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RCRT-18-1787BUILDING PERMIT APPLICATION Miami Shores Village Building Department OCT 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC20 Master Permit No. 9C-P Ii-18- �1g� Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: )--La L City: lMiami Shores County: Miami Dade Zip: Folio/Pa rcel#: 2-0b - Q i b — GO 10 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):C-cVtL opk Phone#: -Z1--0,�F 4 � (00-4' Address: eL 1a7 [ da �C (_4 City: t`7L L b C/LL �O State: p Zip: 'S -* \ 3 Tenant/Lessee Name: Phone#: 4 ZL✓6 O00-5 Email: lCtrr �rl ► �t �[�� CONTRACTOR: Company Name: Address: City: State: Qualifier Name: State Certification or Registration #: Phone#: Certificate of Competency #: Zip: �GZc� vz . 1 DESIGNER: Architect/Engineer: �`" �-. Phone#: ?� ¢ti- • � (p i . 0 4� ) Address: 1 -!,-, q 4 ---\Y ­�v -a �� , City: ~Z 1 � State: 'r-L Zip: '1-2 5i. L 3 Value of Work for this Permit: $ Type of Work: ❑ Addition ❑ Alteration Description of Work: 4-o Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Radon Fee $ Square/Linear Footage of Work: ❑ New ❑ Repair/Replace Training/Education Fee $ CCF $ DBPR $ ❑ Demolition CO/CC $ _ Notary $_ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ �A1ID✓ POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the most Reverend Thomas Wenski, as Archbishop of the Archdiocese of Miami, his successors in office, a corporation sole, has made, constituted and appointed, and by these presents does hereby make, constitute and appoint Sister Elizabeth A. Worley, C.O.O., his true and lawful attorney for him and in his name, place, and stead. Giving and granting unto Sister Elizabeth A. Worley, C.O.O., his said attorney 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 he might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that Sister Elizabeth A. Worley, C.O.O., his said attorney or his substitute shall lawfully do or cause to be done by virtue hereof. In Witness Whereof, I have hereunto set my hand and seal this 20 day of February, A.D., 2015. Signed, sealed and delivered in the presence of: Witnes Witness ignature G�miIL� ��dGlGt� Printed Name ac� Witness Signature Printed Name STATE OF FLORIDA SS: COUNTY OF DADE The Most Reverend Thomas Wenski As Archbishop of the Archdiocese of Miami his successors in office, a corporation sole I hereby certify that on this day, before me, an officer duly authorized to administer oaths and take acknowledgements, personally appeared The Most Reverend Thomas Wenski, as Archbishop of the Archdiocese of Miami, his successors in office, a corporation sole, known to me to be the person described in and who executed the forgoing instrument, who acknowledged before me that he executed the forgoing 7Said ment, who acknowledged before me that he executed the same, and an oath was not taken. person is personally known to me Said person provided the following type of identification: --� Witness my hand and official seal in the County and State last aforesaid this 20 day of February, A.D., 2015. My Commission Expires: �„ypie1iC�a� f- r Meym Nsulim RosseQ pR M � M0 a 190149 y ■ mow, W � •� ■ • • 1 Imo+ s Miami shores village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice of R uireg Building Recertification Date: 6/29/2018 To: