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0401-354 (683) SEISMIC REPORT (2)79691 Arnold Palmer LICENSED CONTRACTOR DECLARATION i U) I hereby affirm under penalty of perjury that I am licensed under provision of BUILDING PERMIT PERMIT 401-3-54 H Chapter 9 (commencing with Section 7000)of Division 3 of the Business and DATE VALUATION LOT TRACT WProfessionals Code,and my License is in full force and effect. J, '<`,j 1, . • License# Lic.Class Exp.DateJOB SITE y O W '731152 E M i 013!31 '( ADDRESS r-•69... 5 AIMOLD { i6sLD PMM, _TPN Z r,— ,Date / Signature of Contractor — ' r' OWNER CONTRACTOR/DESIGNER/ENGINEER _0 ~ o OWNER-BUILDER DECLARA ION 1 Gf AlT;ST.R.E ;^L`.A ' '.A1..ASSOC IA 170-N _J U -,P.O:B0X.10e10 2533 SOt7IR C OAST..I lM.-T ,'A.Y S1'1~ 250 W LUaW I hereby affirm under penalty of perjury that I am exempt from the Contr toes LAQT.3W T.A OA 91253 C1RDBY'0,IE {A 9200-7 U) License Law for the following reason: _ Z ( ) I, as owner of the property,or my employees with wages as their sole 7fsti? 3 "1010 GBS 582.3 compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professionals Code). USE OF PERMIT ( ) I, as owner of the property, am exclusively contracting with licensed GENER G contractors to construct the project (Sec. 7044, Business & Professioals Code). I "t?YILLINT.HRY SE15.M1C'.F24TIt VII co () I am exempt under Section B&P.C.for this reason LO O N Date Signature of Owner L) Z WORKER'S COMPENSATION DECLARATION p Q 1 hereby affirm under penalty of perjury one of the following declaratiolns: VALUATION a,t>ti4,40 i,S r F2 O ( ) 1 have and will maintain a certificate of consent to self-insure for workers' X W LL compensation, as provided for by Section 3700 of the Labor Code, for the O J.Q performance of the work for which this permit is issued. m Q U ( ) I have and will maintain workers'compensation insurance,as required by O L Q Section 3700-of the Labor Code, for the performance of the work for which this rn I— permit is issued. My workers' compensation insurance carrier & policy no. are: d' Z Carrier STATE'f 1314D . Policy No. 04601 UlNITIV0941.1 EMUTU.A 3;FID COST OF 0.01.4 'INUC TION 6,00D.w cr.° O 71' :t L`. .t"1 SUMMARY Q (This section need not be completed if the permit valuation is for$100.00 or less). CONSTRUCTION YER 1011,000.418.000 S?).(M J ( ) I certify that in the performance of the work for which this permit is issuIed, STRC,1 40 MOTIMI FEE a RESID (07-.0400-u 1_0100 $.60 1 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 Se tion 370Q/of the Labor Code, I shall fo!!fthwith comply with'`th fise provis'ons. —I Date: .t V _L_d' ' + ` -- ! ' l. i\ 6 ,; F i s Warning: Failure to secure Workers' Compensation coverage is unlawful end shall subject an employer to criminal penalties and civil fines up to$100,00'0,in E ^w^•"' ?l i i addition to the cost of compensation,damages as provided for in Section 3706 JAN 2 of the Labor Code,interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety C!"7W ` 'A 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 perso I at SUM_-TOTAL CONSPIKUC`11011A D PI...AW CIMM 1.60 whose request and for whose benefit work is performed under or pursuant to 00 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 TOTAL PERMIT Ii—IM,S DUE NOW $8.1.+t i 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 IIIIIIIIIIIIIIIIIIIIIIIII 05 • 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 i IE .the above-mentioned property for inspeption pur'os S. —- RECEIPT DATEBY - DATE FINALED INSPECTOR rn,., o.inno.r - f d t r.,-. n o 7 /7rt'1 `✓2 - ° c' INSPECTION RECORD OPERATION j DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms&Footings Ducts Slab Grade Return Air Steel _ _ Combustion Air Roof Deck _ Q Exhaust Fans O.K.to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans&Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall-Int.Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond - Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg.Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K.for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 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) os Page of ,E DAVE STEAVENS Inspection Services 0, PROJECT P66 W OLA SS I G S PROJECT # oda, -1 'ts'- ADDRESS '7Q-(vq l 6,%Wl CLIENT +�(s6 - 10e-,T— Hz a- AR�1oc DATE 13 hM A t-f cav o �-I- BLDG. PERMIT # 01+0 (- 3 T-q ARCHITECT C�oL-R A A 2 cW ENGINEER�k.�) Std Ov r CONTRACTORflc r c_, BLD S INSPECTION TYPE INSPECTION REPORT -bea fa, S- Vs- ;3 #AJ f L y IJ A I&-/ J&, AA 3 -- v CJ,/ A til� ���/ ����,� J` - �v ti►ti.,�-T�=. �A • ` - �'f'A- !S•7a 004-L.L. �/j� ��-� d4te,wj(. ��!!a^,7L.�rine- L-a- 45AS S-3 ' 1Z1ot r'-Tc2 •�+1D �L`1 /VA r� KJ 1, :Z RL O c..I.l AJN tai:Y A)w c 0'gy�% 7� 1 #.� k'T— CERTIFICATION OF COMPLIANCE:To the best of our knowledge, all of the reported work, unless otherwise noted, e substantially complies with approved plans, specifications and applicable sections of the building codes.This report covers the locations of the work inspected only and does not constitute engineering opinion or project control. CERT.NO. 6 e S� 3 4*-S�� INSPECTOR NAME �A tJ S1 A%V e�-V 5 �{ / '` C` (Print early DATE 17 IY�/� 7 (��!`T INSPECTORSIGNATURE IIIIIII VIII III VIII IIII 07 IE 4 P.O. BOX 1504 t , mN o. 11403 Building79-691 Arnold Palmer 7&105 CALLE ESTADO AddresLA QUINTA,CALIFORNIA 92253 Owner Edward Gall � [[[ Mailing BUILDING: TYPE CONST. OCC.GRP. Address 111 GayinestonmDr, A.P.Number City Zip Tel. AuguL'ta t1E 94732 1207/622-3219 Legal Description Contractor Project Description California Pools Address Spa Es EquipmentWall 41910 Boardwalk W 18 if of 6' block wall CityZip Tela Palma Desert 92260 340-9000 State Lic. City &Classif. C53 1$5102 Lic.# 355 Sq.Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic.# LICENSED CONTRACTOR'S DECLARATION I'hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business andProfessions Code,and my license is in full force and *�-:--�-"�-�-�..� "�• - • � SIGNATURE -' DATE OWNER-BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractors License Law for the following 9000.00 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 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 permit Plan Chk. Dep. A subjects the applicant to a civil penalty of not more than five hundred dollars($500). Plan Chk. Bal. y. 2 ❑1,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,Bulsness and 108.00 Professions Code: The Contractor's License Law does not apply to an owner of property who Const. builds or improves thereon and who does such work himself or through his own employees, Mech. 2 4 V A 0 provided that such improvements are not intended or offered for sale. If, however, the building orimprovement is sold within one year of completion, the owner-builder will have the burden Electrical 45.00 of proving that he did not build or Improve for the purpose of sale.) ❑ I,as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing 27.00 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law n does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 90 such projects with a contractor(s)licensed pursuant to the Contractor's License Law.) Grading ❑I am exempt under Sec. B.&P.C.for this reason Driveway Enc. Date owner Infrastructure WORKERS'COMPENSATION DECLARATION 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.N o. Company O'Gopy is filed with the city. ❑Certified copy is hereby furnished. TOTAL 275.10 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATION INSURANCE his section need not be completed d the `' i 1 �. +•t' r r L' (T p permit is /or one hundred dollars (5100) valuation Ti rT. t� - '��-i-• t or less.) - -. - - - I certify that In the performance of the work for which this permit is issued,I shall not employ any parson in any manner so as to become subject to the Workers'Compensation Laws of California. 