124 4TH AVE N.PDFiiiiiiiiiiiiii
14627
124 4TH AVE N
D LICENSE NO.
AN AL FEES PENALTY AFTER FEB. 15
ttY 0
Bj#ESS LICENSE APPLICATION
,y fJ CITY of EDMONDS
Civic Center •Edmonds, Washington
City Clerk Phone 775-2525
❑ HOME OCCUPATION
INSTRUCTIONS: CLASS YEAR LIC. EFFEC. DATE REASG. LIC. NO. SPEC. $10.00 (A)
• All items must be completed i E>, SMALL BUSINESS
or application will not be ac- FIECEIFIT N DATE PAID PRINT'X' $15.00 (B)
cepted. y IN SPEC. BOX FOR ISSUE OF ❑ Business with 10 or
• Sign and return application FEE PAID PENALTY AI CORRECTED more employees
ADDITIONAL $5.00 ❑
ADDITIONAL $7.50 ❑
ADDITIONAL $25.00 ❑
with fee. Renewals received �106 'LICENSE WITH $50.00 (C)
after February 15 must pay NEW APPLICATION
penalty in addition to fee. ❑ RENEWAL
NEW BUSINESSES AFTER ❑ CHANGE
JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) ❑ DELETE
N7 OF FIRM r e BUSINESS PHONE
D 61
S W
/off 77/��'O
MAILING ADDRESS NATURE OF BUSINESS
C
i
INESS ADDRESS INDIVIDUAL
- �/ ZC /j • c` Drro�y D s GUI /f (S)
JERS-NAMHOME ADDRESS
1E PHONE DATE OF BIRTH PLACE OF BIRTH
—/'700-o?o2-L%CA (gvei2.e-ff Itiv,
EMERGENCY NOTIFICATION: (1) NAME & TELEPHONE
(PLEASE LIST TWO) (2).NAME.& TELEPHONE 406,.E
WASHINGTON STATE TAX
STAFF REVIEW:
APPLICANT'S SIGNATU
(LA)
(LB)
(LC)
NO. OF EMPLOYEES
-;2--
a
PARTNERSHIP CORPORATION
= (P) 0 (C)
SOCIAL SECURITY NUMBER 8a"
�sG> / - -S-S - 5'7_-?
/SO-CPIt, . --')S --t' %(v
le. �cOC ,-- s - QSon
DU NU I VVHI I L t3LLUW I HIS LINt J
FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE - / LAND USE CODE ZONING CODE
KYAPPROVE ❑ DISAPPROVE tc
SIGNATURE %) [ 3 C
Cy
AW �Qv�„t -AZ CONDITIONAL USE PERMIT
COMMENTS - J J !�'1 �.C,+t���J 0 0 m
'P�XLDING DEPARTMENT DATE o17
I16 APPROVE ❑ DISAPPROVE y
SIGNATURE -211
COMMENTS:
CAPACITY: (NO. UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS)
-I t UtF'AH I MtN I
APPROVE ❑ DISAPPROVE
COMMENTS: (.i(1%15- 54m e u �-lQ A5 lLr�5 _W
Building
❑ Hotel/Motel
(L)
Apt. Bldg.
(A)
7A�*❑
Office Bldg.
(0)
Occupancy
Restaurant
(R)
Group
❑ Hosp/Nurs Home
(H)
❑ School
(S)
POLI DEPARTMENT
APPROVE ❑ DISAPPROVE DATE — Z 2 SIGNATURE
COMMENTS:
PUBLIC WORKS DEPARTMENT
❑PROVE ❑ DISAPPROVE DATE Z SIGNATURE
COMMENTS:
APPLICATION
The MY of Edmonds for
SMIC SEWIM PERMT
NEW CONSTRUCTION [] REPAIRS p EASEMENT No . ................... ......................
114-01250
...
OWNER ................. ..... L onni
ng
........ ......... .
ADDRESS....... .... Ave . ...... N ...................................................... CONTRACTOR .................................................................................................. PERMT No . ......................
.............. I .............................. -- ........................... LEGAL DESCRIPTION: LOT No . ...................................... ....... BLOCK No. ............................................
NAME OF AMMON
Dye Tested On Sewer 1972
Approved:
DATE........... .............................. ..... BY .........................
0iY p
CITY of EDMONDS BUSS
LICENSE APPLICATION D LICENSE NO.
Civic Center • Edmonds, Washington 9
>`?
��liy clerk Phone 775 2525
AN AL FEES ENALTY AFTE
. 15
CLASS YEAR LIC.
