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Home My WebLink AboutBLD2014-00402 - MECHANICAL BLD14-00402 BUILDING PERMIT APPLICAN Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00402 Received Date: 10/29/2014 SITE ADDRESS: 1275 SR20 PORT TOWNSEND, 98368 OWNER: DANE SCHOONOVER PHONE: 360-379-2440 1275 HWY 20 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901193003 Section: 19 Township: 29 N Range: 1V\ CONTRACTOR: POWER TRIP ENERGY CORP PHONE: 360-643-3080 83 DENNY AVE PORT TOWNSEND WA 98368 Contractor's License POWERTE934QE Expires 4/15/2016 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW ROOF MOUNTED GRID-TIED PV (PHOTOCOLTAIC- SOLAR ELECTRIC) SYSTEM TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: ill Type Amount Paid By: Date: Receipt: Approved/Date Permit $228.00 SRE 10/29/14 151709 Ai-PROVED Total: $228.00 OCT z 9 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/29/2014 SON c Wkw °-- JEFFERSON COUNTY DEPARTME•OF COMMUNITY DEVELOP•NT Date: 1-t-/ Time Received: 1/ [ m/'pm Mon. Tue. at, Thur. Fri. Date: S— 1 BLD: Ai' Z Contact Name: Owner: Contact Number: 360 ( y3 .00 Address: /c. 7'5-- w-7 Z-D 206 Notes: 72) P V Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling III • c-)\ 2ON co jEFFER5ON COUNTY ,...) ,.., -,E.::.4 -_-,,, DtPARTIVItN 1 OF LOMMUNiTY DEVELOPkit NI She&ici.ir 51.-eet/Port Montse'15,WA .183i8/Weh. www.co.ieffprsonma.usigartimunitydeveloornent ',,,-i -..,. Tel: 350.379 4450/FRK: ISO.37°4451/Emilli: dco@co.ieffersc,t;.wc us ii/\u‘O' EXPEDITED PERMITTING CHECKLIST FOR SOLAR PHOTOVOLTAIC SYSTEMS ***TO BE COMPLETED BY COUNTY STAFF*** Building Permit Required? Ell Yes El No Staff Initials Date Fee: ***TO BE COMPLETED BY THE APPLICANT*** 1. Project Information Project Applicant: Power Trip Energy,83 Denny Ave, Port Townsend,WA 98368,360-643-3080,john@powertripenergy.com Site Owner Name: Dane Arthur Schoonover&Dakshani De Alwis Project Address: 1275 Highway 20,Port Townsend,WA 98368 PV System Description: Roof mounted,Grid-tied PV 2. Determine if your project needs a building permit(check all that apply): Yes No Not Applicable 1. Mounting equipment is engineered and designed for solar PV equipment. X 2. The solar PV system will comply with the National Electric Code(NEC) X including obtaining an electrical inspection. 3. To address uplift the solar modules will be mounted no higher than 18 inches X above the surface of the roofing to which they are affixed. Note: Questions 3-5 Apply to Rooftop Systems 4. Total dead load of panels,supports,mounting,raceways,and all other X appurtenances shall weigh no more than one of the following. If YES indicate which: El Conventional solar modules(one layer of glass)or frameless solar modules(two layers of glass)that weigh three and one-half(3.5)pounds per square foot(PSF)or less on any roof. - El Frameless solar modules(two layers of glass),on sloped roofs df at 3:12 but less than 5:12 pitch,that weigh no more than four and one-half(4.5) 1 pounds PSF. 1 El Frameless solar modules(two layers of glass),on sloped(Offs cif 5919014 pitch or greater,that weigh no more than five(5)pounds PSF. 5. Supports for the solar modules are installed to spread the dead load across as X---') many roof-framing members as needed to ensure that point loads do not exceed fifty(50)pounds at any location. _......_ 6. Attachment to the roof is specified by the mounting system manufacturer. X Note: Question 7 Applies to Ground Mounted Systems 7. Ground-mounted solar PV systems using racking components installed per the X manufacturer's specifications. If you answered yes or N/A to all of the above questions,no separate building permit is required. ----- . .ckk ?viper-1?