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Home My WebLink AboutBLD2000-00339 SFR - BLD Permit / Conditions - 5/25/2000 Inspection Line (360)427-7262 MASON COUNTY PERMIT ASSISTANCE CENTER Phone: (360)427-9670, ext. 352 Ar Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2000-00339 OWNER: HARRY TOLEN RECEIVED: 03/29/2000 CONTRACTOR: /25/2000 SITE ADDRESS: 1441 E TIMBERTIDES DR UNION ISSUED: 11 PARCEL NUMBER: 322357590233 EXPIRES: /25/2000 LEGAL DESCRIPTION: TR 23-C OF SURVEY VOL 1 PGS 210-213 TR 4 OF SP#1562 PROJECT DESCRIPTION: DIRECTIONS TO SITE: RESIDENCE RT 106 TO TIMBERTIDES, TO TOP OF HILL, LEFT TO END OF TIMBERTIDES NEXT TO LAST PARCEL ON LEFT General Information Construction & Occupancy Information Square Footage Information No. of Bedrooms: 1 Type of Constr.: 5N Type of Use: SF Insp. Area: No. of Bathrooms: 1 Occ. Group: R3 Lot Size: Deck: 320 Type of Work: NEW Fire Dist.: 6 No. of Stories: 1 Occ. Load: Building:1,216 Valuation: $74,201 Building Height: 18 Occ. Status: Unknown Basement: Cvr Porch 600 Manufactured Home Information Setback Information Shoreline & Planning Information Make Shoreline: Ft Water Body: � Length: Ft. Front: S 100.0 Ft. Shor Irn �45 Shoreline Desi SEPA?: Model: Width: Ft. Rear: N 1 .0 Ft. Slope: Ft. Side 1: E 45.0 Ft. g': Year: Serial No.: Side 2: W 30.0 Ft. Comp. Plan Desi .: Plumbing Fixtures Mechanical Fixtures FEES Type Q tY Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KLW 03/29/200 $450.78 52984 Hosebibs 2 Fireplace 1 Address Fee GMM 04/24/200 $15.00 53526 Kitchen Sink 1 Furnace<100K 1 Adjust Plan Check Fee MJB 04/28/200 $24.37 53526 Laundry Tray 1 Gas Outlets 2 Building State Fee MJB 04/28/200 $4.50 53526 Lavatories 2 Propane Tank 1 Building Permit Fee MJB 04/28/200 $731.00 53526 Showers 1 Ventilation Fan 3 Mechanical Fee MJB 04/28/200 $99.25 53526 Water Closets (Toilets) 1 Mechanical Base Fee MJB 04/28/200 $22.00 53526 Water Heaters 1 Plumbing Fee MJB 04/28/200 $75.00 53526 Bath Tubs 1 Plumbing Base Fee MJB 04/28/200 $20.00 53526 Clothes Washer 1 Environ. Health Plan KS 05/19/200 $50.00 53526 RlWflft Review Fee KS 05/19/200 $38.00 53526 Total $1,529.90 BLD2000-00339 Please refer to the following pages for conditions of this permit. 1 of 3 CASE NOTES FOR BLD2000-00339 CONDITIONS FOR BLD2000-00339 E 1) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X I �� 2) OWNER MUST SHOW PROOF. F S ISFACTORY WATER SAMPLE and well log PRIOR TO TEMPORARY/PERMANENT OCCUPANCY OF THE RESIDENCE. X 11 3) All upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 1� 4) All approved plans are required to be on-site for inspection purposes. If inspection is called for and plans are not on site, Approval WILL NOT be granted. In addition, a Re-Inspection fee in the amount of$42.00 per hour(minimum 1 hour) will be charged and must be collected by this department prior to any further inspections being performed or approval granted. X (D, fz - 5) PURSUANT TO 1997 UNIFORM BUILDING CODE, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY. MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS. A REINSPECTION FEE, BASED ON RATES AS ADOPTED BY THE JURISDICTION AND THE 1997 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X D i 2, 6) The approved plot plan is required to be on-site for inspection purposes. If inspection is called for and plot plan is not on site, Approval WILL NOT be granted. In addition, a Re-Inspection fee in the amount of$42.00 per hour(minimum 1, our) ill be charged and must be collected by this department prior to any further inspections being performed or approval granted. X t I . 7) UMC Chapter 7. In buildings of unusually tight con ruction, fuel burning appliances shall obtain combustion air from outside (excluding cooking appliances and clothes dryers). X D, 8) Any changes in construction shall be reviewed by engineer of record and submitted in writing to the Mason County Building Department prior to construction. All engineering documents are a part of the approved set of plans and must remain attached thereto. If engineering documents are removed, approval will not be granted. In addition, a re-inspection fee of$42.00 per hour(minimum 1 hour) will be charged and must be collected by this department prior to any further inspections being performed or approval granted.X :b, BLD2000-00339 Please refer to the following pages for conditions of this permit. 