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0201-074 (MISC)79706 Arnold Palmer LICENSED CONTRACTOR DECLARATION BUILDING PERMIT PERMIT# U) I hereby affirm under penalty of perjury that I am licensed under provisions of F- Chapter 9(commencing with Section 7000) of Division 3 of the Business and DATE VALUATION LOT (ZY11 TRACT N W Professionals Code,and my License is in full force and effect. ) 0 12o tP,00 O =) C) License# Lic.Class Exp.Date '' JOB SITE 7 76 4 APN 7: SI I3 1 I t L'3!3 / ( ADDRESS fOI T' .T.I4Irf: . G( ' 0 Z t- Date ' f/' Signature of Contractor - i" • f/ ( f OWNER CONTRACTOR/DESIGNER/EN INEER (D O' J V CD OWNER-BUILDER DECLARATION PGA WE..IrfRESIT:OITLALASSOMAU ON DEU, R.R.I2PACIRCMAWAi.GMTWM,-CJHL14,I W W -I hereby affirm under penalty of perjury that I am exempt from the Contractor's PO BOAC 10,150 2 53 3 8 OUT1J CONTIr1UCy1.1WA.Y ' 250 F- License Law for the following reason: 1A qLTMTA CA 912233 CARIDWIR Y—11-WS' .. Ch. 92-007 Z_ ( ) I, as owner of the,property, or my employees with wages as their sole (760,5564.9500 MW 582,13 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 contractors to construct the project (Sec. 7044, Business &_ProfessionalsTw G ? .2JEC?L3ni Code). Cl) () I am exempt under Section , B&P.C.for this reason F9f➢11rC 3Y iC➢ I' •(?5"r1t15; F9•d r8, 7 •fiSf 'i •ti3 • JOL.Ci? 4'j' C O N Date Signature of Owner STRUCTURAL MODIPICAT TOMS rn d Q WORKER'S COMPENSATION DECLARATION p I hereby affirm under penalty of perjury one of the following,declarations: Lo O O 1 have and will maintain a certificate of consent to self-insure for workers' VALUATION ATION U. X W IL 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 I have and will maintain workers'compensation insurance,as required by O U Q Section 3700 of the Labor Code, for the performance of the work for which this li F- permit is issued. My workers' compensation insurance carrier & policy no. are: Z Carrier Policy No. ob11, O STA`F FUND 0460111AW t f1t O I3 r i' I.n) :f}sr .:F 'aN; 'is Ir ':. umf 20,OMM SIMMARY (This section need not be completed if the permit valuation is for$100.00 or less). POU0 ' g RE ( ) I certify that in the performance of the work for which this permit is issued, CONSTRUCTION I+EM 301-000,418-000 418.070)03 $20169 1 shall not employ any person in any manner so as to become subject to the STRONKI MOTION n.1-•MYSID 101.000-241-•000 _ $2.00 workers' compensation laws of California, and agree that if I should become 3 subject to the workers' compensation provisions of Section 3700 of the Labor r Code, I sliall forthwith comply with those provision's. Date: Applicant l✓I# l .P "-•1 j, 1 t •>^ ' a s r.F ; y Warning: Failure to secure Workers'Compensation coverage s unlawful and I 3 shall subject an employer to criminal penalties and civil fines up to$100,000,in JAtq addition to the cost of compensation,damages as provided for in Section 3706 KJZ ` of the Labor Code,interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety Gil +. 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 I3? -':O7`AI~CONIETAMUC, ON 1 Air<9 uI_A.N M'X $209,00 any permit Issued as a result of this appllcaton agrees to,&shall, IndemnifyLASyR - ;; i { , & 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 IV' '' . f.