EDWARD A MCCARTHY 9401 BISCAYNE BLVD MIAMI, FL 33138-2970 Re: Mandatory 60 year Re -Certification 9221 gISCAYNE BLVD Miami Shores, FL 33138-2918 Dear Owner: According to the information provided by the Miami Dade County Property Appraisers cfXicp the above referenced property has a building or structure that is forty (40) years old or older. In accordance with Miami -Dade County Chapter 8 Section 8-11, the subject property must be inspected and re -certified by a Florida license architect or engineer. A building re -certification report signed and sealed by the Florida license engineer and or Architect along with the required fees shall be submitted to this office within sixty (60) days of receiving this notice. If you would like a copy of Minirnum Inspection Procedural Guidelines for Structural and Electrical Recertification, or if you have any questions, please call my office at 305-795-2204. Sincerely, L�r-~ Ismael Naranjo, BO Building Director. Email: ho msvfl. ov Certified Mail # ti :� �� -f a " '�"•'` VILLA & ASSOCIATES, INC. V ARCHITECTURE - PLANNING - INTERIOR DESIGN 9/3/18 Miami Shores Village Building Department 10060 2 nd AVE Miami Shore F1 33175. Re: 60 Year Building Structural Recertification of building located at Address: 9221 Biscayne Blvd. Miami Shores FL.33138 St. Martha Parish Hall And Parish Offices Folio 11-3206-016-0010 To Whom It May Concern: I have examined the above referenced property in accordance with the "Minimum Inspection Procedural Guidelines for Building Structural 60 Year Recertification" and I found the building to be structurally safe for its use and present occupancy. Please see enclosed copy of report (signed and sealed by myself). Electrical 60 Year Recertification see report prepared by Electrical Engineer. In order to avoid any possible misunderstanding, nothing in this letter should be construed directly, or indirectly, as a guarantee of the safety of any portion of this building. If you have any questions, please feel free to contact me (305) 661-8181. Sincerely, Jorge L. Villavicencio, Architect State of Florida License #AR0012110 7344 SW 48th STREET / MIANZ, FLORIDA 33155 (PHONE) 305-661 8181 / (FAX) 305-661-8710 / (E-MAIL) villarchitecture@att.net MIAMI SHORES VILLAGE BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING'S STRUCTURAL FORTY (40) YEAR RECERTIFICATION INSPECTION COMMENCE INSPECTION NIA Y ❑rGE VILLAVICENCIO Date: 6 / 29 / 18 SIGNATURE: `�� - —`-- INSPECTION COA9PLETED PRINT NAME: Jorge L. Villovicencio Date: 9 / 3 /18 TITLE: Architect MUST BE SIGNED AND SEALED ADDRESS: 7344 SW 48 ST. Suite 201 BY ENGINEER OR ARCHITECT Miami, FL _33155 PHONE: (305) 661-8181 1. DESCRIPTION OF STRUCTURE a. Name of Title: ST. MARTHA'S PARISH HALL AND PARISH OFFICE b. Street Address: 9221 BISCAYNE BLVD. MIAI SHORES FL. c. Legal Description: AMD. PLAT BLK 64 MIAMI SHORES SEC. E PB 51-36 d. Owner's Name: ARCHBISHOP THOMAS WENSKI ( ARCHDIOCESE OF MIAMI) e. Owner's Mailing Address: 9401 BISCAYNE BLVD. MIAMI SHORES FL. 33138 f. Building Official Folio Number: 11-3206-016-00010 g. Building Code Occupancy Classification: RELIGIOUS EXEMPT h. Present Use: PARISH HALL / PARISH OFFICES Description, Type of Construction, Size, Number of Stories, and Special Features Additional Comment: 13,273 SF. MASONRY BUILDING 1 