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 Center Line 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 it work thereunder is 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 agreeto 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 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO.FT.® $ UNITS 2ND FL. SO.FT. YARD SPKLR SYSTEM POR. SO.FT.® MOBILEHOME SVC. BAR SINK GAR. SO,FT.® POWER OUTLET ROOF DRAINS CAR P. SO.FT.® DRAINAGE PIPING WALL S0.FT. DRINKING FOUNTAIN. SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE:Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER y VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL ' FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO.FT.®q BATH TUB SO.FT.®c WATER HEATER MAX.HEATER OUTPUT,B.T.U. SO.FT.RESID®1%c SEWAGE DISPOSAL SO.FT.GAR®3LC HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH_FEE PL.CK.FEE CONST.FEE ELECT.FEE SMI FEE PLUMB.FEE STRUCTURE PLUMBING ELECTRICAL HEATING&AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C.UNIT COLL.AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING(ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND.REINF. GAS(ROUGH) METER LOOP HEATING(FINAL) OTHER APPJEOUIP. REINF.STEEL GAS(FINAL) TEMP.POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING LUMBER GR. INAL INSP�`1� cu.yd. FRAMING FINAL INSP. $ plus x$ =$ REMARKS: ROOFING n% S VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION- CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL IIIIIIIIIIIII IIIIIIII��� 08 44 • IE P.O. BOX 1504 No. 002569 Building 78-105 CALLE ESTADO Address 79-691 ATI)nld V0_11.rpr LA QUINTA,CALIFORNIA 92253 Owner BUILDING: TYPE CONST. OCC:GRP. Mailing Address 705 CXXUltry C1d2 Lr'iM A.P. Number City �Ztz* p Tel. P31. 92260 -%8-2828 Legal Description Contractor Project Description ;E�_-�7•l.C� �� � �_ Address 's"Iy►7CiC C asaw+.► City - Zip Tel. ' Dam State Lic. City 3478 &Classif. _ Lic.# Sq. Ft. No. No. Dw. Size GM 696 Stories Units Arch., Engr., Designer New E)jC Add ❑ Alter ❑ Repair❑` Demolition ❑ Address Tel. City Zip State Lic.# _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SIGNATURE- DATE •% f ` OWNER-BUILDER DECLARATION Estimated ValUatlOn c t� I :ereby`affirm that I am exempt from the Contractor's License Law for the.following $ 211 4a8.00 reason: (Sec. 7031.5,Business and Professions Code:.Any city or county which requires a �r permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance also AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT. - the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of - Division 3 of the Business and'Prdfessidns 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 permit Plan Chk. bep. subjects the applicant to a civil penalty of not more than five hundred dollars($500). " ' ❑1,as owner of the property,or my employees with wages as their sole compensation,will Plan Chk. Bal. r„q*4 QQ do the work,and the structure is not intended or offered for sale.(Sec. 71)44, Buisness and Const.Professions Code: The Contractor's License Law does not apply to an owner of property who 11 fill l 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 !1 or improvement is sold within one year of completion, the owner-builder will have the burden ElectricalV . of proving that he did not build or improve for the purpose.of sale.) __ 73 ❑ I,as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing ��R struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law rA does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.1. such projects with a contractor(s)licensed pursuant to the Contractor's License Law.) 0 I am exempt under Sec. B.&P.C.for this reason Grading Driveway Enc. Date owner Infrastructure 2.000.00 WORKERS'COMPENSATION DECLARATION 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 ❑Copy is filed with the city. O Certified copy is hereby furnished. TOTAL „6 $ CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation 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. 