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0007-135 (SFD). LICENSED CONTRACTOR DECLARATION ' .. I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date JO�¢�© --Dater ` '~ v ,1 "'Signature of Contractor Z� / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the -Contractor's License Law for the following reason: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & .Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this .. permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier EXUIPT Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree. that if I should become subject,to, the workers' compensation, provisions of Section --3700 of the Labor Code I shall -forthwith comply with those provisions Dater, //' Applicarit''' r �✓ Warning: Faire to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property fofor 'inspe/ction purposes. Signature (Owner/Agent)' /' ! r` r ^� Date, BUILDING PERMIT : 'PERMIT# ; DATE VALUATION LOT TRACT a ' O8f23= $108M.20 5 I3LK102.' JOB SITE APN - ADDRESS :52-610 AVFk=A OBREG'ON 773 - OWNER CONTRACTOR/ DESIGNER / EN INFER RAId): Y & SHARON WAA ISGACY HONMEE9 78.553 SAGUARO ROAD ROAD LAQUINTA CA 92253 LAQLUJXTA CA 92253 (760)564-7820 CM4 , USE OF PERMIT MHOIX, T?AMILY i7VJK.LWG SYD-PERMIT DOES NOT INCLUDE BLOCK WALLS OR POOL TRACT CONSTRUCTION 1,780.00 9F PORCH/PATIO 40.00 SAF , OAPLAGWAR PORT (SF) P W,s0 5 FT. 'Brt'OOD PENCE 200.00 LF - X911'. W%0 COS' OF C0145MUC170N $08,08520 .CONSTRUCTION ME 101.000.416.000 $671.00 PLAN CHUCK PEE 101-000-439-318 $536.16 MECHANICAL FF.F. 101.000-421.000 $62.00 ELECTRICAL FEE 101-000-4211-000 $120.94 PLUMBING PEI£ 101.000-419.000 $122,75 STRONG MOT1014 Fft - RESIT? 101-000-241-000 $10.09 GRADING FEE A. 101-000-423-000 $20.00 I71;VE,LOPLR. IMPACT FU �'A' $1,907.00 PRECISE PLAN 101-000.441-345 3100.00 FEE DEPOSIT 101-000-439-318 .$350.00 � SUB -MULL CON LTCTI:ON' AMID P'LAN t'IMCK. $3,570'" r LESS PREPAID FM 4250.00 'Y'O'1'A4.,1'M7i/FSr 11TES DVE NOW SZ,32U u . RECEIPT -"•j- DATE.:, BY., DATE FINALED INSPECTOR , INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings for Ducts Slab Grade Return Air Steel Combustion Air Roof Deck O.K. to Wrap 7 Exhaust Fans F.A.U. Framing -( .o v Compressor Insulation / g Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath tS2j cW Final Final L21--f-or POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs �/ ST " Electric Bond Footings % (� Main Drain Bond Beam 4yr Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping ,1 S7 18 `_[ Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection o o 1567 Encapsulation Gas Piping Gas Test _ Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) — p coo? -l�•^M- _ �4.•-• r �^"L� i,ry b i.svnlr'.// Y —tea k oAL� 1 7 P.O. BOX 1504 ' Building ; ///�� D�Q(�'f{� 78-495 CALLE TAMPICO APPLICATION ONLY Address �tt/V / LA QUINTA, CALIFORNIA 92253 Owner / / Mailing" BUILDING: TY/P—E�C/O�N�ST. �OCCC./GRP. Address if r t, w, c : r` TSal .2r - 6A J [� . rO� r' � :r ..•... �• (.f r' � ( A.P. Number r � w �" Q City Zip Tel. Z. /i#.(.c_ /fes i /'I ("� (p 4 ? �.. _ �� [f. 7 `� Legal Description �L 1 5 Q Contractor r Project Description � r �� •/ �;_! % f = � Uc:�f..�' /`- Address �: > �;%-! Gr / + ✓ lS1 r..1 IBX' City Zip Tel.. .(I i {At l/k< 7- i � lF1 el;? Z S 3 ;,1&161 �&. ` ?Is-? Io State Lic. City & Classif. .�"' P (�I �j Lic. # // " J' :�, %' Sq. Ft. No. No. Dw. Arch., Engr., Size l €� fr Stories / Units Designer L /� C. f %) �'/ / /L Newp Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. q LICENSED CONTRACTOR'S DECLARATION I hereby affirm thatA am Ilcensedunde,provisions,df Chapter 9 (commencing with Section 7000) of Division 3'of the Business and Pro essions Code, and my license is in full force and effect. }�' / ^\ SIGNATURE r DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a ' permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also / requires the applicant for such permit to file a signed statement that he Is licensed pursuant to PERMIT �I/ AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permitPlan Chk. Dep. -' U subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I'll I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Mech. provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) I'I I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner or property who builds or improves thereon, and who contracts for S.M,I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading 1-1 I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION C,-? I hereby affirm that I have a certificate of consent to self -insure, or a certificate of [_ Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No.Company a ;1-�.