STORY. FIRST FLOOR IS A CONCRETE SLAB ON GRADE W/ REINFORCED MASONRY BLOCK / AND GLASS STOREFRONT / CONCRETE COLUMNS SUPPORT A PERIMETER CONCRETE BEAM THAT RECEIVE STRUCTURAL JOIST FRAMING W/ METAL DECK, ( MAIN GATHERING AREA OR HALL). CCD CLASSROOM WINGS HAVE A WOOD TRUSSED ROOF SYSTEM W/ PLYWOOD DECKING. Additions To Original Structure: ORIGINAL BUILDING WAS BUILT IN 1950 AND WAS REMODELED EXPANDED IN THE LATTER PART OF THE 1980"S MIAMI SHORES VILLAGE BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING'S STRUCTURAL FORTY (40) YEAR RECERTIFICATION 2. PRESENT CONDITION OF STRUCTURE a. General alignment (not good, fair, poor, explain if significant) 1. Bulging GOOD 2. Settlement GOOD 3. Defections GOOD 4. Expansion GOOD 5. Contraction GOOD b. Portion showing distress (Note, beams, columns, structural walls, floors, roofs, other) NO DISTRESS SIGNALS VISIBLE @ BEARING STRUCTURE c. Surface conditions — describe general conditions of finishes, noting cracking, spalling, peeling, signs of moisture penetration & stains. NO MOISTURE PENETRATION, NO SPALLING OR PEELING EVIDENT d. Cracks — note location in significant members. Identify crack size as HAIRLINE if barely dissemble; FINE if less than 1 mm in width: MEDIUM if between 1 and 2 mm in width; WIDE it over 2 mm. MINOR HAIRLINE SURFACE CRACKS IN SPORADIC LOCATIONS e. General extent of deterioration — cracking or spalling of concrete or masonry; oxidation of metals; rot or borer attack in wood. NO DETERIORATION OF CONCRETE OR MASONRY UNITS VISIBLE f. Previous patching or repairs — IN GOOD CONDITION g. Nature of present loading indicate residential, commercial, other estimate magnitude. PARISH HALL / PARISH OFFICES 3. INSPECTIONS a. Date of notice of required inspection 6129/18 b. Date(s) of actual inspection 9/3/18 c. Name and qualification of individual submitting inspection report: JORGE VILLAVICENCIO , ARCHITECT d. Description of any laboratory or other formal testing, if required, rather than manual or visual procedures NONE e. Structural repair note appropriate line: 1. None required NONE REQUIRED A 2. Required (describe and indicate acceptance) Il w• MIAMI SHORES VILLAGE BUILDING DEPARTMENT 4. SUPPORTING DATA a. sheet written data b. PHOTOGRAPHS photographs c. BUILDING LOCATION MAP drawings or sketches: 5. MASONRY BEARING WALL = Indicate good, fair, poor on appropriate lines: a. Concrete masonry units GOOD b. Clay tile or terra cotta units NONE c. Reinforced concrete tile columns GOOD d. Reinforced concrete tile beams GOOD e. Lintel GOOD f. Other type bond beams GOOD g. Masonry finishes - exterior 1. Stucco GOOD 2. Veneer N/A 3. Paint only GOOD 4. Other (describe) h. Masonry finishes - interior 1. Vapor barrier GOOD 2. Painting and plaster GOOD 3. Paneling GOOD 4. Paint only GOOD 5. Brick veneer i. Cracks: 1. Location - note beams, columns, other SPORADIC STUCCO HAIRLINE CRACKS 2. Description MINOR j. Spalling: 1. Location - note beams, columns, other NONE VISIBLE AT TIME OF INSPECTION k. Rebar corrosion -check appropriate line: 1. None visible NONE VISIBLE AT TIME OF INSPECTION 2. Minor -patching will suffice 3. Significant -but patching will suffice 4. Significant -structural repairs required I. Samples chipped out for examination in spall areas: 1. No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT NOT REQUIRED 2. Yes - describe color texture, aggregate, general quality 6. FLOOR AND ROOF SYSTEM a. Roof: 1. Describe (flat, slope, type roofing, type roof deck, condition. SOPED ROOF W/ METAL DECK W/ BARREL TILE OVER FELTS H.M. 2. Note water tanks, cooling towers, air conditioning equipment, signs, other heavy equipment and condition of support: VENT STACKS LOCATED ON ROOF PROPERLY ANCHORED AND FLASHED. IN GOOD CONDITION 3.. Note types of drains and scupper and condition of cooling towers, air condition N/A b. Floor systems(s) 1. Describe (type of system framing, material, spans, condition) STRUCTURAL CONCRETE SLAB FIRST FLOOR IN GOOD CONDITION c. Inspection — note exposed areas available for inspection, and where it was found nerPssary to open ceilings, etc. for inspection of typical framing members. SPACES AVAILABLE FOR INSPECTION 7. STEEL FRAMING SYSTEM a. Description STEEL JOIST FRAMING ROOF SYSTEM b. Exposed Steel - describe condition of paint & degree of corrosion: GOOD CONDITION c. Concrete or other fireproofing — note any cracking or spalling, and note where any covering was removed for inspection STEEL STRUCTURE IS SEPERATED FROM USABLE LOWER LEVEL BY FIRE RATED DRYWALL IN GOOD CONDITION d.Elevator sheave beams & connections, and machine floor beams — note condition: 8. CONCRETE FRAMING SYSTEM a. Full description of structural system MASONRY WALLS WITH CONCRETE FOUNDATION, COLUMNS AND BEAMS b. Cracking 1. Not significant NOT SIGNIFICANT 2. Location and description of members affected and type cracking RANDON HAIR LINE CRACKS AT CONCRETE SLABS c. General condition [ ••� n -W Q-7 y MIAMI SHORES VILLAGE BUILDING DEPARTMENT d. Rebar corrosion - check appropriate line: 1. Non visible NONE APPARENT AT TIME OF INSPECTION 2. Location and description of members affected and type cracking 3. Significant but patching will suffice 4. Significant - structural repairs required (describe) e. Samples chipped out in spall areas: 1. No. NO 2. Yes, describe color, texture, aggregate. general quality: 9. WINDOWS a. Type (Wood, steel, aluminum, jalousie, single hung, double hung, casement, awning, pivoted, fixed, other) ALUMINUM FRAME WIDOWS, GLASS DOORS, AND FIXED GLASS b. Anchorage — type & condition of fasteners and latches: SCREWED THRU NON STRUCTURAL PT WOOD NAILER INTO CONC. FRAME AROUND WINDOW AND DOORS IN GOOD CONDITION c. Sealant — type of condition of perimeter sealant & at mullions: CAULKING / IN GOOD CONDITION d. Interiors seals — type & condition at operable vents: TIGHT IN GOOD CONDITION e. General condition: GOOD 10. WOOD FRAMING a. Type — fully describe if mill construction, light construction, major spans, trusses N/A b. Note metal fitting i.e., angles, plates, bolts, split pintles, pintles, other, and note condition: N/A c. Joints — note if well fitted and still closed: N/A d. Drainage — note accumulations of moisture: NONE VISIBLE AT TIME OF INSPECTION e. Ventilation —note any concealed spaces not ventilated: WELL VENTILATED f. Note any concealed spaces opened for inspection N/A MIAMI SHORES VILLAGE BUILDING DEPARTMENT NOTE: ONE STORY CBS BUILDING BUILT IN 1950 USED AS AR RELIGIOUS ED CLASSROOMS BUILDING WAS REMODLED AND EXPANDED IN LTHE 1980'S NEW ADDITION USED AS A PARISH HALL THIS BUILDING IS THE SUBJECT OF THIS 60 YEAR RECERTIFICATION