❑ HOME OCCUPATION
EFFEC. DATE..r REASG. LIC. NO. SPEC. $1 (A) ADDITIDN-A-C$5.00
❑
INSTRUCTIONS:
`��
• All items must be completed
B
1
2
�
IX SMALL BUSIN
Or application will not be aC
RECEIPT NO.
A PAID
pRINT'X'
$15.00 ITIONAL $7.50
❑
cepted.
' • ellIN
SPEC. BOX
FOR OF
❑ Business -nth 10 or
• Sign and return application
FEE PAID
PENALTY AID
ISSUE
O R R E C T E D
m�mpIoyees ADDITIONAL 25.00
❑
with fee. Renewals received
LICENSE WITH
L
LC' ACTION.
$50.00 (C)
after February 15 must pay
X] NEW APPLICATION (LA)
penalty in addition to fee.
❑ RENEWAL (LB)
NEW BUSINESSES AFTER
❑ CHANGE (LC)
JULY 31, 112 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) ❑ DELETE (LD)
NAME OF FIRM
BUSINESS PHONE
NO. OF EMPLOYEES
EDMONDS BEAUTY •.&W@W,
774-0055
2
MAILING ADDRESS
124 4TH AVE. N.
EDMONDS, WA 98020
NATURE OF BUSINESS
BEAUTY SHOP
BUSINESS ADDRESS INDIVIDUAL PARTNERSHIP CORPORATION
124 4TH AVE. N. (=X] (S) 0 (P) (C)
OWNERS NAME D" HOME ADDRESS
BECKMAN, EDGAR P. 308 FIR PL. EDMONDS, WA 980.20
HOME PHONE DATE OF BIRTH PLACE OF BIRTH SOCIAL SE URITY NUMBER
771-5894 36-05-�006/17/17 CHELAN, WA 56
EMERGENCY NOTIFICATION: (1) NAME & TELEPHONE —J. ANN - 582
(PLEASE LIST TWO) (2) NAME & TELEPHONE _JO-Y M41362-0782
WASHINGTON STATE TAX NO. APPLICANT'S SIGNATURE
DO NOT WRITE BELOW .THIS LINE
STAFF REVIEW: FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT
4441 1
.APPROVE ❑ DISAPPROVE
DATE
LAND USE CODE
ZONING CODE
SIGNATURE;gZ;4j
13 1 [-1
CONDITIONAL
USE PERMIT
COMMENTS
E=
m
BUDDING DEPARTMENT
DATE 3 >� I
Building ❑
Hotel/Motel (L)
APPROVE ❑ DISAPPROVE
SIGNATURE 4Ike it?5
Permit ❑
Apt. Bldg. (A)
❑ Office Bldg. (0)
COMMENTS: Occupancy ❑ Restaurant (R)
Group ❑ Hosp/Nurs Home (H)
CAPACITY: (NO. UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS) Z ❑ School (S)
FIRE DEPARTMENT DATE �� Ki `5' U.F.I.R.
14 APPROVE ❑ DISAPPROVE SIGNATURE
COMMENTS:
POLI DEPARTMENT
r PPROVE ❑ DISAPPROVE DATE, SIGNATURE
COMMENTS:
PUBLIC WORKS DEPARTMENT
❑ APPROVE ❑ DISAPPROVE DATE SIGNATURE
COMMENTS: �!(•� '('f I�,�D
PLEASE RETURN TO CITY CLERK
y
Memo to Architectural Design Board
November 26, 1980
Page 3
10. ADB-93-80 - Edmonds Rotary Club - Review of preliminary desion and
location of a gazebo at Edmonds City Park on 3rd Ave.
and Pine Street
Engineering has no comment on this item.
11. ADB-94- 80 - Ed Beckman - Review of signs for Edmonds Beauty Salon
at 124 4th Avenue North.
Engineering has no comment on this item.
AM E. ADAMS
DS: jky
G
4-IS-60
As
'ROW
CROSS - INDEX —AND REVIEW ASS16NMENT-5
INITIATIW4 ACTION/,`/�`�,e�4/-,!Fc) DATF-..ZZ-,?-,,f`-Sv PAGE OF
OWNER NAME,' /V
A D.p RE 53*-
'APPLICANT NAME:
ADDRE55:
SITE LOCATION OF,
A 0 NE:
LEGAL DESCRIPTION:
ATTACH EI)
--FILE.N.TENARrL
TYPE OF
ACTION
D V., 1;
RECIP.
