,after making this declaration,you should bet me subject to the Outlets
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - 4 Range . 3- ng
comply withith such provisions or this permit shall be deemed revoked. $Witchee
CONSTRUCTION LENDING AGENCY i Gas Service 'Outlets / Water Closet - • - WO Sign • • I. SZ.
I hereby.affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) • Garbage Disposal Standing Sections
Lender's Name" - Interceptors Water Heater
Lender's Address - Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the / Lavatories ± Auto-Wash OO
following reason (Section 7031.5 Business and Professional Code: Any city or -
county which requires a permit to construct,alter,improve,demolish or repair P-Trap - Laundry Trays
any structure, prior to its issuance, also requires the applicant for such permit '
to file a signed statement-that he/she is licensed pursuant to-the provisions ofRoof. Drains '
-the Contractor's License Law (Chapter 9(commencing with Section 7000)of
gnivision 3 of the Business and Professions Code)-or that he/she is exempt • Reinspection Fee $15 Issue Fee $ v OfIl•
'efrom and the basis for the alleged exemption. Any violation of Section -
1.5 by any applicant for a permit subjects the applicant to a civil
�y of not more than five hundred dollars($500): I ` DEVELOPMENT SERVICES REQIRrFMENTS: v/` /f
as owner of the property or my employees with wages as their sole Reinspection Fee $15 ' Issue Fee $ 3 Zoning Approved By ((0 Date((/
compensation, will do the work,and the structure is not intended or-offered
-
for sale (Secion 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By 1'
License Law does not apply to an owner of a property who builds or improves _ _ - Date �y///���sZ����•��
thereon, and who does such work himself/herself or through his or her own - Y Application Issued By Dat: 'WWI
-
employees, provided that such improvements are not intended or offered for Boiler - r: 'Hood or Type I ❑
sale. I however, the building or improvement is sold within one year of com- Canopy Type II ❑ SUMMARY OA FEE
plebthe owner will have the burden of proving he/she did not build or im- Duct-Under Ground - p
pr a for the purpose of sale). - 904- BUILDING PERMIT $ �1O • •
SMIP $ Z
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System CHECK
' tractors to construct the project (Section 7044,Business and Professions Code: PLAN $ r
PERMIT
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ 7.: oO ISSUANCE $ -
builds or improves thereon. and who contracts for such oroiects with a'con- ENERGY $
trac or(s) license pursuant to me Contractor's License Law). I am aware that —Exhaust System ❑ Multiple❑ Sys Repair/Alteration PLAN CHECK 25% $ P.C.p
pr f of their Workers Compensation s ante should be provided to me. ^'Q, GRADING 11 $1'_
lam exempt under Section / B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers ELECTRICAL $ /+. �._ '�
PLAN CHECK 50% $ � MICROFILM $ _
Date _l-12-f Owner' •- • Aft. Heating System &Ducting Registers • •
MECHANICAL $ ' ' IIB TOTAL FEEQ •Q
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 TL - I 1''s �R 1 Fc) 19,8
Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ I D
and•state laws relating to building construction, and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for --
inspection purposes, n /'y � _ „`"A`�• t`�
DSisvers' - �."C`"` Date Ot. j - 9 Reinspection Fee $15 Issue Fee $ 3 p rrµ OF COS �ILs•
Dr ers' License or=SS•If CM 1 '