INSPECTION AND IS FOUND TO BE GOOD CONDITION FOR CONTINUED CURRENT OCCUPANCY AND USE. CERTIFICATION OF COMPLIANCE WITH PARKING LOT GUARDRAILS REQUIREMENTS IN CHAPTER 8C OF THE CODE OF MIAMI SHORES VILLAGE Date: Sept 3, 2018 RE: Required 40 Yr Inspection Property Address: 9221 Biscayne Blvd Building Description: Parish Hall & Parish Office The undersigned states the following: I am a Florida registered professional Engineer or Architect with an active license. On Sept-3, 2018 , I inspected the Parking Lots servicing the above reterenceo building for compliance with Section 8C-8 and determined the followirio; [ X ] The parking lot(s) is not adjacent to or abutting a canal, lako. or other body of water. [ ] The parking lot(s) is adjacent to or abutting a canal, lake or other body of water, and parked vehicles are protected by a guardrail that complies with Section 8C-6 of the Miami -Dade County Code. [ ] The parking lot(s) is adjacent to or abutting a canal, lake or other body of water and parked vehicles are not protected by a guardrail that complies with Section 8C of the Miami -Dade County Code. I have advised the property owner that he/she must obtain a permit for the installation of the guardrail and obtain all required inspection approvals to avoid enforcement action. t, Lml Signature and Seal of Architect or Engineer (Print Name) ..� •� '` ` i* - fix' � � ! � �.. _� � �..101 Y sk. 4. -� •- -r _. ter.- - 41 pr r ■ ■ ■ a+y . F I ' f . a • r s POP ' • AIM •\i S 10 '- ■ rh ■ r r 13 - r.,�- � . ,- _ _ � r� � � r. - - � � �q� „ .... �� .. '.� I' . .� �._ e�1 , • — � '�yS�n' �' �: -. � �. t"'�' r _ �, PAPM Mr WOO Off; H,M, Mf5 OMf'MOO MCK O\U WOOP ,J015f POP110N OF PULPIN PU f IN 195O NSW f OUON OF PULPING GOOFING A5 M5COM19 A30V� W/ MM, MCK ANn 5tLl. J015f iN1rKIUK VIEW UP F)W15H H&I, 6UILf IN TH� 1980115 Guillermo Nunez, P.E. September 14, 2018 Miami Shores Building Department Attn.:Building Official Re: 9221 Biscayne Blvd., Miami Shores, FL 33138 Folio No.: 11-3206-016-0010 We would like to certify that the building of reference is electrically safe for its use and occupancy as per Miami- Dade County Code, Chapter 8, Section 8-11 (f)(iv)(1). 7591 SW 150"' Street • Palmetto Bay, Florida 33158 • Phone (305) 345-4409 Guillermo Nunez, P.E. CERTIFICATION OF COMPLIANCE WITH PARKING LOT ILLUMINATION STANDARDS IN CHAPTER 8C OF THE CODE OF MIAMI-DADE COUNTY September 14, 2018 Miami Shores Building Departmant Attn.: Building Official Re: 9221 Biscayne Blvd., Miami Shores, FL 33138 Folio No.: 11-3206-016-0010 Building Description: Parish Hall/ Parish Offices The undersigned states the following: I am a Florida registered professional engineer with an active license On September 3, 2018 1 measured the level of illumination in the parking lot serving the above referenced building. Maximum 5.3 foot candle per SF, Minimuml_2 foot candle per SF, Maximum to Minimum ratio 4.4:1 foot candle The level of illumination provided in the parking lot meets the minimum standards for the occupancy classification of the building established in Section 8C-3 of the Code of Miami- Dade County. The level of outdoor lighting overspill meets the limitations established in Section 33-4.1 of the Code of Miami -Dade County uille o Nunez Lie. o.:30782 7591 S.W. 150 Street • Palmetto