PLBG (0301-265)79535 Marigold Lane
0301-265
15024
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 # 4 Lic. 0 Class Exp. Date( .1., . - P.1m,
6105
/ f "Date f Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
l,'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).
( ) , 1, as ow ' ner 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:
- (, ) :1 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. 4
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 - R:KL?MPT '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.'Iaws'of California, and agree that if I should become
subject -to the'workers' comoensatio provisionsp,c,)f,seciibn 3700 of the Labor.
Code, I shall Prthwith comply With those provisions.,
,"Date.: el V A p p I i ca nt
Warning: failure 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 pefs'bn 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 'r'elating to the building
construction, and hereby authorize representatives of this City to enter upon
.'N
the above-mentioned property f6fe inspectiogjpurpoges.
Signature (Owner/Agerit) Dat
0
.
'BUILDING PERMIT PERMIT#
DATE iJ qr VALYATIONI;0 7
LOT TRACT
JOB SITE
ADDRESS APN
OWNER CONTRACTOR/DESIGNER/EN (NEER
DAVE J OHNSIX)IN It Y 9 MWERUCDOT DRAN WRVTCT
8-2154. TAH QIUM, AVE 3-,
CA
T -A Q17DT.rA CA 92W I'ablo
USE OF PERMIT
PLUMBING
WA;1'r_,R H&A.T15.1 CHA,11020UT
VAJAIAT)ON M100 LIS
J-,rMaXD con OF CON.!nRVJ7 17014
J .2
AR 12 903
CITY OF 04 rdtiINTA
PI
SUBAKMAL 0.01WRTYMONT PIRD MAN. M-11, r,
I'Vois 1-,P_R4&6,FF_ES
TMAL 110nar MI; Es DUE NOW
$7111-50
$0.00
$110 -No
[RECEIPT DATE -7 —< JBY _ _ ——I'DATEFINALED INSPECTOR
I .1h 5 1 1
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
'Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
:{ewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
i
SF►ZR185A LOWE S HCME CENTERS, INC.. EL9 0208
PASS: 1 DATE: OL/11103 78-863 HIGHWAY ill
LA QUINTA
DRD£RED FOR: JOHNSTUN, DAVE (7681771-5566
ADDRESS: 79 -MS NARIGOLD LN
LA (0JINTA CA 92853 PHONE: (760)360-9091
V-WaR NAME: R Y 5 CONSTRUCTION.& DRAIN CONTAM
ADDRESS: ATT PHONE: (7601347-9175
ImIO I CA 92201 FAX. (760)342-6640
PROJECT: (87920)506 NGAS W/H LONOX 9YR WP
LONE$ PO: 60ES5 LOWES INVOICE: 77916 ASSOCIATE: VICTOR RAMIR
EST DELIVERY: 01/12/03 AR NUMBER:
7 .
i
i
SF►ZR185A LOWE S HCME CENTERS, INC.. EL9 0208
PASS: 1 DATE: OL/11103 78-863 HIGHWAY ill
LA QUINTA
DRD£RED FOR: JOHNSTUN, DAVE (7681771-5566
ADDRESS: 79 -MS NARIGOLD LN
LA (0JINTA CA 92853 PHONE: (760)360-9091
V-WaR NAME: R Y 5 CONSTRUCTION.& DRAIN CONTAM
ADDRESS: ATT PHONE: (7601347-9175
ImIO I CA 92201 FAX. (760)342-6640
PROJECT: (87920)506 NGAS W/H LONOX 9YR WP
LONE$ PO: 60ES5 LOWES INVOICE: 77916 ASSOCIATE: VICTOR RAMIR
EST DELIVERY: 01/12/03 AR NUMBER:
STY ITEM ITEM DESCRIPTION VEND PART # COST EXT COST
1 128751 PERMIT
1 99094 VATER
22.50 222.50
INSTALL 200.00 200.00
FREIGHT
TOT 4222.50
fvA a+ e- c I C&
r
0CZ
7 .
CA
STY ITEM ITEM DESCRIPTION VEND PART # COST EXT COST
1 128751 PERMIT
1 99094 VATER
22.50 222.50
INSTALL 200.00 200.00
FREIGHT
TOT 4222.50
fvA a+ e- c I C&
r
0CZ
P.O. BOX 1504
Building 79-535 Marigold. 78-495 CALLE TAMPICO, '
'Address LA QUINTA, CALIFORNIA 92253
Owner '. & Mrs. Dan D^aaVine _
Mailing'
Address Same*-
. City Zip Tel.
La Quanta, . CA 92253 345 -798I.
Contractor
Rago2 Corist. Co.
Ad reSs.. .
t W $5 Cd6tuS his..