€rMWTMNDW, w >: I&AWN 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. '+ — IIIIIIIIIIIIIIIIIIIIIIIII 1 certify that I have read this application and state that the above information is + I 31 • correct. I agree to comply with all City, and State laws relating to the building IE construction, and hereby authorize representatives of this City to enter upon L - - ---- the above-mentioned property for inspection purposes. ) RECEIPT DATE y BY DATE F A ED PECTO Signature (Owner/Agent) ' ` l ! tt 19 . Date jr! - - f 7i " INS INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K.to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 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 Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg.Test Final I 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) CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES .1ST FL. SO.FT.® $ UNITS 2ND FL. SO.FT.@ YARD SPKLR SYSTEM POR. SO.FT.® MOBILEHOME SVC. BAR SINK GAR. SQ.FT.® POWER OUTLET ROOF DRAINS CARP. 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 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,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. SO.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 ti 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 APPIEQUIP. 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 r FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL IIIIIIIIVIIIIIIVIIIIIII 32 4 4 C 3 IE A' '13913 Q P.O. BOX 1504 N o. 13 v13 Building 79-706 Arnold Parr 78-105 CALLE ESTADO Address LA QUINTA,CALIFORNIA 92253 Owner John Byrne MailingBUILDING: TYPE CONST. OCC.GRP. Address A.P. Number City Zip Tel. La Quintap CA 12253 Legal Description ContractorPool and Spa Palm Desert Pool Construction Project Description Al2 S34 Degert Dr. City l'Cho Mirage ZIpCA 92270 Tel.568-0060 State Lic. City &Classif. C-53 402959 Lic.# Sq. Ft. No. No. Dw. Size Stories Units -Arch., Engr., _ _..-.__ 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 and Professions Code,and my license is in full force and effect. : ^1 i i ; /`r e, SIGNATURE L !' DATE OWNER-BUILDER DECLARATION Estimated Valuation $28,000.00 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 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. ' subjects the applicant to a civil penalty of not more than five hundred dollars($500). 27 Plan Chk. Bal. ❑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, Buisness and COr1St. - • Professions Code: The Contractor's License Law does not apply to an owner of property who 27 builds or improves thereon and who does such work himself or through his own employees, Mech. 1 provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year or completion, the owner-builder will have the burdenElectrical ..00 of proving that he did not build or improve for the purpose or sale.) O I,.as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing 27.0101 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of 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 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.) ,T Policy No ` ` Company t ,y opy is filed with the city. ❑Certified copy is hereby furnished. I M TOTAL /,—, + • CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATION INSURANCE I^ !! (This section need not be completed if the permit is for one hundred dollars ($100) valuation nl jET t n q( ( 19"14- !1 t 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: a''- ) - 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. Y v 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 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 IIIIIIIIIIIIIIIIIIIIIIIII 33 ARCHITECTURAL/LANDSCAPE VARIANCE APPLICATION IE PGA WEST RESIDENTIAL ASSOCIATION, INC. Please complete and include this request form, along with ` four (4) sets of your proposed home improvement plans to: PGA WEST RESIDENTIAL ASSOCIATION, INC. P.O. Box 1060 La Quinta, CA 92253 or, 55-940 PGA Boulevard La Quinta, CA 92253 Attn: Property Manager 1 