-4 Er30-4-1 co. foriz8izz,t L( App t Signature ate 4-bi-0.1 S.ft.e-t.t 6r- • • EXPEDITED PERMITTING CHECKLIST FOR RESIDENTIAL PHOTOVOLTAIC SYSTEMS: ROOFTOP MOUNTED ----TO BE COMPLETED BY crry A -- Building Permit Required? ❑Yes 0 N Qualifies for Electrical OTC? DYes DNo Staff Initials Date:Ciick hef e to enter text. Staff Initials Date:Cl€k ile e to enter text. --------TO BE COMPLETED Y APPLICANT------ @Project Information Project Applicant: Power Trip Energy Co,83 Denny Ave, Port Townsend,WA 98368 Site Owner Name: Dane Arthur Schoonover& Dakshani De Alwis Project Address: 1275 Highway 20, Port Townsend,WA 98368 PV system description: Roof Mounted,Grid-tied PV(Solar Electric) •etermine if your project needs a building permit (check all that apply): Yes No 1. PV system is designed and proposed for a detached single family house. X ❑ 2. PV system is designed for rooftop of a house in general compliance with applicable codes. X ❑ 3. Mounting system is engineered and designed for PV. X ❑ 4. Rooftop is made from lightweight material such as shingles. X ❑ 5. PV system has been pre-approved by electrical permitting agency. X ❑ 6. To address uplift, panels are mounted no higher than 18"above the surface of the roofing to X D which they are affixed. Except for flat roofs, no portion of the system may exceed the highest point of the roof. 7. Total dead load of panels,supports, mountings, raceways and all other appurtenances weigh no X ❑ more than one of the following. If YES, indicate which: X No more than three and one-half(3.5)pounds per square foot(PSF) ❑ Frameless panels on at least 3/12 pitch roof weighing no more than four and one-half(4.5)PSF ❑ Frameless panels on at least 5/12 pitch roof weighing no more than five(5.0)PSF 8. Supports for solar panels are installed to spread the dead load across as many roof-framing X ❑ members as needed to ensure that at no point are loads in excess of fifty(50) pounds are created. 9. Attachment to the roof is specified by the mounting system manufacturer. X ❑ 10. Method and type of weatherproofing roof penetrations is provided X ❑ 11. Home is code compliant to setbacks and height,or code allows expansion of nonconformity for X ❑ solar panels. 12. Panels are mounted no higher than the roof ridge or apex of roof(applies only to pitched roofs) X ❑ Applicant Signature: 'Na Printedme John S Fleming,-Power ri Energy Date:10/28/2014 If you answered yes to all of the above questions,crr;sepa3aV uildihi'permit is required. , Created by the Evergreen State Solar Partnership v1.0 1 IR.- ( C°6 JEFOZSON COUNTY • • DEPARTMENT OF commumrt DEVELOPMENT 621 Sheridan Street i Port Townsend,WA 98368 I Web.w~ww.co jeftersan.wa.us communitydeveiopment sivl"G"o Tel:369.379.4450 I Fax:360.379 4451 ¢Email:dcd( cojefferson.wa.us Building Permits&Inspections!Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center Master Permit Application MLA: Project Description(include separate sheets as necessary): Roof Mounted, Grid-tied PV (Photovoltaic-Solar Electric) System Tax Parcel Number: 901 193 003 Property Size: 10.6 acres (acres/square feet) Site Address and/or Directions to Property:1275 Highway 20, Port Townsend, WA 98368 South of Eaglemount, north of Fairmount Hill, on west side of Highway 20. Property Owner(s)of Record: Dane Arthur Schoonover&Dakshani De Alwis Telephone: 360 379-2440 Fax: email: schoonoverdane @gmail.com Mailing Address: 1275 Highway 20,Port Townsend,WA 98368 Applicant/Agent(if different from owner): Telephone:360-643-3080 Fax: 360-539-1857 email: John @powertripenergy.com Mailing Address: Power Trip Energy Co,83 Denny Ave,Port Townsend,WA 98368 What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ❑Building ❑ Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family Cl Garage Attached/Detached ❑ Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑ Special Use(Essential Public Facilities)** ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address ❑ Road Approach ❑Short Plat** ❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan** ❑Propane ❑ Long Plat** ❑ Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development** ❑Temporary Use ❑ Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: L&I Electrical permit Please See Attached DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE , TR4 EV4ekiril CO. Date: 4742014 By signing this application arm,the owner/age ests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falseho., nr any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap lication$fit e.r she wants prior notice. ' FN � co, Date: �J.t3/2014 Signature:'41111, . The action or aeons Applicant wil6 ertake as a result of the issGano qfd s irr5rdyl i afi'ef, h1i-t• upon one or more threatened or endangered species and could lea. • a potential"take"of an endan44 diliecies as those'terrrts are de n=d►i i the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the ac .m• hat will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on belh$If. an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development T e tipplicant acknotwl'■c es that he,she or it holds individual and non-trans rable y for adher ng to and complying with the ESA.