0865-46,rev. 5/88 white - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
- • r
•
CONSTRUCTION AND PLANNING • - POO' 'PA ` •
r Date Inspector ) .Date -Inspecto?' I
�APPRQVALS Permit# i APPROVALS Permit#
IYTemporary Electrical Service'or Pole ; -52. Pool & Equipment Location IY
2. Soil Pipe-Undrgrnd. , ,J: ,53. Steel Reinforcement r.
34Elec[ical Conduit Utility-Undigrnd. � te
s 54. Forms - ••
rr IL
4S"Elecirical Conduit-Undrgrnd. 55. Electrical Bonding 1_
'5':1 Steel Reinforcement? 56. Rough Plumbing & Pressure Test
'6, Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE V ,
7.Footing T r 58. Electrical Conduit-Undrgrnd. .i. yl N
8'i our*Jation Ii 59. Gas Pipe, 0 Undrgrnd.,Test 1. -,
L n m .n
9:JWater Pipe-Undrgrnd. •--� 60. Backwash Lines, P-Trap, ❑ Undrgrnd. V
'i •a. 'r - o n10:Structural Floor System 4 61. APPROVAL TO DECK i
11..Property Sewer Line & House:Connection :ei 62.-Backwash & Receptor-Final j r1
12. Sevrer•Cap . X - 63. Heater & Vent-Final 'j-,
4
13. Roof,Drains64. Plumbing System - Final • Yal
14. RoughPlumbing F. 65. Electrical-Final f� ?v
15. Rough'Eledtrical-Conduit
I 66. Solar System-Final •
116?Rough Electric Wiring '41 1J
I7- v - .‘- y 67. Fencing & Access Approval
1117� Rough Wiring Sign Al 1i _ 68. APPROVED FOR PLASTERING
18; Rough Electrical-T.Bar Ceiling 6 6 69. POOL'/SPA SYSTEMS FINAL
a9: Rough Hating & Air Condrtlonmgf:J FIRE DEPT. REQUIREMENT ,• -
20. RougF'IFactory. Fireplace 5- V APPROVALS Permit#
2.1? Ducts, in Structure 40 l: 4.,. 70. Underground Hydro
•
22. Ducts, Ventilatin
. .
r r 9 - 71. Product Piping 0 Gas 0 Oil
23 Gas Pip Rough&spit r .;.,,:.,:".9 r. 72. Underground Flush /
24t Roof Fr�ming W 73. Undergrnd.Storage Tank D Gas ❑Oil /
25'. Roof Sheathing Kr • d _ . 1 74. Overhead Hydro:_ (1
26. T-Bar`Ceiling (Structural) 'IzzMonocoat , 75. Dry Chemical
27. Freneland Flashing li `1 = 76: Dry Standpipe
2$? La4
thipg1&°Hidingti 77: FIXED SYSTEM FINAL •
29. Inulat •gn :5p 78. FIRE PREV. FINAL
30. Drl`wailrNailing -� ✓j ', - HEALTH DEPT. REQUIREMENT
31. PlastePBrown Coat 9 N `1 - '79. FINAL INSPECTION
32. Eloetrical Power iulefer-Finally Cf 8G. FOOD CERTIFICATE ISSUED
33. FiraI ElectricN*tes: e2
34. Final Heating & Air Conditioning - L• Lf (7
35. Final Gas Pipe-Test 0 Q -7
36. Hood or Canopy
t
137. Finn)al actor,,-Fireplace)V
38. Final Plumbing ;l .,p. ••+.
(39: Wafer Service7Final Gam- IA . - -
e. 1-+ 1
•
f4' GJ.'" vicp,F(nal -;._r_ r• 1 ' ' `
4�. Solar Domestic-Finall 0, �rr 7c��y!' la u
42. Backflow Preventers ' r `t' �' fr =?
] -' f , if
43. Backflow Irrigation t ' ,
. 44. Landscape1lrrigation System '.;,.
45. Sound •
AYtenuationt-- ` • o
46. Handicap Regulations ) tj - r'
r47. FINAL STRUCTURE&BUILDING L
48. Special Requirements Completed
' 49. Electric Release to Edison /%' i.-t)
.1
50. Gas Release to Southern'California Gas Co - -�
'51./CERTIFICATE OF OCCUPANCY •
;j i • .• n• (,' y.
i >- 1
j No. Date 1,' ,�, , i%
•• v '1
I I
-++ - _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 2 7- 2-94-
• PERMIT NO. TRACT NO. LOT NO. UNIT NO.
CITY'OF'COSTA MESA CONSTR UCTION P RyA T f A.P.# 212 — zone
�7 �+ g F 3 cd 14-3 // a LIS 4.59
Project Address - L�� L�I`� a y� Jam/ • ��•; 'L L��SrII S Main Building: Accessory Building:
TYPE OF CONSTRUCTION M NEW Li ADD LI ALTERATION LI REPAIR Appyarit's Mailing Address. .V1 ACAS() - /H'�Y..1Q- E z
/:;- �/ 4 /. hone(QTy47-7 C- III CONVERSION ❑ DEMOLISH ❑ OTHER • T Front 2_1 Tp r-2s i ..e.4 r .Lt O
10v4ner's Name . v `-(0 CAW/. U= Phone r(`ic-nVt( _ DESCRIPTION OF WORK/USE OF BLDG. e+� Lt/(7 C+ . ' B Rear / - - N
'Address -- .G•-.._- V•± .s- :n-• isc ..r-.. j _ i Pr QV-Ate A 's 1
i- e. "f � �/- pplI 1 C Right / N
Arch/Eng. LicenseNb - ' ' - TYPE OERMIT ALJ GRADING ❑ FOUNDATION /.y STRUCTURAL 37 G
Left te
Address" /�
-'-"4-‘..><' "}s'' ID TENANT ELECTRICAL ❑ PLUMBING Li MECHANICAL $ '� R
/' . ,5/ . ❑ OTHER PIng. Ref.# -- ParkingRe E
Contractor's Name O//7 - Phone - 'y� OCCUPANCY " q./Provided
PROJECT DESCRIPTION SQ. FT. O
Address(mailing) - �•-- ., • ' PlanningNotes: / �.J
o . .CONSTRUCTION TYPE L—K) VALUATION $ 7 203 r 7 a 7 aP "�'�' G �'�.-� M
City License No. •r' " - ZONE GRADING CU.YDS. ACRES `�•=JO '• C_�� V txV4j•e $.