NAME: DATE:—7/7- ADDRESS : ADDRESS : PHONE: UNIT: PROPOSED STARTING DATE: APPROXIMATEOM ET DATE: Homeowner' igna ure The lowing appropriate information should accompany your completed application: 1. Four (4) sets of complete plans to include: a. Improvements and/demolitions b. Plot plan c . All dimensions proposed d. Relationship to neighboring units e. Material and color scheme f. Planned modifications of all external systems (landscape, sprinklers, gas lines , electrical, etc. ) 2. Agreement and Covenant Running with the Land completed and notarized. Two (2) original. 3 . Conditions of Approval and Disclaimer form (signed) 4. Facing and Adjacent Neighbor form (if applicable) 5 . Construction Regulations form (signed) ELECTRICAL , ] p ved [ ] Disa/p�pr ved + Signature Date LANDSCAPE [ l Approved [ ] Disapproved p + Signature %�— �!� Date ARCHITECTURAL COMMITTEE .[ ] Approved [ ] Disapprove 71 Ci Signature Date 7 _g ARCH/Rev 6/94 1 I REVISIONS BY a � 41 t� A ci LJ Fl`� W3 1 �1 0' t` 114.1 ?')�4 000 oL U, o0) . .' e ' 4 J co(75 cu LM CL - .�� n t(}; 1 (o00 _ L- Ln 00 0 � � t 0 , J - • M 0 i r , • t f. I r4l L - _ p OOL AREA TO BE ENCLOSED BY - T. HIGH FENCE. MINIMDM`�' ALL GATES TO BE SELF-CLOSING AND SELF-LATCH IN DR AWN ITY OF L U j NTA CHECKED BUILDING & SAFETY DBPART ANT DATE CC��.DMONALLY I�j 19 SCALE ACCEPTED FOR CONSTRUCTION ►1. �u SUBiECT TO INSTALLATION AS PER JDB NO. SHEET AND ALL APPLlCA SLE CO ES 1 DATE ` �`, 0; p =garE_ Is r- ,,;:: a= -a:•+t- �.;,. •, - -,. -z. ,.. ..:^., o« ti._....... ..-..._:. _+'�s.c°'�f' r. ," _.h.. ,.. .ale..:. . .:.,.. �:: .x•^e.�..;�>. .:^44E: .s..c s:.... _. �, w ...,z �"�ti"�"F4 �R.":..,• ....,°�A.�.� :�^,�.:�'�., . _ �a. - .:�'��'"` ._. r.;� wx ' 'w'�y^';;",�'�,;�`� s t 6 l IIIIIIIIVIIIIIIVIIIIIII 34 `0 4 IE A' P.O. BOX 1504 Nu, 002703 Building •79-706 Arnold LA QUINA,CALIFORNIA92253 Address _ . Owner SIVIrim COMPWIV BUILDING: TYPE CONST. OCC.GRP. Mailing Address7. „ A.P. Number City Zip Tel. Palm Das=t 92264 56892028 Legal Description Contractor Project Description PM VM PLUM 13 $ l Address Ind lctat tb City Zip Tel. Sam State Lic. City Ds 2825 &Classif-288130 Lic.# 328 Sq. Ft. GM % No. No. Dw. Size Stories Units Arch., Engr., Designer New j 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(commencingth Segtlon 7000)of Division 3 of the Business and Professions Code,and my license is in full.forrcee ander effect./ _ SIGNATUREJa..r= - ,!" t' DATE . /' - OWNER-BUILDER DECLARATION Estimated Valuation I hereby affirm that I am`exempt from the Contractor's License Law for the following 178r307178r307.00reason: (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 r 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 . Plan Chk. De for the alleged exemption. Any violation of Section 7031.5 by'any applicant for a permit p subjects the applicant to a civil penalty of not more than five hundred dollars(5500): Plan Chk. Bal. ❑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,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,as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing •: 1 struct-the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law _. does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. such projects with a contractors)licensed pursuant to the Contractor's License Law.) - Grading O 1 am exempt under Sec. B.&P.C.for this reason Driveway Enc. Date owner Infrastructure AP! 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. ❑Certified copy is hereby furnished. TOTAL 3 dA5 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 th?work for which this permit is issued,I shall not =any person in any manner so as t0 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 1 have read this application and state that the above information is correct. Issued by: Date ermit 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. 