C.t Tel.:"
BMS, A Zip X3224'0 329-5755
No. -x.5024
BUILDING: TYPE CONST.- -- OCC: GRP.•
A:P. Number
Legal Description
Project:Descriptiorl
Patio' .Cdve—ar
State Lic
& Classrf. 3 7Fic3$5
City
Lic. # .
Sq. Ft.
Size .52$ .••
''No. :' No. Dw.
Stories "Units s
Arch.,.-Engr.,
Designer
New ❑ - Add EI,.
•: -Alter ❑ Repair ❑ :Demolition ❑
Address
Tel.
City
Zip
State
Lic. #-
LICENSED CONTRACTOR'SDECLARATION
+
I hereby affirm thatd am licensed under provisions of Chapter 9 (commencing with'Section
of Division A&&;the Business and Professions Code, and my. license . is in full force and
ffect. • W. F - f ✓fir4j,
, ' -
- - •.
f SIGNATURE - J DATE
OWNER•BUILDER DECLARATION
I hereby affirm that I, am exempt from the Contractor's License Law for the following
• reason: (Sec. 703,1.5,Business and ProfessionS_Code: Any city or county which requires a
permit to construct, after, lmprove, demolish, or repair any structure, prior to its issuance also
• ,.requires the applicant for such permit to rile a signed statement that he islicensed pursuant to
the provisions of the Contractor's License Law, Chapter .9 (commencing with' Section 7000) or -
Estimated Valuation
AA
•-2s +•. .- f 2 r V
""^------- -- t• •''
• PERMIT S -
_ 'AMOUNT --
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
subjects the applicant to a civfl penalty of not more than live hundred dollars ($500). - - .
❑ 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
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,
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
of proving that he did not build or Improve for the purpose of sale.) - .
Plan Chk. Dep..`'' ,
-4 y •"
,
64.3
Plan Chk..Bal.' , .,
- -
•
COflst. •
' Mech. '?- fi - "
Electrical - " -
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to corn
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 .
such projects with a, contractors) licensed pursuant to the Contractor's License Law.)
I
"❑ I am exempt under Sec. ` B. & P.C. for, this reason -
- S.M.L -
d
-
Grading
Driveway Enc.
Date Owner
Infrastructure
"
`
WORKERS' COMPENSATION DECLARATION
I here affirm that I have a certificate of, consent to self -insure, or'a certificate of -.
Worker's ompensation Insurance, or a certified copy thereof: (Sec., 3800, Labor. Code.)
Pol cy o. - .Company
opy. is filed with the city. O Certified copy is hereby furnished. _.
• w
TOTAL
•rr . v s
CERTIFICATE OF EXEMPTION FROMREMARKS
i • • - WORKERS' COMPENSATION INSURANCE : .
'
-
'
his 'section need not be c
(T completed r/ the permit !s /or one hundred dollars. ($400) valuation
' ' or less)
I certify that in the performance of the work for which this permit is issued, 1, shall not
'employ any person In any manner so as to become subject to the Workers', Compensation ••
Laws of California
' r
NOTICE TO APPLICANT: lf, after making this Certificate• of Exemption you .'should become ZONE: - BY: r
subject "fo the Workers' Compensation provisions of, the Labor Code, you must. forthwith- -
comply with such provisions or this permit shah be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear. Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line
SHALL SUBJECT AN EMPLOYER. TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
..HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF -COMPENSATION,' Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
' FINAL DATE `INSPECTOR
7hisIs a tiuildin r
g permit when properly filled out, signed and validated, and is subject to. •.
expiration it work thereunder is suspended for 180 days. \
1 certify that I have read this application and state that the. above information' is correct. Issue by: Date ' Permit
I agree to comply with all city and county ordinances. and, state laws relating to building I,
construction, and hereby, authorize representatives of .this city. to enter theabove-.
above-. '
mentioned property for inspection purposes.. Validated by: 0
Signature of applicant Date
,.Mailing Address Validation:
City, State, Zipy • q
t;•i 1 l 19
Y
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEFS
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SD. FT.
WALL SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 C
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
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 I 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
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
T` -
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7
= 44 p.
a SL
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f; , ' yam°-' • /' f.
F_t•F t
Building
Address
Mailing
Address
City
,, is •i'
Ctintractc
1
P.O. BOX 1504 N O . 058-90.
78-105 CALLE ESTADO
79-535 '1-larimld tYafte LA'QUINTA. CALIFORNIA 92253
Lit. Qi>i to Associates
BUILDING:' TYPE CONST. OCC: GRP. -
43-875 lgashimton St. A.P. Number `
lin . ITel
P.D.
Address
City Zip
State Lic.