•,_ k . n copy is filed with the city. O Certified copy is hereby furnished. r - TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE aa (This section need not be completed it the permit is for one hundred dollars ($100) valuation 1 .a '•-� or less.) I certify that in the performance of thg work.for which this permit is issued, I shall not �_`', ;+-+r s•'j employ any person in any manner so as to become subject to the Workers' Compensation `- - Laws of California. t Date Owner NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from CenterLine Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder it suspended for 180 days. I certify that I have read this application and state that the above information is correct. Issued by: Date Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Validated by: _ Signature of applicant Date - Mailing Address Validation: City, State, Zip (J/ 1 WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION z' Deseirt'Sa®dsThlried' Scfioot i)isfrict"` `47450 Dune.:Palhis R6ad Notice: La`Quinta; CA, 92253 Document Cannot Be" Duplicated 'i60 771=515 CERTIFICATE OF COMPLIANCE- Date OMPLIANCEDate 8/18/00 APN # 773-285-006 No. 20904 i®eisdlction La Q,uinta Owner lvameRandy 8i Sharon Bills Permit #0007-135 No. -52-610 street `,'Avenida Qnregon Log # Y. City La,Quiiita zip 92253 x Study Area . S Tract # Lot # Square Footage 1788 Type of Development SingleTFarriily-Re'Sidence- No. of Units 1 Comments At the present ume, tne.iLesert' banks unineu' Acnuvl-vizitrtct.; uvcb 'uut vii ;gu. u�c„acu Nv. w, wvv, va, patios/walkways,: res identtal additions`under.500square feet,. detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is`exempt from paying•'school fees at'tliis time due ,to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed.pursuant to Government Code 53080 in the -amount of 2.05 X ` 1,788 or$ 3,665"40` the� roperty'listed-above and thafbuilding permits.and/or Certificates of Occupancy forahis square footage in this proposed` project may now be issued Fees Paid By CC / 1st `Batik / Sharon=Bills Teleptione 760-564-7820 Name:onahe check r- - By Dr.' Doris Wilson i Superintendent v Fee collected /exempted by Annette .Barlow Payment Received. $3;6.65.40 Check,No. 550.44 Signature F NOTICE: Pursuant of Aasembly,811130111 (CHAP 549 ,STATS iggli) this will sane to ncttfy you Beat the W -day approval:per100 in which you may Protest the fees or other payment identified above will begin to tun from the date on which the building or lnsteilatlon:ponnit for thls project is issue Qcr on which May are paid to the Distrtcgs) or to another public entity authorized to collect them on the Dfstrict('sxs') behalf, whichever fWeanier. Collector: Attach a copy of county or<city plan check application form to district copy for all waivers. Embossed Original- Building DeptJApplicant.Copy-_Applicatit/Receipt Copy Accounting Zi At the present ume, tne.iLesert' banks unineu' Acnuvl-vizitrtct.; uvcb 'uut vii ;gu. u�c„acu Nv. w, wvv, va, patios/walkways,: res identtal additions`under.500square feet,. detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is`exempt from paying•'school fees at'tliis time due ,to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed.pursuant to Government Code 53080 in the -amount of 2.05 X ` 1,788 or$ 3,665"40` the� roperty'listed-above and thafbuilding permits.and/or Certificates of Occupancy forahis square footage in this proposed` project may now be issued Fees Paid By CC / 1st `Batik / Sharon=Bills Teleptione 760-564-7820 Name:onahe check r- - By Dr.' Doris Wilson i Superintendent v Fee collected /exempted by Annette .Barlow Payment Received. $3;6.65.40 Check,No. 550.44 Signature F NOTICE: Pursuant of