-
DATE
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ASSIONEP- -NOTES 1.4
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R E V I E W5
0 5
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DATE
TO
DATE
BY
-ASSIONSO
�
DATE
ITO
DATE
BY
PREVIOUS HISTORY
SITE REVIEW VISIT
UTILI.TJES
PRAINA4a/TO POSRAPH Y
STREETS/.SIDEWALKS
TRAFFIC/PARKING
ZONING CODE
FIRE MARSHAL
tTy 0
"- rITY of EDMONDS BESS LICENSE APPLICATION D&LICENSE NO.
-= Civic Center • Edmonds,, Wash!ngton 98020 ANNUAL FEES
City Clerk Phone 775-2525 PENALTY AFTER FEB. 15
❑ HOME OCCUPATION
INSTRUCTIONS: CLASS YEAR LIC. EFFEC. DATE IREASG. LIC. NO. SPEC. $10.00 (A) ADDITIONAL $5.00 ❑
• All items must be completed _ C SMALL BUSINESS
RECEIPT NO. DATE PAID $15.00 (B) ADDITIONAL $7.50 ❑
IN S
or application Wlil not be aC- PRINT'X'
PEC.' BOX
Cepted. / FOR ISSUE OF El Business with 10 or
• Sign and return application FEE AID PENAL PAID CORRECTED more employees ADDITIONAL $25.00 ❑
9 PP n LICENSE WITH $50.00 (C)
with fee. Renewals received V 'LC• ACTION.
after February 15 must pay NNEW APPLICATION (LA)
penalty in addition to fee. ❑ RENEWAL (LB)
NEW BUSINESSES AFTER ❑ CHANGE (LC)
JULY 31, 1/2 FEE (PLEASE MAKE ANY NECESSARY CHANGES) ❑ DELETE (LD)
NAME OF FIRM BUSINESS PHONE NO. OF EMPLOYEES
//i�./
/,
MAILING ADDRESS NATURE OF BUSINESS
/BUSINESS ADDRESS
INDIy.IDUAL
PARTNERSHIP
CORPORATION
( )
OWNE-RS-NA-ME
HOME ADDRESS
/
HOME PHONE
---[DATE
OF BIRTH
,
PLACE OF BIRTH
SOCIAL
SECURITY NUMBER
67
�.
EMERGENCY NOTIFICATION: (1)
NAME & TELEPHONE
(PLEASE
LIST TWO) (2)
NAME & TELEPHONE
WASHINGTON STATE TAX NO: "' ' `=. `=--`'`"` APPLICANT'S SIGNATUREIj
DO NOT WRITE BELOW THIS LINE.,
STAFF REVIEW:
FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT . DATE LAND USE CODE ZONING CODE
❑ APPROVE ❑ DISAPPROVE
SIGNATURE
CONDITIONAL USE PERMIT
COMMENTS 0 0 m
BI,N'LDING DEPARTMENT DATE Z� - Building ❑ Hotel/Motel (L)
tin APPROVE ❑ DISAPPROVE SIGNATURE Permit ❑ Apt. Bldg. (A)
COMMENTS:
L� CAPACITY: (NO. UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS)
f IPE DEPARTMENT
APPROVE ❑ DISAPPROVE
LLLaLEI�1� VS. Office Bldg. (0)
Occupancy ❑ Restaurant (R)
Group ❑ Hosp/Nurs Home (H)
❑ School (S)
PUBLIC WORKS DEPARTMENT
❑ APPROVE ❑ DISAPPROVE
COMMENTS:-
_
BUSIOS LICENSE APPLICATION 10(
CITY OF EDMONDS ' ( 10
250 5TH AVENUE NORTH
EDMONDS, WASH. 98020
TELEPHONE (206) 775-2525
INSTRUCTIONS
1. PRINT APPLICABLE LICENSE CLASS, FEE AND PENALTY PAID
IN ANNUAL FEE BOX AT RIGHT. PENALTY DUE ON RENEWALS
RECEIVED BY CITY CLERK AFTER FEBRUARY 15.
NEW BUSINESS: COMPLETE ALL LICENSE APPLICATION BOXES.
LIC. RENEWAL: REVIEW LICENSE INFORMATION BELOW. PRINT
CORRECTIONS AND ADDITIONS AT RIGHT.
1 SIGN AND RETURN APPLICATION WITH FEE (AND PENALTY).
4. LICENSE WILL BE MAILED TO YOU UNLESS YOU ARE NOTIFIED
TO APPEAR FOR APPLICATION REVIEW. ,
LICENSE RENEWAL, __•
'REVIEW BELOW INFORMATION, PRINT CHANGES AT RIGHT.
2. APPLICANT
NAME SOCIAL SECURITY NO.