't Validated by: Signature of applicant f1, sA- Date ' ?xx'4AII Mailing Address "'` Validation: City, State, Zip A6745 11 _14 5485, 17 Ch, HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL NO. PLUMBING FEES 1ST FL. SO.FT.® UNITS 2ND FL. SO.FT. YARD SPKLR SYSTEM POR. SO.FT.® MOBILEHOME SVC. BAR SINK GAR. SQ.FT.® POWER OUTLET ROOF DRAINS CAR P. SQ.FT. DRAINAGE PIPING WALL SQ.Ff. DRINKING FOUNTAIN SQ 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,TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ.FT.®c BATH TUB SO.FT.®c WATER HEATER MAX.HEATER OUTPUT,B.T.U. SO.FT.RESID®11/4 c SEWAGE DISPOSAL SO.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 rSEWEIR ND PLUMBING/ s'9 UNDERGROUND A.C.UNIT COLL.AREA SLABGRADE H PLUMB.a BONDING HEATING(ROUGH) STORAGE TANK FORMS OR Sj IC Gs NY#P OUGH WIRINr) DUCT WORK ROCK STORAGE RC FOUND.REINF./ GAS(ROUGH) o METER LOOP HEATING(FINAL) OTHER APP./EQUIP. REINF.STEEL GAS(FINAL) TEMP.POLE GROUT WATER HEATER SERVICE INAL INSP. BOND BEAM WATER SYSTEM GRADING LUMBER GR. INAL INSP.S�(0—'T1 cu.yd. pie FRAMING 7 INAL INSP.S-� $ plus x$ _$ ROOFING �Coe ow T O vie,r-110 REMARKS: VENTILATION 0 R� W�6C NA Imo` FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL 004ATHING MESH 101WINSULATION/SOUND a S FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL 35 Page of IIIIIIIIIIIIIIIIIIIIIIIII DAVE STEAVENS Inspection Services PROJECT W S+ 1•.er.Lo b 5 PROJECT # &7.+y a . o 9 ADDRESS A,.J / 7 / CLIENT 26 A &u E gT .4oA I DATE J / .?4r se .7 fi-02. BLDG.PERMIT# ARCHITECT Go4iol 412CI4 ENGINEER]u rJ� S�J�/E /mac CONTRACTOR'.' .'a~ MA A PP GQ INSPECTION TYPE t INSPECTION REPORT 7,04 IA; cO r10 "t.i �w /7 Pzr!A/ 71-5 AA/40 Jia.M kJA 1 i,,!C_ C,u�►,..kc• �j .�L AJ!L • 13 y, sfR, , '7, /�/��,' /?'•d[��rl AAFTt12 . PI.Y i bE 1. S.A-*7 L4 0 C,W I Ai /I-35 Ji lc'a I � 3 4 i I If I hC T ik ILS 4A,1s 7 Ls • 7 - ,SLdca'i4✓e X-15's 1..• 7v 5 -SJS Sclutas I ; A f:Tr A7-ric 'e!os BcVCA!isD AT A/ IN, Ll�" 5 - -- C.- '7u i F f CERTIFICATION OF COMPLIANCE:To the best of our knowledge,all of the reported work, unless otherwise noted, F substantially compliesmith approved plans,specifications and applicable sections of the building codes.This report covers tie ofWai work inspected only and does not constitute engineering opinion or project control. i CERT.NO. e:;7 110V 3 4�6 INSPECTOR NAME -_�A 6/6 7't A de. �5 DATE INSPECTOR SIGNATURE L " f Page l of DAVE STEAVENS Inspection Services «y ~6 PROJECT P6 k% JA1C5T M.LF(09 X1105 PROJECT # m70 Q ADDRESS e d G 1 G + 7 CLIENT ':�6 A 0 C ST DATE 7 .7'/•e AJ tr 6140A. BLDG. PERNIIT# ARCHITECT 6o U j& r1 Ailc a ENGINEER a1� SAtNte !A/C. CONTRACTOR lEL INSPECTION TYPE INSPECTION REPORT "�.� �,�.�. - �►. 9 t'1 � 6,�rr�,.� /s. -t - ��uc.�r}�t, �-3 S - . ��T- �t 4 _ •— ' #,;.1`P !t. : . *'t ? g •'1 - C C u S 'T �Ly c�!��.1 k ' L A�f-r c +�I G — � z LAE A ILL 5 .3G W.1-W 5, gL p,-k#j c_ I¢-IgJi f i MNk Y �) • • '� ii.A 1Z AJ iAt 1.i C. w C d t" r '• ' } t f �+�,fig, Jj/)r t�T y W^l 1 r J �-Y f CERTIFICATION OF COMPUANCE:To the best of our knowledge,all of the reported work, unless otherwise noted,(D ' bstantially cor�p]�es with approved plans,specifications and applicable sections of the building codes.This report covers su } I0miorW1611hdwork Inspected only and does not constitute engineering opinion or project control. CERT.NO. 3�{� —S� INSPECTOR NAME 0 - { �r 4 DATE '/ 7aAJC er;24xi 2- INSPECTOR SIGNATURE V