Aasembly,811130111 (CHAP 549 ,STATS iggli) this will sane to ncttfy you Beat the W -day approval:per100 in which you may Protest the fees or other payment identified above will begin to tun from the date on which the building or lnsteilatlon:ponnit for thls project is issue Qcr on which May are paid to the Distrtcgs) or to another public entity authorized to collect them on the Dfstrict('sxs') behalf, whichever fWeanier. Collector: Attach a copy of county or<city plan check application form to district copy for all waivers. Embossed Original- Building DeptJApplicant.Copy-_Applicatit/Receipt Copy Accounting nils Am RF�ColtD�IN�G,itE r / D BY First American Title Ins. Co. AND !1'liEN RECORDED MAIL TO: Randy C. Bills 78555 Saguaro Rd. La Quinta; CA 92253 DOC 8*..,,.2001.0-275038 07/1472000'08:006 Fee:6.00 Page.,l of 1 Doe T Tax Paid Recorded"in Official Records Coutiiy of Riverside Cary L. ,Oreo Assessor,, County,;Clerk 8 Recorder }. 1 A.P.No.: TRA'/t: C) C ^A . R .i. L COPY !oNG REFUND NCHG GRANT DEEB THE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAXIS: COUNTY 517.60 [ X ] computed on full value of property: conveyed, or, [[ ] computed on full value less value of-liens,or cumbrances remaining at time of sale, ] unincorporated area;. [A] City of LA' OUINTenA and FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged, William L. Marlin and Margaret S. Marlin, or their.successors, as Trustee of the Marlin Living Trust, U/A dated April 16, 1993 hereby GRANT(S) to Randy C. Bills. and Sharon Bills, husband and wife as Joint Tenants the following described property in the City of LA QULN"FA, County of Riverside State of California: Lot 5 of Block 162 of Unit no. 17 Santa Carmelita'at Vale Lia Quinta, as shown by map on file in Book 19, Page(s) 19 and 20 , of Maps, records of Riverside County, California. -and Margaret --S--- -------- Marlin, ------ Marlin, or their successors, as Trustee of the Marlin Living Trust, U/A dated April 16, 1993 By:� William L. arlin, T stee S. Marlin, Trustee Margare Document Date: June 2, 2000 STATE OF CALIF )SS COUNT OF. L t� 1,0� ) /7 On tJ/�l� / c�'2O�C7, _ before me.,. personalty appearedj1 _/lwq 6ieG/ii1 illj' i12 ��%5 /(•� �tJ personally known to me (or proved to ine'on the basis of satisfactory evidence) to be the person(s) whose,,rame?s).ts/are subscribed tothe within insrrument and acknowledged to me that he{she/they executed the same in h+sAw/ heir'iuthorized capaciry(ies) and that by h+sAtrr/their signature(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument: WITNESS my hand and official seal. Signature CINDY BURbIN COMM. # 1180.893 ,,,IJOTARY PUBUGCALIFORNIA �` ✓ -, RIVERSIDE COUNTY .M thy Comm. Expires AP0122, 20D2 a RC DISTRICT PLAN=NING REVIEW FORM This form is to be�used by CDD staff for review of single family dwellings in the.^RC .(Cove Residential) District, in order to determine the applicability of coinpatibil ty-issues or need to require the filing of Master 4 .k... Design Guidelines by the -'applicant , It shall be transmitted to the:Building and Safety Department as your correction list. Please attach additional explanations as necessary, QA APPLICANT LEGACY HOMES. '.. LENCH DESIGN SITE ADDRESS 52-610 Avenida Obregon .: . APN 773 = 285 - 006 BIN NO.: CASE,NO.: 2000-274 LEGAL: LOT 5 BLOCK aINIT S.C.@V.L.Q. CHECKED BY: P e l' i P' Mou r l' a la n d DATE: �% owl `0 Inform the assigned Build r g plan.rchecker upon> your assignmenf'tothis case. The CDD Executive Secretary maintains a log book to;track applications'and assign case`riumbers. REQiJIRED. ITEM'' Y; N' ; ' ' .COMMENT/C.ORRECTION 3. Compatibility Review Case logged and number. assigned Verify legal and APN.information Consistent with MDG on file (as applicable'k,,- MDG filing required (5 •;filings since 9/3/98) Consistency. with street/surrounding,area:' Colors Lo Materials +` E „. . Architecture` Other Requirements: = '" Vl� 0 cVWO. Certificate of Occupancy Cif of:La Qutnfa Bd�ld�n and Safety Department0 This .Certificate issued -pursuant to the requirements of Section X09` of the Uniform Building Code, certifying that, a:f the; rme of issuance, this .structure was in comp/lance with the: various ordinances. of ttie Cityegu/sting bui/ding construction or use. For the -fol%wing BUILDfiNG ADDRESS:52 6":10:.AVENI-DA :OBREGON Use Classific-ation: SFD '°Bldg. ,Permit Nb.'