LICENSED CONTRACTOR DECLARATION /�
1 he by affirm that I am licensed under provisions of Charter 9(commencing Remarks: 9
C t 0 0 X0/71 pc J_36,'4 3r \ - — .
with nn 77000 of Di isle 3 of the Business and Professjpns Code, and 0-11^ • '
my license is in full orce and effect. ELECTRICAL FEES
• EX76iUB•{.v
3roAa Gre To 4//7/90 3/a
License class License No.Date Signature PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATION - Bar Sink Showers Construction Pole Sub. 050+ KW
I hereby affirm that I have a certificate of consent to self-insuie or a certificate
Yorkers' Compensation Insurance, or a certified copy thereof (Section / Cooking Unit Meter Dula to 100 amps
r, Lab. C.) - - Backflow Preventer Service Sink ,
r..uc No. Compan � - Dishwasher Meter Dover 100 am s
v v � Backflow Irrigation Sewer Cap r P
8 Certified copy is hereby furnished.' '- - Dryers ❑Gas DElectric Sub Panel -v
Certified copy is filed with the city Building Division:i —
Bathtubs Sewer Connection - i:.
Date Applicant • - Fan Motors 00-1 HP 011/4-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ' Clarifiers Solar Collectors ,•
(This section need not be completed if the permit is for one hundred ($100) or F.A.U. - Inc.Solar 09-15 HP 016-15+
less). Dishwasher Solar Piping ,
I certify that in the performance of the work for which this permit is Issued,
shall not employ any person in anFixtures Microwave
y�'man manner so as to become subject to the '- Drinking Fountains_ Solar Tank .. / )Z
Workers' Gomp,apsa(Uspoqx Laws of California) /� Q Device Boxes
1. - Date Liy-'oi-z” Signature,- - Z - Floor Drains - mming Pool w/Spa Pole Light
NOTICE: If,after making this declaration, you should b ome subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - ,� Urinal 9
, comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY i Gas Service OutletsWater Closet Z. Sign
n / SC
I hereby affirm that there is a construction lending agency for the performance
of the'work for which this permit is issued (Section 3097 Civ. C.)' Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name -
Lender's Address Kitchen Sink ' Water Service Generator ❑0-5 KW ❑5-15 KW Trash Compactor
OWNER BUILDER DECLARATION • -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
I following reason (Section 7031.5 Business and Professional Code: Any city or ,
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trats -
any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
' the Contractor's License Law(Chapter 9:(commencing with Section 7000)of -
Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee "a
-efrom and the basis for the alleged exemption. Any violation of Section P $1@ Issue Fee $
/ by any applicant for a permit subjects the applicant to a civil
Aty of not more than five hundred dollars($500). - DEVELOPMENT SERVICES R ClUIREMENTS: r �//
.se I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 • Issue Fee $ 3 t Zoning Approved By Date /^
compensation, will do the work,and the structure is not intended or offered
• for sale (Section 7044, Business and Professional Code: The Contractor's 1
License Law does not apply to an owner of a property who builds or improves MECHANICAL FEES Building Approved By Date >/�"i
thereon, and who does such work himself/herself or through his or her own ApplicationBy --/�i
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
Issued /I^-� Date
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FE
pletion,.the owner will have the burden of proving he/she did not build or im- Duct-Under Ground '
We for the purpose of sale). BUILDING PERMIT $ 74. 00 ' SMTP $ ...51• �'I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System • PLAN CHECK $ PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License taw does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ ,ISSUANCE $
builds or improves thereon.and who contracts for such oroiects with a con--
`_ ENERGY P.C. $
tract r(s) license pursuant to the Contractor's License Law). I am aware.that Exhaust System ❑ Multiple❑ ystem Repair/Alteration PLAN CHECK 25% $ - ` '
Pr f of their Worker's Compensation)fjyrpnce should be provided to me. - `Oo GRADING • $
am exempt under Section `7 ELECTRICAL $ �I.
p B. &'P,c:for this reason Firepl/Fact.Blt, IC80# Fire Dampers PLAN CHECK 50% $ I1 IFh JM;6�$ •'1
Date "to2-�c"7 Owner _ y Tp C-LHeating System& Ducting Registers '' ��•` 'R^''
�- )'l}yYMECHANICAL $
I hereby certify -that I have read this application and state that the above DO-100,000 BTU 0100,000 BT TOTAL FEE $ r .S/
e ' _.
Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to building construction, and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for Miry tutIUVJIA r.�
-
inspection purposes. /� qq[[��
Signature --ILL
Date�-12'-a-r 'a-r..
Drivers' License or SS Reinspection Fee $15 Issue Fee • $ 3
0865-46,rev.5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
COI'hTRUCTION AND PLANNING P001 'JA 1
i Date Inspector ,Date • Inspector
APPROVALS Permit# APPROVALS Permit#
17 Tempotary Electrical Service or Pole 52. Pool & Equipment Location
2.'Soil Pipe-Undrgrnd. I 53. Steel Reinforcement Cs
34 Electrical Conduit Utility-Undrgrnd. - 54. Forms c l
417Electrical Conduit-Undrgrnd. I 55. Electrical Bonding L. ^�
'51 Steel,Reinforcement 56. Rough Plumbing & Pressure Test
vv
6 Electrical UFER Grrt . I 1 t1/91 3! - 57. APPROVAL TO COVER-GUNITE l 1^
77'.-Footings ee 570-7f g t lob ts 40 0 58. Electrical Conduit-Undrgrnd. . 1
8. Fou dation I r , 59. Gas Pipe, 0 Undrgrnd., Test 2-
r . Y_
9;;Water Pipe-Undrgrnd. r� 60. Backwash Lines, P-Trap, 0 Undrgrnd. '1 J'
10- Structural Floor System ,,,Di it �,=_ 61. APPROVAL TO DECK I
,,?1;-Property Sewer Line & House1Connection I 62. Backwash & Receptor-Final
12:1 Sewe,C2p 63. Heater & Vent-Final _
•
13. RooVOrains 64. Plumbing System - Final }• _A
•
14. Rough Plumbing 65. Electrical-Final �-, l;_
15. Rough Electrical-Conduit 66. Solar System-Final . .
16! Rough Electric Wiring ,ah* 67. Fencing & Access Approval
' 17. Rough Wi}ng Sign • 68. APPROVED FOR PLASTERING •
•
18. Rough Electrical-T Bar Ceing 69. POOL/SPA SYSTEMS FINAL
, 19'. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT •
' 20. Rough'Factory Fireplace 'I APPROVALS Permit# _
-
21A Ducts, iiil Structure 1, g : 70. Underground Hydro
22. Ducts, Ventilating l'; , ''' 71. Product Piping 0 Gas 0 Oil
,
23iGas Pipe-Rough &1Test (1. /72. Underground Flush i 7
24 Roof Framing cla I i, / 73. Undergrnd.Storage Tank O Gas poi! /
25. Roof Sheathing.,- �. ^- 74. Overhead Hydro
26. T-Bar-Ceiling (Structural) &7Monocoat 75. Dry Chemical
27. Frameiand Flashing �1 ,776. Dry Standpipe
2B'. Lathing 8/Siding j, 77. FIXED SYSTEM FINAL
29. Insulation * ' 78. FIRE PREV. FINAL
30. Drywall Nailing L. ri /// n HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coal cC 44/90 Y't 79. FINAL INSPECTION
32. Electrical Power•Meter-Final'9 yi/Ap
11/ GGG 80. FOOD CERTIFICATE ISSUED
- 33. Final Electric \ 1 Notes: ,
•
34. Final Heating & Air Conditioning (A LI ,
, 35. Final Gas Pipe-Test t
.
36. Hood or Canopy
IL- �
, p. ,
:37. Final,Fa gory Fireplace
`'38. Final Plumbing ..* r
.39. Water Service-Finales i 0
-40. Gas Service-Final j3' J 7
41. Solar Domestic-Final , H_i: a_ _ •
(42. BackflowPreventerl-a1 L_‘) y tv
7;43. Backflow Irrigation , '7)' n 0
44. .Landscape Irrigation.System < / J
,:;,: 45. Sound Attenuation_,.- ^ 67�
y` 46. Handicap Regulations r
• 47. FINAL STRUCTURE & BUILDING 100
- 1,
48. Special Requirements Completed
' 49. Electric Release to Edison ••-.� -
50. Gas Release to Southern California Gas Co .t?- y (,;)
v
51. CERTIFICATE OF OCCUPANCY N1 ' n�• C!: J
No. - Date ,t i 1,,. -
s