!DATE OF BIRTH PLACE OF BIRTH
(TOME ADDRESS
1
ANNUAL
FEES
TYPE BUS. CLASS
FEE PENALTY
HOME A
$10.00 $ 5.00
SMALL B
15.00 7.50
*GENERAL C
50.00 25.00
�3. BUSINESS IDENTIFICATION
BUSINESS NAME
I
NATURE OF BUSINESS BUSINESS PHONE
I
WASH. STATE TAX NR. EMPLOYEES ORGAN. OCCUPANCY
'OVER 10 EMPLOYEES, OR EMPL WORK
OVER 120 MAN -MONTHS PER YEAR.
CLASS FEE PAID .PENALTY PAID
TYPE ORGANIZATION.
IF BUSINESS IS:
TYPE
CAPACITY
HOTEL/MOTEL
L
NR OF ROOMS/UNITS
•1 C • CORPORATION
APT. BLDG.
A
NR OR APTS
L - LTD. PART
OFFICE BLDG.
0
NR OF OFFICES
P•*PARTNERSHIP
RESTAURANT
R
NR OF SEATS
S - SOLE OWNER
HOSP./NURS. HOME
H
NR OF BEDS
I
SCHOOL
S
NR OF STUDENTS
4 BUSINESS ADDRESSES
1 BUSINESS ADDRESS
I LICENSE MAILING ADDRESS
5. EMERGENCY NOTIFICATION I
NAME
AREA
TELEPHONE
(u
12)
t
.Urrlt,IAL Uat UIVLT
U.F.I.R. CODE BLDG. PERMIT OCCUR.
•
C.U. PERMIT LAND USE ZONING
CITY CLERK'S
SIGNATURE
APPROVED DISAPPROVED DATE
STAFF ACTION
R�RSE APPL. NO.: _j S
DATE: - �!
APPLICATION FOR:
BUS. ❑ RENEW YEARNSE
OFFICIAL E N
LICENSE NUMBER ACTION
_
( LA - NEW BUS.
/
J
Jl` LB • RENEWAL
i-�
LC -CHANGE
LID -DELETE
1
CLASS
YEAR
LIC. EFFEC. DATE
REASG. LIC. NO.
I.SFEC.
RECEIPT N0.
DATE PAID
PRINT 'X'
IN SPEC. BOX
FOR ISSUE OF
CORRECTED
E PAID PENALTY PAID
i
LICENSE WITH
'LC' ACTION.
_.. LICENSE APPLICATION AND,CHANGES 4 i
PLEASE PRINT CLEARLY,
2. APPLICANT
LAST NAME, FIRST INITIAL SOCIAL SECURITY NUMBER.
I✓lH I V l l s l�l `alA4�IM l I
%
DATE OF BIRTH PLACE OF BIRTH
MO. DAY I YEAR CITY
STATE
^
HOME ADDRESS
BLDG. NUMBER
ST EET
APT. N0.
CITY
STATE
ZIP CODE
3. BUSINESS IDENTIFICATION
BUSINESS NAME (FULL)
NATURE OF BUSINESS (DRUG STORE, CPA, ETC)
BUSINESS PHONE
t'
71z, v9 `
WASH. STATE TAX NR. ANTICIPATE yOCCUPANCY
(REGISTRATION) NR. EMPLOYEESTYPE CAPACITY
t-- ENTER APPLICABLE TYPES AND CAPACITY
T T
4. BUSINESS_ADABES$ '
BLo MBER STREET APT. NO.
LI SE-bFA'It-YNG�tDDRESS
BLDG. NUMBER I I STREET I I APT. N0.
CITY JJ STATE ZIP Cl
`IOV}11/)INOI l l I I I I I 1 I __ CI,
5. EMERGENCY NOTIFICATION (IN EVENT OF FIRE, BURGLARY, ETC.)
LAST NAME, FIRST INITIAL AREA CODE TELEPHONE
cl>
LAST NAME, FIRST INITIAL AREA CODE TELEPHONE
(2)
LI.F.1.R. PRIM.
CODE
GOND. USE PERMIT
_LJL.LLJL
— 55 OFFICIAL USE ONLY
UNITS . BUS.
LAND U
BLDG. PERMIT
OC U, GRP,
E7
ZONING
CITY
OF E D M 0 N D S
TO: +P
♦ ♦
Lu
0
Q
H
Z
W
Q
SUSPENSE DATE:
MAYOR
As We Discussed
Investigate
and report
Take Appropriate
Action
Prepare Letter/Memo for
My Signature
Mayor's Signature
Previously Ref'd
Status of Action?
For your Information
Note & File
Return to:
MAYOR'S ADMIN. ASS'T.
CHIEF of POLICE
CITY ATTORNEY
CITY CLERK
COMMUN. DEVELOP. DIR.