.0007=1'35 Occupancy-Group:'R 3 Type of Construction: VN" ` Land Use Zone: RC Owner of Building: RANDY &'SHARON BILLS. Building Official Address: '78 -555 -SAGUARO ROAD City: . LA' aUINT . CA` 92253. By: . STEVE TRAM Date: 02-09-01 POST IN A CONSPICUOUS PLACE .m C6TY OF LA SUH-CONTRACTOR LIST �o�lP f'O! ���6�Gr- PERMIT't11UMBER�—_ --- .; = . a JOB AD ESS— " -'-- 1 m s n a can eco Qiace. Only persons appearing on this list or their employees are authorized to work I ppsted on the lob �it�1�Ino Insn, ctiprt C�Ld ;�L�LEi -� J - a This toren ►� , An`:chbngCs-tathis 11st must be'approyed by;the Building )Division. must be camnleted by a plicantk "Oni1File"ure t s n t an acceptableo comply will result, r esponse.age_oF work and/or the voidance on'thi^ "ob Y — " i le trade;':ell information r nested b . N - ' hcab `of bui For eacfi ap mit. Vlipiki is: ,......<•s,.,,..• ' . , ... .• ;:,<„<>-%” S`4ale<�onttactOr s{cQii m :.::... „r•: ,-,y-Gasrt►OotuQs}...... __,arc= Com 8rtsa - u:6nce s .:: ;.C{t Bsiness�rcense e m 'TV ! C184iificatTOn Pori Nu ber Exp .Date license Number '£ttp x]X—xl r.., Company Name Classificietlon, t'rcense.Numbor Exp- Date CarreEv.Name eY c0ii fe.g. A, B, C-t3l.. (xttxitax! {xx/rsx/tixl. fe.g. State Fund..CalComq! (Format Vanes! (xxldtt/xttl (Kxxx} Ittalx><fxx! /�/l�O�ii°_ /f" LQ R_ i EneTliwoNiticaa!( f 0IV, , CE 1n o�.::. /7�1i. K4 n n"74- . 'rA—)-4 r `� �' ��3 11 i. �:: ___-�" Sladden Engineering 6782 Stanton Ave., Suite E, Buena Park, CA 90621 (562) 864-4121 (714) 523-0952 Fax (714) 523-1369 39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 fax (760) 772-3895 FIELD MEMO Project Name Site Address L fk J� �✓�A Job Phone Work Done _ Test Summary / Footings Inspected Date ?` 2T. DD Job No. 52-2 — U < < S Client: Test No. Location e.,... Elev. - • Dry Density Moist % % Relative Compaction Ref. Max pcf Moist % Comments 24 hour notice requested:to;schedule Field Technician. Thank you for the.opportunity to be of service. (wSladden Engineering 6782 Stanton Ave., Suite E, Buena Park, CA 90621 (562) 864-4121 (714) 523-0952 Fax (714) 523-1369 39-725 Garand Ln:, Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895 Date Job No. FIELD EMO Project Name Client:�c- _ r� � Site Address 5� �X OY.\ Job Phone Work Done Test Summary / Footings Inspected Test No. Location Elev. Dry Density Moist % % Relative Compaction Ref. Max pcf Moist % — � (r/ C7 �- ( ZSR Comments 24 hour notice requested to schedule Field Technician. Thank you for the opportunity to be of service. a� AVF- RICHARD N. LLEWELLYN P.O. Box 1477 Yucca Valley, CA 92286 (619) 366-9460 REGISTERED INSPECTOR'S WEEKLY REPORT TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑, STRUCT. STEEL ASSEMBLY ❑ ❑ POST TENSIONED CONCRETE ❑ ASPHALT OTHER REINFORCED MASONRY PROOFING C fl '❑f�FIRE (�❑ J0��1=NF, REP® SEOON 1 N Q I T E OF S�T.P �C� U� ��R;E� PERMIT N0. OATi 0 DAY OF WEEK 44 "/& 'r MATE RIAL, DE YL�iIPTION ^ ^ / 0 ) ^ �, t INSPECTOR IA3"SISTAGN•T'S HRS. CHARGED �•� �,,rr.O E'NGINEERr , D TE INSPECTION GENERAL SUB CONTRACTOR L ! eSCONTRACTOR �jC 41/G� �� y � al RICHARD N. LLEWELLYN P.O. Box 1477 Yucca Valley, CA 92286 (619) 366-9460 REGISTERED INSPECTOR'S WEEKLY REPORT TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑, STRUCT. STEEL ASSEMBLY ❑ ❑ POST TENSIONED CONCRETE ❑ ASPHALT OTHER REINFORCED MASONRY PROOFING C fl '❑f�FIRE (�❑ J0��1=NF, REP® SEOON 1 N Q I T E OF S�T.P �C� U� ��R;E� PERMIT N0. OATi 0 DAY OF WEEK 44 "/& 'r MATE RIAL, DE YL�iIPTION ^ ^ / 0 ) ^ �, ARCHITECT INSPECTOR IA3"SISTAGN•T'S HRS. CHARGED �•� �,,rr.O E'NGINEERr HRS. CHARGED D TE INSPECTION GENERAL SUB CONTRACTOR L ! eSCONTRACTOR �jC 41/G� �� y � al ` v ,t 4 7; ,e IAJf-ke c -/ems- 7�Re Yb les Y �� A e- f4) A � -e-1-1- /)p COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ �., PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED,TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE r.OVER.NINC BUILDING LAWS All I 0SIGNATURE�OF REGISTERED INSPECTOR gy / . X�V7-xuz/ I ( DATE OF REPORT REGISTER NUMBER