° he Ap5iplidant has read tlIiis isciia�ymer and signs and dates it below. Signature: a � t� R-iQ NiR Co. '�"`7 014 i nEPT.Or COMr jUNITY DEVELOPMENT 07/24/2013 • • f BUILDER STATEMENT • The signer of this statement does hereby certify that they are'the Owners of the parcel referenced herein,that they are ids licensed contractors and that they will be a uming the res onsibiliittyy of the General Contractor for the proposed project. Signature: ` onP�-Tht p tat4t9- CAE Date:iQ/ '/2014 GENERAL CONTRACTOR OR M UFACTURED HOME INSTALLER: PHONE: FAX: Power Trip Energy CO. (360 )643-3080 ( 360 ) 539-1857 MAILING ADDRESS: 83 Denny Ave, Port Townsend,WA 98368 EMAIL: john @powertripenergy.com CONTRACTOR'S LICENSE WAINS 003-472-00 NUMBER: POWERTE934QE NUMBER ARCHITECT/ENGINEER: PHONE (360 ) 643-3080 FAX:( 360 ) 539-1857 MAILING ADDRESS: 83 Denny Ave,Port Townsend,WA 98368 EMAIL john @powertripenergy.com Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ii- New ❑ Wood Existing: C Sewer C Addition L Steel Proposed: Bank n Community System C Alteration/Remodel C Concrete Total: Height: C Individual System ❑ Repair L} Masonry SEP Permit# C Demolition Li Other: Bedrooms: Water Supply: Existing: Setback: Li Private well Two Party Type of Heat: Proposed: C Public Total: Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: Underground Tank Above ground tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO i evotS telleP I knaT retaWtoH I Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: Other Heated Base fee: a1 b .a Mezzanine 441ditit al ction: l .p a Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport " 7 / --1 i SUBTOTAL Decks j " 914 d Approach fee: OCT Other I 11 TOTAL: $ a��t0 J °---s Rec ipt Number: \t3I N' c rn-Cas !Check Number: . ESTIMATED COST(REQUIRED) Date: ^� f .Fair market value of all labor and materials foundation to finish 1O' S- 1/` Initials: C L 07/24/2013 • 0 PV Installation contract 83 Denny Ave Port Townsend, WA 98368 (360) 643-3080 lic # POWERTE964JN Consent to Act As Agent on Permit Application To whom it may concern, I Dane Schoonover , grant Power Trip Energy Corp. Permission to act on my behalf for the purpose of acquiring a Solar Electric Permit from Jefferson County and grant Power Trip Energy permission to complete and sign the permit application on my behalf. Signature: ---- Date: WW1' '1 Jefferson County Department of Community Development will determine the Solar Building Permit fee. This fee will be invoiced separately from the Estimate for the PV system installation,and is subject to the 30%federal tax credit. ECM cQ �� Li , OCT 282014 IEFFrRSJi�l COUNTY D PI OF COMfoRus 'DEVELOPMENT September 30,2014 Page 5 of 9 Dane Schoonover 10/28/2014 • Jefferson Co Dept of Comm Dev WA-Online Pass Jefferson county Community unity Dev c pm t'2 vpt Stoll Confi€i i., :,J F' ce€pt Step 3: Confirmation and Receipt Result: Payment Authorized Confirmation Number: 15567168 Your payment has been authorized successfully and payment will be processed. Jefferson County Department of Community Development thanks you for your payment.For questions about your account,please call 360-379-4452 Thank you for using our bill payment services. Please save or print a copy of this receipt for record keeping purposes. My Bills Amount Due Residential Applications payment of$247.00 on Parcel Number 901193003 $247.00 Subtotal: $247.00 Customer Information Convenience Fee: $7.50 First Name: Power Total Payment: $254.50 Last Name: Trip Energy Address Line 1: 83 Denny Ave Address Line 2: City: Port Townsend State: Washington Zip Code: 98368 Phone Number: 3606433080 Email Address: john@powertripenergy.com Payment Information Card Number: ************8600 Expiration Date: **/** Print OCT 292014 )i-i r i_;'iS(.)