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Home My WebLink AboutPermit 4625 - Fort Dent Office - Fillw CITY OF TUKWILA (. Building Division 6200 Southcenter Boulevard Tukwila, Washington 98188 (206) 433 -1845 BUILDING PERMIT PERMIT # tilP7-�-7 Control # 86 -440 Work to be done Fill (5200 c.y.) Site Addresses t, Arr.Pss Suite # Tenant Radovich Building Use N/A Assessors Account # p p 25 Phone 454460650 Property Owner John C. Radoyich Address 2000 124th Avenue N.E. B -103 Contractor M.R. Construction Address 14734 N.F q5t FOR BUILDING PERMIT ONLY Bellevue Sq. Ft. Office storage/ e War hous Retail Other Occ. Load 1st FT. 2nd F . 3rd F . Total Fire Protection: [ Sprinklers [( Detectors Zoning Type of Construction Special Conditions Zip 98005 Phone # 885 -2781 Redmond Zip 98073 Fees sq. ft. @ sq. ft. @ sq. ft. @ sq. ft. @ 1st Fl. 2nd Fl. $ other $ other $ Total Valuation of Construction $ Bldg. Permit Fee Plan Check Fee Demolition Surcharges Other Other TOTAL Receipt #5476q, $ 162.00 Receipt #/'G" Receipt #! $ Receipt # $ Receipt # $ Receipt # $ 30.00 FOR SIGN PERMIT ONLY Q Permanent [( Temporary 0 Single Face [( Double Face 0 Wall Mounted C1 Free Standing [] Other Building face Setbacks: Front Square Footage of each sign face Special Conditions anwerimrslur THIS PERIM BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANUONLU FUR A PERIOD OF 180 DAYS Af ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ANU ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DUES NOT PRESUME TU GIVE AUTHORITY TO VIOLATE OR . CANCEL. THE PRUVISL NS OF J1JlY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TIlE PERFORMANCE OF CONSTRUCTION. = l z-.5'7 . Side Side Rear Total square footage of sign gned Date LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of the Business and Professions Code, and my license is in full force and effect. Contractor (signature) Date OWNER - BUILDER, DECLARATION ( ) I, as owner of the property, or my employees, with wages as their sole compensation, will do the work, and the structure is not intended or offered fur sale. ( ) I, as owner of the property, am exclusively contracting with licensed contractor's to construct the project. Owner (signature) Date CITY OF TUKWILA ,sl Building Division 6200 Southcenter Boulevard Tukwila, Washington 98188 (206) 433 -1845 BUILDING PERMIT Work to be done ; Fill (5200 c.y.) Site Address Southrenter R1 N Ft. Bent AncPSs Suite # Building Use N/A Assessors Property Owner John C. Radovich Address 2000 124th Avenue N.E. B -103 Contractor M.B. Cofistructton Address 14734 N.F. 95th St. P.O. Box 404 PERMIT # C--/(0Z5 Control # 86 -440 Tenant Radovieh Account Phone 449454 -60600 Zip 98005 Phone # 885 -2781 ` Redmond n f Zip 98073 Bellevue FOR BUILDING PERMIT ONLY S Ft. Sq. Office Warehous Warehouse Retail Other Occ. Load 1st Fl. 2nd FT- 3rd-Fl. r 1 Total Fire Protection: [( Sprinklers Detectors Zoning Type of Construction Special Conditions Fees sq. ft. @ sq. ft. @ sq. ft. @ sq. ft. @ 1st Fl. $ 2nd Fl. $ other $ other $ Total Valuation of Construction $ Bldg. Permit Fee Plan Check Fee Demolition Surcharges Other Other ■ TOTAL Receipt #5q(p. $ 162.00 Receipt # -44-7/$''- 30.Q0 Receipt # $ Receipt # $ Receipt # $ Receipt # $ $. 