2 of 3 9) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS AND OCCUPANCY IS LIMITED TO THE PERMITTED AND APPROVED CLASSIFICATION. ANY CHANGE OF USE E OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x 10) Changes to approved building plans that effect compliance to the 1991 Washington State Energy Code, 1991 Ventilation and Igdoir Quality Code, the Uniform Building Code and/or Mason County Regulations must be approved by Mason County prior to constructionX �� 11) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE.x "T_>; 0 12) If the tank size is between 125 and 500 gallons you must follow these guidelines: 1. Tank is to be 10 feet from any buidling, public way or property line. 2. If the tank is exposed to probable vehicular damage, provide protectiv�,poIla s. 3. All weeds, grass, brush, trash and other combustible material shall be kept a minimum of 10 feet away from LP containers. X yy� I ' 13) Fuel piping shall be inspected after the installation of gas piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances attached to the piping shall not be used until the final inspection has been approved by the building inspector. 14) All property lines shall be clearly identified at the time of foundation inspection. X R 15) The plan review corrections, along with the Energy Compliance Worksheet (when applicable) are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked APPROVED, they may not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply will result in failure of required building inspections. Every permit shall expire by limitation and become null and void if the building or work authorized by such permits is not commenced within 180 days from the date of issuance, or if the building or work authorize by such permits is suspended or abandoned at any time after the work is commenced for a period of 180 days. X `D This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before in an be occiinied. OWNER OR AGENT: DATE: 6</ BLD2000-00339 Please refer to the following pages for conditions of this permit. 3 of 3 CONCRETE MECHA CA MOBILE HOME r ! Footings k[�Setbac /< ,�j,ICsrc date 00W by ZdRibbons date by .� Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Final Floors date by date (O—(6 —00 by [ Final date date by FRAMING ',�,�T FIRE DEPT. date Walls ' ��lii.J by �� date � � �J by date by PLUMBING Attic OTHER Groundwork date 0 - 6 00 by L ,� date b WALLBOARD NAILING D.W.V. G dates nU by date 0 b ZG Water Line FINAL INSPECTION date 6� ,� by date ( _ 2 7—OZ) by date by 1 ✓ tz-ft,/ /2 �d d vc-Jhl of all L, R, ►P.s 3, rr v^cj er 4- C. e- , t,��L Tt,-, 4� L',, ja,-j v L-•oil f i 7,10ty �4 c 4cU,- f t, roo.+�� 8/15/00 Conditions Associated with Case #: BLD2000-00339 4:48:10 PM Cond. Stat. Changed Updated Code Title Hold Status Changed By Tag Updated By 3020 Owner Responsible 0 Not Met 4/3/00 CEW Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.X 3005 WATER ADEQUACY 0 Not Met 4/21/00 SMK OWNER MUST SHOW PROOF OF SATISFACTORY WATER SAMPLE and well log PRIOR TO TEMPORARY/PERMANENT OCCUPANCY OF THE RESIDENCE. X 0060 Erosion Protection 0 Not Met 4/27/00 SLO All upland areas disturbed or newly created by construction activities shall be seeded,vegetated or given an equivalent type of erosion protection(silt fencing or straw matting).X 1001 PLANS REQUIRED ON SITE 0 Not Met 4/28/00 MJB All approved plans are required to be on-site for inspection purposes. If inspection is called for and plans are not on site, Approval WILL NOT be granted. In addition,a Re-Inspection fee in the amount of$42.00 per hour(minimum 1 hour)will be charged and