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 Center Line 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 is suspended for 180 days. I certify that I have read this application and state that the above information is correct. Issued by: Date 9-10-86 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. f Validated by: Signature of applicant '��- Date /I"'• � Mailing Address ' ""' Validation: City, State, Zip A6311 9 . 10_ 3665, 62 U, HARD COPY CONSTRUCTION ESTIMATENO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ.FT.® $ • UNITS 2ND FL. SQ.FT. YARD SPKLR SYSTEM POR. SQ.FT.® MOBILEHOME SVC. BAR SINK GAR. SQ.FT.® POWER OUTLET ROOF DRAINS CAR P. SQ.FT. DRAINAGE PIPING WALL SQ.FT. DRINKING FOUNTAIN SO.FT.® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE:Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ.FT.®c BATH TUB SQ.FT.®c WATER HEATER MAX.HEATER OUTPUT,B.T.U. SQ.FT.RESID®11/4 c SEWAGE DISPOSAL SQ.FT.GAR®3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST.FEE ELECT.FEE SMI FEE PLUMB.FEE STRUCTURE PLUMBING ELECTRICAL HEATING&AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C.UNIT COLL.AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING(ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND.REINF. GAS(ROUGH) METER LOOP HEATING(FINAL) OTHER APP./EQUIP. REINF.STEEL GAS(FINAL) TEMP.POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING LUMBER GR. FINAL INSP. cu.yd. FRAMING FINAL INSP. $ plus x$ =$ ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL AR,CHITMCTM:tAL APPFXNAL APPLI=ICc7 M.L C=3TROCT:':S Orman cazAT= BY T-13 MO MCA,'ZC9 :MOST BE RE.`f = FROM T= CC:eL= DAILY IIIIIIIIIIIIIIIIIIIIIIIII 09 � MA WW YSM28MAL A%SDCJrZ&ML Date Homeowner Appl ca t• Jame Is) Address 1�2 AV GAJ STYE (Primary �.:iasace� .aleoaoae - a 6 o g .96 lPGA1 hest) (Lonq O:suate) PGA West Address f—�- =act Lot 1.3 Mcd13_:4=ical31 Requested CJI ►n77 c %-") . ... . w A...1_ . Qa4.c� P�.-Ari I r,STALd_ ACO Q�«1 (CA►��6�ZR.a. S•rc�t� t�s��.fZS FEct P Work Schedule Ca=mencsment Data Completion Data Caat_ac_a_is 1 C_A l_% F=o 4P-Pa t A t:oo L_.�-. AaD SMAS a 4- TV _V = ARC=-==L1L C--M==: You are heresy aavised that the above work Is proposea ane approval is requested. At--ached is a arawsnq of =a worr. to be done and .types of materials to be used as isdicatsa on tts dzavL:tgs. Ne uaaerszand ttat buildlnq perstits for home improvements ase required by the Ci_y of La Gulsta and t=at tts cost of tis permits and rssponsihillty of obtalaiaq permits anal suosequsnt L=pection will be borne by t:s'appil-eat. He acknowledge t=st all approved ctsages in the osiginal deadga will be at our expeaast that any and all damage to build—'-q or other damage .rusu.Lt -q f--= the coast=cyan of tis proposed i3provement shall be at our (owner's) expense. Additiznally, any masatsnancs of t" permitted improvements shall be at the applicants expsase • and tie applicant agaves to hold the PGA West Residential Association harmless for its cost of maintenance of same. Homeowner agrees to ladsmnify, defend and hold harmless M West Resicant:al Association.' its officers, agents and employees from any 11", -.y arisizq from execs t:nr. of '3 appilcation. Sigaat__ss of /l/J ail :vne rs XXXJ// / ARC8I»^.IRAL C9S.40L CC"'T I= Appr:veo V Conditanal y Approved Disapproved Reason ::: Caadi- anal Approval or Disapproval Oats `1I INy signature—vi Arc:.(=act:t. Cant:oi CammLttae C:ai_-:as La acait:cn t_ :is 'approval, you nest obtain C::y approval for t=e requested oodi==cation as wei: as any otter necessary bui::iLaq permits. You are requi-ea to su=UZ eVLdenCe of tie Assoc=tion approval to obtalA t_e buildlaq permit. For tris purpose. all blleor:nts and :tanswi'� .e emaossed With tis Assoc_at::n's seal. the signat_ro of t-s ?:rperty .mwager. and cis data of t-he approva:. Caapistsa Warx S:znea of= by Data