1g2.nn FOR SIGN PERMIT ONLY [j Permanent [( Temporary D Single Face ❑ Double Face [j Wall Mounted 1 Free Standing ❑ Other Building face Setbacks: Front Side Side Rear Square Footage of each sign face Special Conditions Total square footage of sign 'THIS PERMIT BECOMES NULL ANU VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS :SUSPENDED OR ABANDONEU FUR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE O / - _THE PROV S NS Q F Y OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. Date ,6,.../2711_5? LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of the Business and Professions Code, and my license is in full force and effect. Date Contractor (signature) I, as owner of the offered for sale. ( ) 1, as owner of the property, am exclusively contracting with licensed contractor's to construct the project. Date OWNER - BUILDER. DECLARATION property, or my employees, with wa9es as their sole compensation, will do the work, and the structure is not intended or Owner (signature) raw CITY OF TUKWILA Building Division 6200 Southcenter Boulevard Tukwila, Washington 98188 (206) 433-1849 Type of Inspection r-r.110,..1 Site Address (. 7ZQ cO T-L) INSPECTt' N RECORD PERMIT # Date Date Wanted 0- 4-1'"$°7 Project F3Y 4JJ4 a.m. p.m. Requestor Phone # Special Instructions Inspection Results /Comments: Inspector A;t14-2 Date ?%// /g, RE: MMe I0nzvviP TELEPHONE MEMO I e (�VIQWIJ. Y lyurlirm�l SIONIC(COV5 f"oti't Uhl (Ilet) PERSON CONTACTED: tlibyli,Q 14411)-eif 1 5'3! 'o).) I% 6ohlp-e 1400114 9V PERSON CALLING: cO(.,l( c Orr-PNIN DATE: °/1,3/' INFORMATION ITEMS: t�7r Toy4//)el tGi I 1142. Y1� �1( c( ittovi et )Cd ��2_ �f1(' lkio7'� Q / 7L s. /240/zsec( f� cr t /c�m old Ivo/ C�'e i`/ er,mlwel 1 h4 4- ; T' air( r( ✓401 [ii Ltii ;'1 /000 fpriwekr a f -r� oZzvi �rn,e (r 6.J-71 21� �1 u��G f (D 11 1044 <f [ e ic[ Qci `� L JV 4- I/1Ivii2 eatYr Bey co?? 6 'WU c 1 402.41cd0. ve s .ui u 1c %l� a l) Pp' y1 `f" e e icC )4,0 watt( Kathleen M. Brown Assistant Vice President Relationship Banking February 10, 1987 City of Tukwila 6200 Southcenter Boulevard Tukwila, Washington 96188 Re: Fort Dent Office Perk File *EPIC- 353- 66; CN- 86 -440 Developer: John C. Radovich Gentlemen: This letter is to certify to you that John C. Radovich has an operating line commitment from SEAFIRST Bank under Loan No. 756221 -50005 for various construction projects. At the direction of John C. Radovich, we have set aside funds from this commitment in the amount of $4,500 for the removal of fill materials from the above project. SEAFIRST Bank agrees on behalf of John C, Radovich to pay City of, Tukwila: upon demand $4,500, or amounts thereof, if the removal of fill materials from the project has not been made in accordance with the approved and accepted plan and specifications of the City of Tukwila. SEAFIRST Bank will hold said funds ($4,500) until it has received written release from the City of Tukwila certifying that all work has been satis- factorily completed. Sienna Bank 701 Fifth Avenue /15th Floor /Post Office Box 3566 /Seattle, Washington 98124 Telephone (206) 442.3567. CITY OF TUKWILA February 10, 1967 Page 2 This is an irrevocable commitment of funds which is not subject to recall by SEAFIRST Bank. A copy signed by all parties should be returned to SEAFIRST Bank, attention