must be collected by this department prior to any further inspections being performed or approval granted.X 1002 POST ADDRESS 0 Not Met 4/28/00 MJB PURSUANT TO 1997 UNIFORM BUILDING CODE, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY.MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS. A REINSPECTION FEE,BASED ON RATES AS ADOPTED BY THE JURISDICTION AND THE 1997 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X 1012 PLOT PLAN REQUIRED ON SITE 0 Not Met 4/28/00 MJB The approved plot plan is required to be on-site for inspection purposes. If inspection is called for and plot plan is not on site,Approval WILL NOT be granted. In addition,a Re-Inspection fee in the amount of$42.00 per hour(minimum 1 hour) will be charged and must be collected by this department prior to any further inspections being performed or approval granted. X 3006 COMBUSTION AIR 0 Not Met 4/28/00 MJB UMC Chapter 7. In buildings of unusually tight construction,fuel burning appliances shall obtain combustion air from outside(excluding cooking appliances and clothes dryers).X 5002 Engineering 0 Not Met 4/28/00 MJB Any changes in construction shall be reviewed by engineer of record and submitted in writing to the Mason County Building Department prior to construction. All engineering documents are a part of the approved set of plans and must remain attached thereto. If engineering documents are removed,approval will not be granted. In addition,a re-inspection fee of$42.00 per hour(minimum 1 hour)will be charged and must be collected by this department prior to any further inspections being performed or approval granted.X 5003 ALL CONSTRUCTION 0 Not Met 4/28/00 MJB ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS AND OCCUPANCY IS LIMITED TO THE PERMITTED AND APPROVED CLASSIFICATION. ANY CHANGE OF USE OR OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE.x 5030 Changes to Approved Plans 0 Not Met 4/28/00 MJB Changes to approved building plans that effect compliance to the 1991 Washington State Energy Code, 1991 Ventilation and Indoor Air Quality Code, the Uniform Building Code and/or Mason County Regulations must be approved by Mason County prior to constructionX 5045 Field Correct 0 Not Met 4/28/00 MJB CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE.x 5090 Propane Tank 0 Not Met 4/28/00 MJB If the tank size is between 125 and 500 gallons you must follow these guidelines: 1. Tank is to be 10 feet from any buidling, public way or property line. 2. If the tank is exposed to probable vehicular damage,provide protective bollards. 3. All weeds,grass,brush,trash and other combustible material shall be kept a minimum of 10 feet away from LP containers.X 5095 Fuel Piping/Gas Piping 0 Not Met 4/28/00 MJB Fuel piping shall be inspected after the installation of gas piping is complete,and before the attachment of fixtures, appliances,or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances attached to the piping shall not be used until the final inspection has been approved by the building inspector. 5510 Property Lines Not Met 4/28/00 MJB All property lines shall be clearly identified at the time of foundation inspection. X 1003 PLAN REVIEW CORRECTIONS 0 Not Met 4/28/00 MJB The plan review corrections,along with the Energy Compliance Worksheet(when applicable)are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked APPROVED,they may not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply will result in failure of required building inspections. Every permit shall expire by limitation and become null and void if the building or work authorized by such permits is not commenced within 180 days from the date of issuance,or if the building or work authorized by such permits is suspended or abandoned at any time after the work is commenced for a period of 180 days. X • Page 1 of 1 SCGt'2C� �� P �A� Arry L . 