FINANCE DIRECTOR
FIRE CHIEF
PUBLIC WORKS DIRECTOR
COMMENTS:
MF
•
R
- r
FROM:
DATE:
(3/77)
BUILDING DEPARTM
Applicant Fill
USE RMIT -
ZONE J�/ti MBER
PERMIT APPLICATIO
Inside Heavy Lines
//✓V�/
ADIJOB
ADDRESS
NAME (OR NAME OF BUSINESS
LEGAL LOT
PLAT NAME
SUBDIVISION NO
E
OYES ❑ NO
W MAILING ADDRESS
Z 4 A
0
PUBLIC RIGHT OF WAY PER ORDINANCE
NO.
CITY
TELEPH NE NUMBER
77 /�
a 7040
EXISTING RIGHT OF WAY
PROPOSED RIGHT OF WAY
NAME
F
U
DEFICIENCY OF RIGHT OF WAY
W ADDRESS -
F
STREET/UTILITY WORK REQUIRED
❑YES
El NO
UPERMIT
FOR WORK IN PUBLIC R/W
UNDERGROUND WIRING REQUIRED
❑VES
❑YES
El NO
El NO
K CITY -
Q
TELEPHONE NUMBER
CONNECTION TO SANITARY SEWER
SEPTIC TANK PERMIT REQUIRED
❑ YES
❑YES
❑ NO
❑NO
NAME /�
11 /`
SEPTIC TANK PERMIT NO. -
° ADDRESS
Q'/1'
SEE MEMO DATED
'
E ITV((//
TELEPHONE NUMBER
REMARKS -
-
z
--"e
U STAT R
CITY LICENSE NUMBER
CHECKED BY
S�►o p wIr�E2
Legal Description of Property (Show Below or Attach Four Copies)
METER SIZE
I BUILDING SUPPLY SIZE
z
° b
sac
1
d -
SIGN AREA
ENV. REVIEW
ADB NO.
E
U
N
n
U�/l
ALLOWED PROPOSED
COMPLETE EXEMPT
�-
W
SHORELINE
J
Q
REMARK
j�%�(
1/V 7V
W
J
VARIANCE OR C
PLANNING REVIEW BY
DATE
YARDS
LOT COVERAGE
NEW
RESIDENTIAL
GAS
FRONT
-
SIDE REAR
❑-
LINE
FIRE ZONE
TYPE OF CONSTRUCTION
CODE
HEIGHT
R ADD
NON-RESIDENTIAL
SIGN
/
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
❑ DEMOLISH ❑ RETAINING
ALTER
�
EXCAVATE
WALL
FENCE
REQUIRED
❑ YES NO
GROUP
LOAD
.
CCC VII
❑
OR FILL ❑
( X - -,
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
REPAIR
PRE -MOVE
swim
-
INSP.
POOL
SHOULD BE CODED 31.04.
Z NUMBER OF STORIES
NUMBER OF
REMARKS
°
'DWELLING
�-�
/.
kd
F,
UNITS
4' NATURE OF WORK TO BE DONE
°
m
PLAN CHECK FEE
O PROPOSED USE VALUATION
PLOT PLAN (INDICATE BUILDING S
K ABUTTING STREETS)
U
h
W
0
m
O
n
m "Applicant, on behalf of his or her spouse, heirs, assigns .and
successors in interest, agrees to indemnify, defend and hold harmless
f the City of Edmonds, Washington, its officials, employees, and
' a
agents from any and all claims for damages of whatever nature,
x arising directly or indirectly from the issuance of this permit. Issu-
0 ance of this permit shall not be deemed to modify, waive or reduce
° any requirement of any city ordinance nor limit in any way the
= City's ability to enforce any ordinance provision."
I hereby acknowledge that I have read this application; that the in-
formation given is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and in doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
relating to Workmen's Compensatiol Insurance.
NOTE: Permit Limit One Year(Except DEMOLITIONS and FILL
PERMITS without conditional use permi 'ch shall be completed in 90
ED-IN BUILDINGS shal be jillompleted in six months.)
(GNAT RE NER OR AGEN DATE SIGNED -
.� �. 9
This Permit covers work to be done ofi private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC 304, 306.
ua•76
PLUMBING 0
MECHANICAL
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
AL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
775-2525
O Y
!T'
0°�
APPLICATION APPROVAL
This application is not a permit
until signed by the Building Official or
his Deputy; and fees are paid, and
receipt is acknowledged in space pro-
vided.
DIRECT Q4S SIGNA4UR10-
ORIGINAL — File YELLOW — Inspector
PINK Owner GOLD — Assessor
/
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OW
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