the undersigned. Sincerely, Kathleen M. Brown ACCEPTED: CITY OF TUKWIL JOHN C. RADOVICH C 1�a'dG' ✓r �:�' SAFECO ( GENERAL POWER OF ATTORNEY FU. b MX 1 COL t klEhUE$T +» 'IVA1 SAlris'i'I'A TITLE :NSUkA1 ;CE COMPANY at+liit) M.E. Nth S'N T IIKLLEVUE, I ASdfrGTIW Wit* KNOW ALL MEN BY THESE PRESENTS, That John C. Radovich PRINTED FOR DISTRIBUTION BY SAFECO TITLE INSURANCE COMPANY • ha &.made, constituted and appointed, and by these presents do,ea make, constitute and appoint Katie Greif :1 his true and lawful attorney for him hts use and benefit and in his name , place and steadand for Rr CORDED 11 $ D*V gI� ao AR 13 ' , ------trt—rrTETITVISTONAW I* & ECTON El KM comm. '' to ask, demand, sue for, recover, collect and receive all such sums of money, debts, dues, accounts, legacies, bequests, Interests, dividends, annuities and demands whatsoever, as are now or shall hereafter become due, owing, payable or belonging to him and have, use and take all lawful ways and means in hi s name , or otherwise, for the recovery thereof, by attachments, arrest, distress or otherwise, and to compromise and agree for the same, and to make, sign, seal and deliver acquittances, or other sufficient discharges for the same; for him and in hi s name ,, to bargain, contract, agree for, purchase, receive and take lands, tenements, hereditaments, and accept the seisin and possession of all lands, and all deeds, and other assurances in the law therefore; and to lease, let demise, bargain, sell, remise, release, convey, mortgage and hypothecate lands, tenements and hereditaments, upon such terms and conditions and under such covenants as he shall think fit, to assign and transfer any note or mortgage; to dedicate any street, avenue, alley, place, way or park for public uses. ALSO to bargain and agree for, buy, sell, mortgage, hypothecate, and in any and every way and manner deal in and with goods, wares and merchandise, choses in action and other. property, in possession or in action, and to release mortgages on lands or chattels, and to make, do and transact all and every kind of business of what nature and kind soever. AND also for him and in hi s name , and as j,i s act and deed, to sign, seal, execute, deliver and acknowledge such deeds, leases and assign- ments of leases, covenants, indentures, agreements, mortgages, hypothecations, bottomries, charter parties, bills, bonds, notes, receipts, evidences of debt, release and satisfactions of mortgage, judgments and other debts, and such other instru- ments in writing, of whatsoever kind or nature, as may be necessary or proper in the premises: GIVING AND GRANTING unto h1s said attorney his full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done in and about the premises as fully to all intents and purposes as 1J might or could do if personally present; John C. Radovich hereby ratifying and confirming all that his said attorney Katie Greif shall lawfully do or cause to be done, by virtue of these presents. TL•20 R2 2/76 IN WITNESS WHEREOF, John C. Radovich ha_Q_hereunto set his .74 day of in Signed, and Delhibred iqBence of o d4i •' j.ek�� 71 (Seal) Tel • / , (Beall. H C, a0 STATE OF WASHINGTON County of King On this day personally appeared before me Joh" C. Radovich hand and seal the 