1o`" 32235--45- 902-3-3 n � W E fl S ti 2? n a N J ({ �ro P o se d 3okE M 4 v o.. 0 h o G "J 50` ot 3 _ o o� o Z2 9 30 Ix Io�..i low-e s�4- PERMIT NO.: BLD 3/ MASON COUNTY 3 Lf BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION 1. Owner } e nr•l L . ��le,n Contractor Name �'pYi i�v✓ Can ST Mailing Address 1 1000 li NA,1" Dr.S L.J Mailing Address 05-, L12ZII.✓ K,�5e LNG City Sec,-{1l2 State WA Zip Code 'IF1$(v City //yA State h),a Zip Code S Phone 2( D(b ) 932 - 0351 Other Ph.( ) Ph. 3( Ld )y2L_17k Other Ph.(fie 0 41:W Lien/Title Holder Contractor Reg. # kzvf=601 /%Ocs Address Expiration /C / =. / as SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System PARCEL INFORMATION-12 digit Tax Parcel No. 321-3S /-75 / 107-33 Fire District Legal Description Site Address(Please include street name, street number and city) Directions to site RA-. 10(, 4. T,.hb��'T;deS. -}o -foe )r kn01 lei 4e e^4 of Mm w-, T;dk c, P + In s V a4vc-e &- P Will timber be cut and sold ih parcel preparation? (Ye ) Is your property within 200' of the following: Body of er(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New V Add Alt Repair Other Use of Building Res i&A c-t Describe Work No. of Bedrooms I No. of Bathrooms_L SQUARE FOOTAGE-1st Floor-}ireO 2nd Floor 3rd Floor Loft Basement Deck_R O Other Cr_ Pliuii - ft. (000 Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit ?(Yes/No) Installer Name Certification No. i NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X Date 3)f-4 lo C) X Date FOR OFFICIAL USE BEYOND THIS PO NT Accepted b ^' l Date � -Lmittal Amount Due p Y � Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES. Building Department /`isf3 Occ Grou Type constr. 5N �d Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation $ 1q , J00, �3, FEES Building Permit Fee >� 3 O Site Inspection Plan Review Fee LA 50,17 UFC Plan Review Fee t 34 3'7 Plumbing & Base Fee c 00 Public Works Review Fee Mechanical & Base Fee ta' as Other STAarC So Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal TOTA FEES FORM MUST BE COMPLETED IN INK PERMIT NO.: PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner ` c,1 0� > Contractor Name _ Mailing Address Mailing Address City State Zip Code City State Zip Code Phone(_ Other Ph.( ) Ph.( Other Ph.( Lien/Title Holder Contractor Reg. # Address Expiration SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. / / Fire District Legal Description Site Address(Please include street name, street number and city) Directions to site Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets I Type of Unit No. of Units Fees Bath Basins _a _ Furnace Bath Tubs �_ Heatpumps Showers , ; Vent Fans Water Heater Propane Tank _�_ `r, so Laundry Wsher J_ Gas Outlets Sinks _s� Wood/Gas/Pellet Stove Dishwasher Direct Vent? Other LO Z-3as S-`` Other -i _o..cl_ Other Other I `f,s 0 �yS Base Fee "`' Base Fee -�Ia,oo TOTAL PLUMBING q S,°C TOTAL MECHANICAL 111,�5 A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. .. AEPAR..MIENTAE REVIEVtC:: ........... AP .RS�VED.. DENIER Building Department Occ Group Type Constr. Planning Department Other Other SEES......:.' .. .. . Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical& Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal Violation Fee +, TOT T AL FEES 1ttC1r1e WIVS kc, /14� C,II/fcvn �PPc�c4�r��✓ FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION 32235-95-9flZ33 Case No. Name L PARCEL NUMBER S 15(--L Lo+ �O 4 Date 3Zi i DO SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line- I I f-adjacent property line I I See- adjacent property line-> ' ' adjacent property line SAMPLE SITE PLAN adjacent property lined 3io� _ _ Fadjacent property line I D 30' FR�SeRvE gel gE.ASo%J AL_ I c I Hom L, I Gaaen� I Houses I j Frio PaseD I 1 , I �-- 6 0' --/30• '�11 I � VAGnNT I fi C ARAaCS I /" 3 i PN poser) A&RiCLLLTuJiAL 50 40-- \ yo• I I I I 80, I � I RS i /0O" I \ I I \ I � r"•eLL I \ I I I adjacent property line-� ; �e \; <-adjacent property line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE dl s+a"C_a- +,o ruc+L4_1Ye_ �okk d;9'tar,L[. to top& -foe ` dts+snc m r to a 3/Iq/oo Signature I Date 1