`• COUNTY r"A7,1l iNI T Y DEVELOPMENT https://client.pointandpay.net/web/JeffersonCoDeptofCommDeyWA 1/1 Parcel Details Page 1 of 2 • • iefferson county „, , .j.,. ,. •.:. ..,�= _ ,-�a,,. ,«mow� ,,,y, Home County Info Departments Search Parcel Number: 901193003 SEARCH Parcel Number: 901193003 Printer Friendly Owner Mailing Address: DANE SCHOONOVER PSC 303 BOX 18 APO AP96204 Site Address: 1275 HIGHWAY 20 PORT TOWNSEND 98368 Section: 19 School District: Port Townsend (50) Qtr Section: SW1/4 Fire Dist: Discovery Bay (5) Township: 29N Tax Status: Taxable Range: 1W Tax Code: 0151 Planning area: Discovery Bay (5) Sub Division: Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: S19 T29 R1W GOV LOT 5( N OF HWY #9) Tax, A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats &Surveys Septic Monitoring Info -', Jefferson County .. HOME 1 COUNTY INFO 1 DEPARTMENTS 1 SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac pI )I t. 1 111 OCT 2 9 2014 I' J lEFH`:SO";COUNTY 'L OE CM MIUNITY DEVELOPMENT http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=901193003 10/29/2014 POWER TRIP ENERGY CORPORATION Page 1 of 2 • • Ask Washington State Department of VAP & Industries POWER TRIP ENERGY CORPORATION Owner or tradesperson 83 Denny Ave COCHRANE,ANDREW P PORT TOWNSEND, WA 98368 360-643-3080 Principals JEFFERSON County COCHRANE, ANDREW P, PRESIDENT CARR, STEVE, VICE PRESIDENT COCHRANE, ANDREW P, AGENT Doing business as POWER TRIP ENERGY CORPORATION WA UBI No. Business type 602 349 562 Corporation License Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Electrical Contractor Active. Meets current requirements. License specialties GENERAL License no. POWERTE964JN Effective—expiration 04/15/2004—04/15/2016 Designated administrator Active. Carr, Steven E Meets current requirements. License type License no. Electrical Administrator CARR"SE906P5 Bond CBIC $4,000.00 Bond account no. SF5019 Received by L&I Effective date 04/15/2004 04/05/2004 Expiration date Until Canceled Savings No savings accounts during the previous 6 year period. License Violations https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602349562&LIC=POWERTE964JN&SAW= 10/29/2014 POWER TRIP ENERGY CORPORATION Page 2 of 2 No license violations during the prOus 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. Y fY p p p L&I Account ID Account is current. 063,472-00 Doing business as POWER TRIP ENERGY CORPORATION Estimated workers reported Quarter 2 of Year 2014"7 to 10 Workers" L&I account representative T1 /NIKKI BUTLER(360)902-4918-Email: BUTQ235 @Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 06/23/2014 Violations inspection no. 317320984 Location 1605 DanKelly Rd. Port Angeles, WA 98363 Washington State Dept.of Labor&Industries. Use of this site is subject to the laws of the state of Washington. Access i'ashington �r OCT 292014 COUNTY ._ WMfJUNI1Y DEVELOPMENT https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602349562&LIC=POWERTE964JN&SAW= 10/29/2014 • . Jefferson County Building Division Permit Number: BLD14-00402 Applicant: SCHOONOVER BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes - Miscellaneous ,1/ 7e,6r Ma.,u1e� Ca- n ,, 6.&'c11 �.,° � �Nec 5r5T6;y A final inspection will not be scheduled until the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION 47:1:51' ic()F- x 6 tfi -nee tdNEL 5,-51044 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD14-00402 Received Date: 10/29/2014 SITE ADDRESS: 1275 SR20 Issue Date 10/29/2014 PORT TOWNSEND, 98368 Expiration Date 10/29/2015 OWNER: DANE SCHOONOVER PHONE: 360-379-2440 1275 HWY 20 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901193003 Section: 19 Township: 29 N Range: 1V1 CONTRACTOR: POWER TRIP ENERGY CORP PHONE: 360-643-3080 83 DENNY AVE PORT TOWNSEND WA 98368 Contractor's License POWERTE934QE Expires 4/15/2016 PROJECT DESCRIPTION: NEW ROOF MOUNTED GRID-TIED PV (PHOTOCOLTAIC- SOLAR ELECTRIC) SYSTEM TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: - WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $228.00 SRE 10/29/14 151709 Exist: Exist: Total: $228.00 Prop: Prop: Total: Total: Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY JEFFERSON COUNTY ..X:D No. 151709 DATE 17)/411 /1L4 RECEIVED RECEIVED FROM OU) .✓ trip 'r(. DESCRIPTION BARS# AMOUNT ��(?j,( � `! CURRENCY (c`L�.•ter, 4.(C 1 '1 C7 , fJC7 1\104) SDIar PV SM S COIN s 1�.�./ l�l• `G .00 qbI - 193-010. 0 m n 0 RECEIVED BY 8 • qj'iS TOTAL r)14-4. .