Bay, Florida 33158 • Phone (305) 345-4409 MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING ELECTRICAL RECERTIFICATION INSPECTION COMMENCED INSPECTION MAD [� Date: 3-Scp-18 _ Sign Print Name: ill erm unez INSPECTION COMPLETED Title: P.E, Date: 3-Sep-18 Address:7591 SW 150" Street Palmetto Bay, FL 33158 1. DESCRIPTION OF STRUCTURE: a. NAME OF TITLE: b. STREET ADDRESS: c. LEGAL DESCRIPTION St. Martha Parish Hall / Parish Offices 9221 t3iscavne Blvd., Miami Shores, FL 33138 AMD PLAT BOOK 64 MIAMI SHORES SEC E PB 51-36 d. OWNER'S NAME: Archbishop Thomas Wenski ( Archidiocese of Miami) e. OWNER'S MAILING ADDRESS: f. FOLIO NUMBER OF BUILDING: 9401 Biscayne Blvd. Miami Shores, FL 33138 11-3206-016-0010 g. BUILDING CODE OCCUPANCY CLASSIFICATION: Religious Exempt h. PRESENT USE: Parish Hall / Parish Offices I. GENERAL DESCRIPTION, TYPE OF CONSTRUCTION, SIZE, NUMBER OF STORIES, AND SPECIAL FEATURES. ALSO ADDITIONAL COMMENT. 13,273 SF masonry building 1 sto GUIDELINES AND INFORMATION FOR RECERTIFICATION OF ELECTRICAL SYSTEMS OF FORTY (40) YEAR STRUCTURES 1. ELECTRIC SERVICE: 1. SIZE, AMPERAGE: ( 400) FUSES ( ) 2. PHASI120/240 3PH (XX ) 1 PH ( } 3. CONDITION: GOOD( X ) FAIR ( ) 4. COMMENTS: 2. METER AND ELECTRIC ROOMS: 1. CLEARANCES: GOOD( X ) 2. COMMENTS: 3. GUTTERS: 1. LOCATION: Electric Room 2 3. COMMENTS: 4. ELECTRTCAi_ PANELS: LOCATION 1.PANEL WAIN Electric Room 2.PANEL #A Electric Room 3.PANEL # A/C Outside 4.PANEL # S.PANEL # 6. COMMENTS: BREAKER(XX } NEEDS REPAIR ( ) FAIR ( ) REQ'S CORRECTION ( ) GOOD ( X ) NEEDS REPAIR ( ) GOOD ( ) NEEDS REPAIR ( ) GOOD( X ) NEEDS REPAIR ( ) ( Cofx) ( X ) NEEDS REPAIR ( ) GOOD( X ) NEEDS REPAIR ( ) GOOD ( ) NEEDS REPAIR ( ) GOOD ( ) NEEDS REPAIR ( ] ELECTRICAL PAGE 2. 5. BRANCH CIRCUITS: 1. IDENTIFIED: YES( X ) MUST BE IDENTIFIED ( ) 2. CONDUCTORS: GOOD( X ) DETERIORATED( ) MUST BE REPLACED( } 3. COMMENTS: 6. GROUNDING OF SERVICE: GOOD( X ) NEEDS REPAIR ( ) COMMENTS: 7. GROUNDING OF EOUIPMEN'I: GOOD( X ) NEEDS REPAIR ( ) COMMENTS: 8. CONDUIT RACEWAYS: CONDITION: GOOD( X ) NEEDS REPAIR ( ) COMMENTS: 9. CONDUCTORS & CABLES: CONDITION: GOOD( X ) NEEDS REPAIR ( ) COMMENTS: 10. TYPES OF WIRING METHODS:CONDITION: CONDUIT RACEWAYS: RIGID: GOOD( X ] NEEDS REPAIR ( ) CONDUIT PVC: GOOD ( ] NEEDS REPAIR ( ) NM CABLE: GOOD ( ] NEEDS REPAIR ( ) BX CABLE: GOOD ( ) NEEDS REPAIR ( ) ELECTRICAL: PAGE 3. 11. CONDUCTORS: CONDITION: COMMENTS: GOOD ( X ) NEEDS REPAIR ( ) 12. EMERGENCY LIGHTING: COMMENTS: GOOD( X ) NEEDS REPAIR ( ) 13. BLDG. EGRESS ILLUMINATION: COMMENTS: GOOD( X ) NEEDS REPAIR ( ) 14. FIRE ALARM SYSTEM: COMMENTS: N/A GOOD ( ) NEEDS REPAIR ( ) 15. SMOKE DETECTORS: COMMENTS: GOOD( X ) NEEDS REPAIR ( ) 16. EXIT LIGHT'S: COMMENTS: GOOD( X ) NEEDS REPAIR ( ) 17. EMERGENCY GENERATORS: COMMENTS: N/A GOOD ( ) NEEDS REPAIR ( ) ELECTRICAL: PAGE 4. 18. WIRING IN OPEN OR UNDER COVER PARKING GARAGE AREAS: COMMENTS: 19.OPEN OR UNDERCOVER PARKING GARAGE AREAS AND EGRESS ILLUMINATION COMMENTS: 20. SWIMMING POOL WRUNG: COMMENTS: N/A 21. WIRING TO MECHANICAL EOUIPMENT: COMMENTS: 22. GENERAL ADDITIONAL COMMENTS - REQUIRE ADDITIONAL GOOD ( X ) ILLUMINATION REQUIRE ADDITIONAL GOOD ( X ) ILLUMINATION GOOD ( ) NEEDS REPAIR ( ) GOOD ( X ) NEEDS REPAIR ( ) r \7 r a• � ■ ■.•• •r•• • boo• ■,.•�■ � ••1s•a 6 a ill AD t =:: t rrt"-Q rep W# M 4. IL