12th July in the year of our Lord one thousand nine hundred and eighty -three to me known to be the individualwho is A. II � ,1 • described in and who executed the within and foregoing instriirhent and acknowledged to me that he signed the same as purposes therein mentioned. Given under my hand and official seal this 12th SAFECO SAFECO TITLE INSURANCE COMPANY , Filed for Record at Request, of day of NAME -3-.0 it w c o'enc 4./7- ADDRESS c D / .P4 Ate . N.E 3 CITY AND STATE 'iVie Uv ` 4449 .. ya�TJL�.t� his free and voluntary act and deed for the July tg 83 or the State of Washington, Notary public in an residing at Bellevue, Washington THIS SPACE RESERVED FOR RECORDER'S USE � TELEPHONE MEMO ✓ RE: ! 1 OUtt.k, 411 PERSON CONTACTED: 444112 (:00 p.Al. PERSON CALLING: /RCS DATE: i/50 INFORMATION ITEMS: i. �cess ��stnio.NE— c s4ce. davac, 1 1 A 41140cnroes 5 rbadiforma,,/ I, Phi is o‘ei efisiontiiii- igke, ,ezezei- bwe# HzL /?i(5 /72-7: /V/M 11;4/46 4/04z /1 ■ ai3d /Ce�42r. a ito-air- 8-44 AiregLir 42,14Wi-6 4/*/lie .3t1 3 r J, vier w/de %%�: �a n //, jiKS dt/k, ai VAe.4 d&pe4-a/ en Ifin vld dadhms Vh/.5 s)�e. bble-1/ 4,nce hei e+arn%'aeitc�e+' 614 e"( ub7rfes /&v&d,» 'tea.% (9-re e otgteite e tce. (ec evr di //ace. / y� vU� Y vOld 6211 z ,5f�, -,If Jra)1aqe U�i7, radovich fill central permit system ENVIRONMENTAL REVIEW ROUTING FORM: TO: (D BLDG E] PLNG PROJECT rLv ,9 /AL LOCATION DATE TRANSMITTED Rad9P7M CN g67-6/416 -61416 EPIC J ?- E5_5; F I L/ P.W. [] FIRE POLICE {] P & R 1a-a3-Ft STAFF COORDINATOR anifE NO. RESPONSE REQUESTED BY RESPONSE RECEIVED THE ATTACHED ENVIRONMENTAL CHECKLIST WAS RECEIVED REGARDING THIS PROJECT. PLEASE REVIEW AND COMMENT BELOW TO ADVISE THE RESPONSIBLE OFFICIAL REGARDING THE THRESHOLD DETERMINATION. THE ENVIRONMENTAL REVIEW FILE IS AVAILABLE IN THE PLANNING DEPART- MENT THROUGH THE ABOVE STAFF COORDINATOR. COMMENTS REGARDING THE PROJECT YOU WISH CARRIED TO THE PLANNING COMMISSION, BOARD OF ADJUSTMENT, AND CITY COUNCIL SHOULD BE MADE ON THE ATTACHED CENTRAL PERMIT SYSTEM ROUTING FORM. ITEM COMMENT Boer -rklis REV IGw -14(14. MANN4(o MGM' 'D v1ar,7 rrAI` us r Br fitomSi1 Fvt� Bis} W0%4 .WIN %WACIi<- E, _ tTEtAtlil IPIkkix IPA 2 itsF 11 s T o 3.10.47 ? & E'LL- - "lHis F(LL simij stEt ' red is 5 L. ICItt.H a•�11" ¶ tlemEwe0 C-trf■•Pvh rC6 ' tifik StP"'Llty� Our Dail caup rry -rue 1. INfoksWill /.4 VS/Dv %O11/3 1144 S Ft1 /1. PI • _ 1► I Lib- _%a 1 • .1 APptuvPt.S wtlL gg. VLovlOV) NE\ PtMSrTL Flu. • 1-11.01L►N% (1St. S YCii) gk41,h, tEsTfte.LA Lilco Tti Ftit CAN Rltl''t114r,N 13tC Pe n1G PEV L•PAtt.lr is tALI (MTV° Ty ILK MoVV SM 4 Fit, Li ALAI 4 Irt*IIN-tt?. 5 u► • l:iws\o... 4•+�ti►\ 1;IV11C.tc3. F'(■ %Pitt, PtAU O ufz 'ANA . S y+40.i l Thititm 3'tamtNk . b 1 %mt - MI1T tip. 01144A. ? d1/4.t+•Wtt"3'- i ■d14)sty krt•►-1u k. t r f i s era cv t:4, 4 rwM01.L 14° C ►tr T1tMtt• A Z. T4 t• s Lpf ¢ s t t*LL. At L.O w fro oN tW• Pt AT aF tHls PILL . 1 itt (14AotaA41 AccxSs is OFf of A "P1tWWIL kW. Nor A P11131aG _aLL AI • -t► a aI •11 • I UPSt. cif 1'is 'whim Ib•, i-Mk11L Ac cxt% >qs DutcAjDfil) P0.to^.10 1syJ+0.