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FEDERATED WOMEN'S INSTITUTES 0F ONTARIO 7382 WELUNGTON RD. 30 RR. #5 GUELPH. ONTARIO NIH 6J2 Tel: (519) 836-3078 PAYTOTHE ' ' ORDER 0. Hillier W.l. ROYAL BANK OF CANADA 0 0 2 2 7 1 MAIN BRANCH 74 WYNDHAM STREET GUELPH. ONTARIO NIH 4E6 10/0 I /2006 $‘*20 000.00 â€"_â€"â€"â€"_â€"__ _2_â€" Twenty Thousand and 00/]00inant:*******=i==i=Haggairaizairnal:**********4:****=i=*4:H*********************H ,« Hillier W.l. c/o Brenda Dunlay 331 Huyck's Pt. Road, RR # 1 Wellington, ON KOK 3L0 MEMO .NDUEETTW not?g2mooau COUNTY OF PRINCE EDWARD - PLANNING A BUILDING SERVICES @ 72 KING STREET. PO. BOX 1570 -PHONE: 613-476-3880; FAX: 613476-8144 Schedule 1: Designer Information ho re 'ews and takes responsibility tor design_activ s with respect to the pm'ect. Use one formâ€"for each ind’ 'dual 5'A PréjefétliifanTa’tio ' Buflding number. street name - 1 . U 86,50 Loyal/5f pll’ L Municipality H’l/Ief I Postal code I; Plan number/otherdescription ‘33 Individual who réyiews and takes‘responsibility for design activities .- . ' 1. -- V -. Name ‘ Film - I Street address w H, ' Unit no. Lot/con. Municipality Postal code Province E-mail Telephone number Fax number Cell number ( l , ( l ( I C.V:Desig'it'tactiyitie's‘vundertaken Hyiindividualidentitied in Sectidan. ’[Building‘Code‘tTah‘Ie 2.20.2.1] ' . ' C! House 0 HVAC â€" House El Buflding Structural El Small Buildings E] Building Services CI Plumbing â€" House CI Large Buildings CI Detection. Lighting and Power 0 Plumbing -All Buildings Cl Complex Buildings_ CI Fire Protection CI On-site Sewage SEtems Description of designer's work _ (MagflAcm ,rq @JOVIA‘ITOA) Carlee. CHAIA £13m." marshy 2’}; in Mt D.’ Declaratio'n,6f Designer . I declare that (choose one as appropriate): (print name) D I review and take responsibility tor the design work on behalf of a firm registered under subsection 2.17.4. ot the Building Code. I am qualified. and the firm is registered. in the appropriate classes/categories. lndivldual BCIN: Firm BCIN: C! I review and take responsibility for the design work and am qualified in the appropriate category as an 'other deslgnei’ under subsection 2.17.5. at the Building Code. Individual BCIN: Basis for exemption from registration: D The design work is exempt from the registration and qualification requirements of the Building Code. Basis for exemption from registration and qualification: I certify that: 1. The information contained in this schedule is true to the best at my knowledge. 2. l have authority to bind the corporation or partnership (if applicable), Date Signature ot Designer 'For the purposes at this form. ‘individual‘ means the 'person' retailer! to in Clause Z.t7.4.7.(l )(d). Article 2.I7.5.1. and all other persons who are exempt liom qualification under Subsections 2.17.4. and 217.5. NOTE: 1. Firm and Individual new numbers are not required tar snarling permit applications submitted prior to January 1. zoos 2. Schedule 1 does not need to he completed by architects. ar holders of a Certificate at Practice ora Temporary License under Iha ArchitectsAcL Application for a Permit to Consli'uct or Demolish Schedule 2 06/07/05 REVIEW OF THIS 'PERI‘i‘tIT APPLICATION' All THE PLANS, DRRWINGS, SURVEYS, INFORM AND DATA PERTAINING TRERETO. BY THE id: '997 CORPORATION OF THE COUNTY OF PRINDE £5?st ’ SHALL I191 RELIEVE THE OWNER. HIS CONT CT OR RII’I OTHER PARTIES OF THE REQUIREMENTS THE 'OIITARIG EUItOitIG CODE” (LATEST am an _ _ , . A ANTI ArtstlnitrtilS' OHAIIY OTHER littltt'isTtltagan x 30 infill good Door c/w Autcmultc Closer ” neautltnons Asrrllt'iAFPL‘r. ush 5: Put or were. U 2. All Partitions to be as Follows â€" I} a Z l 4 Stud: at 15' o/c. t b 1/1' Drywall Each Side Pointed. ,5 c 4' Fiberglass Sound Attenuation Blanket. L" d) 4' Vinyl Base Cove all Round. 5:: f _ . _ r " t I . t» 3. Flooring to he ‘0‘ 61;; “" 'â€"““â€"_" ‘ . . ' ”"4 DOLLARS too-"I. ELI-i tn- Vy [SVTH’J'S Hill: figfi‘ffifi is'â€"io' . . _ _ . . Unisex 4 ‘5 5 5 ‘0 Washer - M‘nimum Existing wtndows 7 I I to Remain ”5% ll VW'C' :_ . 9 .. _ s .. ' . : Sink. [DUrinal Unisex Unisex ~Barrier Free Washroom / . - Q ”was“ 5 n E 3 :r 2‘ it it \ ' ‘m 52‘ tr ao‘ _ 5 C :0 .tr; ‘ E rs Sink 'o 3 \ Wall Hung .1 E \ Q .E \ .SW" 2 12‘ x 50' 5 Existing Openingâ€"1 Builetln Board - 94 Barrier Fm a Remain \ Ent . \ ry . Exlt \ REVEIGI 700R N ' O t 5.4. 5. 4._°. 5. 5._5. i’e‘rtll Proposed Barrier Free WoshrOom Floor Plan. GENERAL NOTES : I. Unisex Barrier Free Washroom Scope of Work â€" w . - E IEWED Still in E; Raised Water Closet 4- 4 . all Hung Sink c/w Extended Paddle Valves. 4' Metal Grab Bars Wall Mounted per 0.8.C. milled in 30' High Wood Door c/w Automatic Closer. sh .9; Pull Hardware. Privacy Lock per 0.8.0. Guide 1997. a Seamless Wnyt Floor Covering or b ‘l/B' vcr Fully Adhered Float files. 4. Calling to be - a) 1/2' Drywall Pointed. .. ' ‘ b) Relocate Existing Washroom Ceiltng Light Futurasr D) Add New Ceiling Light Fixture in Chair Storage Area 5. Plumbing to be - 1:) Installed per 0.8 C;‘(Latest Edition): i ' ' ' ELVIEWEMIEQ. REVIEW OF THIS 'PERMIT APPLICATION' AND THE PLANS. DRAWINGS. SURVEYS. INFORMATION I AND ORTA'PERTAINIIIG THERETO, BY THE E CORPORATION OF THE COUNTY OF PRINCE EOWARD.. I SHALL wRElIEVE THE OWNER. HIS CONTRACTOR t l OR ANY OTHER. PARTIES OF THE REQUIREMENTS OF _ 'THE IONTARIO BUILDING CODE‘ (LATEST EDITION ' ANO'AMENDMENTS) OR ANY OTHER tit-LAWS AND/OR ‘ . EREOULATIONS AS MAY APPLI: I . . - . . fiKri'iWIF- EFTâ€"66419645.; - .>l< mot/e..Pt.noue teatâ€"j ' '- l l E r E l i E ..;.t,g. ; I i r . i I r l l r : I I . i ' z . I r i l I