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�.`�? 15 : <br /> _ _._.___.......... ... ................. <br /> 1�7C"7 ` _� .�'. .....�.� .-._i i. <br /> C+7 i'c_.,,. cpY. <br /> a� <br /> ,�a�x <br /> a H - <br /> a�3 cn <br /> rx <br /> H �H � <br /> � H� <br /> �.I Y1..� <br /> 1 �"� 1 <br /> yH Date: ,5 - (�- �U <br /> f� o n <br /> H C7 <br /> OH <br /> � �o 'I'o: 3en Edwards, P1ans �xamir.er <br /> 47 Y C) <br /> H <br /> C ~� <br /> yz Re: Owner's Name: [j.-�a � E(�'e (Jec.r <br /> HH <br /> �j �'H project Adcress: ISOG Ho�'t- _ <br /> �� d� <br /> �i �r � . <br /> z y� Attached are the Repair Specifications for L:,a 3be•;e me:itioned <br /> '� o�' project. Flease provide CAZP the followinct ir�:orm�t� �n by <br /> initialing the proper box: <br /> YES NO <br /> lR., .,,�` <br /> Plan Check Required: ❑ �� <br /> ,.� ,�. �i <br /> : � <br /> Please return this f�rm to CHIP as soon as possible. � � <br /> B j <br /> �- "" Thank you. <br /> -� .�.. _ CHLIP S�� <br /> � <br /> d o�J� <br /> (` � <br /> � � <br />