& Classif. 493939
Arch., Engr.,
Designer
Legal Description Phage 11 Lot 35
Project Description' P ' = Cactus Floes
Corp. -
Tel.: .
city'
Lic. #123L y Sq. Ft. No.
Size' '.21'. Stories
New [T Add ❑ Alter ❑
No. Dw.. "
Units
Repair ❑ 'Demolition ❑
Address
Tel.
City
State
{ w
r
Lic. #
~
LICENSED CONTRACTOR'S DECLARATION
! ?f hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
a ::7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect
a•a...
SIGNATURE - DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (sec. 7031-5,t iress and Professions Code: Any city or county which requires a
penm7 to construct, after, krprove, demofsh, or repair any structure, prior to its issuance also
requires the. applicant for such permit to fife a signed statement that he is licensed pursuant to
• the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
• ' Okision 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the staged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a cin? penalry of not more than Ove hundred dollars .($500).
❑ 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
Professions Code: Tire Canhadoes 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,
provided that such irprovemerds are not intended or offered for sale. M however, the building
oimprovement d within one year of completion, the owner -budder will have the 'burden
proving rrprove for the purpose of sale.)
Estimated Valuation : -w7 tr `1 "='•:,•..,
, PERMIT '_ AMOUNT,
-
t
Plan Chk. Dep. -
Plan Chk. Bal. 488.7.7
Const.
Mech. ". -
Electrical . , • . ,.
Plumbing -'123.00
;- ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
' struct the project (Sec- 7044, Business and Professions Coder The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects wfth a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 a exempt under Sec- B. & P.C. for this reason
_ L •
S.M.I. 6.16
Grading s
Driveway Enc. -
Date owner
Infrastructure
WORKERS COMPENSATION DECLARATION
t `
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
El Copy is filed with the city. ❑ Certified copy is hereby.fumished.
_ R.
TOTAL
• CERTIFICATE OF EXEMPTION FROM
ULORKERS' COMPENSATION INSURANCE ' • '
- REMARKS " lcr;dSf %ezis"Sa7`ilfA ,f 2'7fy±``f s;li $,s
.... c= rw..". - .. >• a .... - ,. „ .. f
• (This section need not be completed ff the permit is' for one hundred dollars (S100) valuation • ,
or lass.)
I certify that in the performance of thg work for whichthispermit is issued, I shall not
• employ any person in any manner so as 4o become subject to the Workers' Compensation' .
Laws of California.
- -
Date - Owner
?ONE: - - BY: -
Minimum Setback Distances:.
NOTICE TO'APPLICANT: ft, after making this Certificate of Exemption you should become
' subject to the Nbrkers' ConpensaWn provisions • of the Labor Code, you must forthwith
' cmply with such provisions or this permit shall be deemed revoked. -
Front Setback from Center Line •
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
1 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.)
Lender's Name
-Side Strebt Setback from Center Line •
Side Setback from Property Line,
Lenders Addte4s
This is a building permit when property filled out, signedandvalidated, 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 aboveinformation is correct.
I agree to comply with all dry and county ordinances and state laws relating to building
construction and hereby authorize representatives sof this city to enter the above-.
• mentioned property for inspection purposes-
' n
FINAL DATE '-INSPECTOR
Issued. by: Date Permit
Validated by:
Signature of applicant Date
Mailing Address— • '
Validation:
City,. State, Zip
..
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE ` ! f 7
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT.
GAS (FINAL) 7j/6fO
EMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN,
GROUT
WATER HEATER
URINAL
SQ FT a
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
$ plus x$
FLOOR DRAIN
MECHANICAL FEES
FRAMING t
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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 ` ! f 7
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUNINCEINF. G
GAS (ROUGH)LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL) 7j/6fO
EMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR. FINAL INSP./ r `' %
FRAMING t
FINAL INSP. '
ROOFING /f
VENTILATION v
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL 1
LATHING
MESH
INSULATIONISOUND l
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
Douro oww
REMARKS:
SIGNATURESIINITIALS
GARDEN WALL FINAL
Jun 20,88.16:48 GIBRALTAR LOANS.! RANCHO MIRAGE S FAX# 619-321-5672 P.02
Date;
To whom it may concern:
We are currently in µthe, process of purchasing a living unit e
located at - ,Dss'i Calif in
the 3
We have chosen to allow the closing of escrow on this unit prior
to the installation - ofA carpetingAin the unit.
.1.
6C4 •.vt -
, We hereby certify that we hold the seller, DeVM -DrM B S
ASSOCIATES, totally and fully non-responsible for any potential
deleterious consequences that may occur as a result ofthis
decision.
%/2/ .
buyer date Buyer date
Buyer date Buyer date
x..
GPivvr 7-
. A