(P. -11-HS PCM1't PDn Ft LL . DATE 14 ar1.8.ko COMMENTS PREPARED BY C.P.S. Form 11 \ I . OTTO rBENIAL? & ASSOC TES, INC. 6747 M. L. KINGWAYSOUTH, SELWA98118; 725-fr6b6-- 1 10 19K CONSTRUCTION INSPECTION REPORT PERMIT NUMBER: 25A r JOB NUMBER: 87-031 PROJECM Fort Dent ADDRESS: t 6720 Southcenter Blvd., Tukwila INSPECTOR AND DATE R. Bogl.A 5-14-87 INSPECTOR'S REMARKS • , . -Inspected deck puddle welds and punching of side seams for metal deck'for roof section. Welding done by WABO certified welder Scott R. Moul (card expires 7-1-87). Welds and punches inspected located between lines 1 to 7 and A to K. Workmanship as per plans and approved specifications. J. Anderson Inspected and •aprpoved welding and beam seats at four places. First floor 7-27-87 at grid line C-1, detail K-9 typical. This connection needs i" filler plate where beam does not sit on angle. Three connections similar at firs 1 and second floor OK. Also inspected engineers detail 111 correction at grid line D-6. Two parabolts not installed as yet. Balance OK. Will required re- , inspection. J. Bucklin Inspected beam to P. C. panel connection at D-6 second floor. Parabolts placed 8-4-87 in bottom of connection as per detail 111 dated 6-8-87. No parabolts at top as this has been welded. Inspected beam connection at 1-C.2 second floor and found shimms welded between beam and connection so that no gap exists between the two. -4- OTTO ROSENAU & ASSOCIATES, INC. 6747 M. L KING WAY SOUTH, SEAT1Lt, WA 98118 725.4600 CONSTRUCTION INSPECTION REPORT PROJECT: I Fort Dent PERMIT NUMBER: 4625. ADDRESS: 6720 Southcenter Blvd., Tukwila JOB NUMBER: 87 -031 INSPECTOR AND DATE INSPECTOR'S REMARKS R. Bogle Inspected and approved the resteel and forms in dumpster screen panels 4 -24 -87 1, 2, and 3 and three unnumbered tilt up panels for front entrance. Also inspected footings lines E and G at 3.2 line, lines A to G at line 1.2. Resteel as per approved plans and specifications. Last minumt perimeter slab on grade lines A to C and 1 to 4. Resteel' grade is 60, as specified, from NU. W. Hansen Inspected and approved the resteel and forms in two columns located 7'0" 4 -29 -87 off of 1 line and 6'0" each way off of F grid. Resteel grade is 60, as specified, from Seattle Steel. B. Russell Arrived at 3:30 PM to inspect structural steel and found the crew finishing 5 -5 -87 work for the day. It was decided that it would be a good idea to cancell inspection because it is unsafe to be here by myself. B. Russell Inspected and approved the high strength bolted connections in the following 5 -6 -87 locations: second floor A/3.3, A.95/4, B /4, A.95/2, C.1 /1 *, C.5/1.7, C.95/3, D /3, D/4 (east and west), D/5 (north and southeast and west), D /6 *, D.4/3.1, E /3.5, E/4.5, E /5, E/4.55, G.95/3 *, G.5/5, H/4 (north and east), H /5, H /6, J/4 (north and west), K /4. • roof B /4, C.1 /1 *, D/5 (north and west), D/4 (east and west), D /3, D.5 /5, E/3.4, G/3.7, G/3.2, G.5/5, H/5 (south, east and west), H /4, H /6, H.6/4, G.95/3 *. *indicates precast panel weld plate embed set 6" to 12" too high and doesn't allow full lenth welds per detail K -9. Superintendant will call structural engineer for approved repairs. Structural steel is per City of Tukwila approved plans high strength bolts at 361 ft/it K- joists at roof level D- G.5x5 -7 changed to WFB's to support mechanical on roof. W. Hansen Inspected and approved the resteel and forms in second floor 4" floor slab 5 -8 -87 grid A -D between lines 1 and 6 and from grid D -E.5 between lines 1 and 5, also column to panel tie -ins at entry archway. Resteel grade is 60 and 40, as specified, from NU. Grade 40 where resteel welded to angle iron around openings, also 6 "r.6 "xW1.4xW1.4 welded wire mesh. B. Russell H. Hurlbut 5 -12 -87 Inspected and approved the resteel and forms in mechanical slab on roof and north half of second floor slab. Resteel grade is 40, as specified, from Davis Walker. Welded wire mesh is 6" square W1.4xW1.4. T. Thrasher Verfied the metal decking to 22 GA galvanized as specified. The welds 5 -14 -87 and button punch not ready for inspection. -3- �' -. CITY of TUKMILA GRADING /FILL /EXCAVATION �. Building Oivislon r (16.- . 6200 Southcenter Boulevard ; y (206)1433w18hington 98188 PERMIT APPLICATION CONTROL# A2 - #) Site Address Southcenter. Boulevard & Firt Dent Access Road Suite# Floor# Project Name /Tenant Radovich— One Acre Parcel Valuation of Grading Assessors Account# 295490- 0425 -00 Property Owner John C. Radovich Phone 454 -6060 Address 2000 124th Avenue N.E. B -103, Bellevue, WA Zip 98005 Applicant John C. Radovich Phone 454 -6060 Address same as above Zip Architect /Engineer Pac —Tech Engineering Phone 473 -4491 Address 2601 South 35th Street, Tacoma, WA Zip 98409 Contractor M.B. Construction License# Phone MBCONC- ;1793ZG R85-2781 Address 14734 N.E. 95th St., P.O. Box 404, Redmond, WA Zip 98073 Hauling Co. undecided Phone Address Zip Describe the purpose and extent of fill, excavation or grading Filling site from Radovich office project across street -- ,,1 5200 Cut (c.tt. ) (Fi 1� (c.u. ) t Two (2) sets of grading /fill /excavation plans must be submitted which meet the application requirements of Section 7006(d), 1985 Uniform Building Code. A soils engineering report and engineering geology report may also be required. An Environmental Checklist is required to be submitted ($100.00 Fee) to the Planning Depart- ment for any grading /fill /excavation 500 cubic yards or more. A Hauling permit is required for any grading /fill /excavation of cubic yards or more. A $2,000 bond, certificate of insurance, route map, and permit fee of $25.00 are required. I HEREBY CERTIFY THAT I HAVE READ AND EXA ED TH ?APPLI TION AND KN -THE SAME TO BE TRUE AND CORRECT AND THAT I HAVE THE PROPERTY 0 N R' A T OR A Y 0 DO THI>S'WORK. Applicant /Authorized Agent (signature CG ?:7 Date / 2;- 3--,.' / (print ndme7 John C. Radovi.ch Contact Person (please print) John C. Radovich or Katie Greif Phone 454 -6060 ml OFFICE USE ONLY FEES: Grading Permit Fee (000/322.100) $ / (p ,O O Receipt# Date Paid Plan Check Fee (000/345.830) _ .30D(5— Receipt# Date Paid Other ( ) Receipt# Date Paid TOTAL f q oj, OO (OWES: $ / q ;, Y) ) Excavation Ordinance #1341: Bond Required: $ Cert. of Ins. Amount $ KIN∎,. V . DATE I N DATE OUT COMMENTS 1•111■•••=1 BLDG ,a l 9,,\1 Approved for Issuance PLNG ,fir) A \ a qs1 Approved (Initials) HIV S SEPA Checklist require : Yes ❑ No SEPA Determi nation l otll0'�1S �� G'edr ►� mkgiz , i. la 4 116 . SEPA F i 1 e# Epic -:353 -g(, Ju 1pkotiz, ,sfi.� � ' berm PWD ,��j' \'): Approved ni t i al s � '// •t' i' #0i (� ctit 'c (.. .) Hauling Hauling Permit Require.: ❑ Yes lNo .L ✓IIt .0 ' 4 .r .. Min - - i fefec/r( oror renewl 6411