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BPLB2015-007278-495 CALLE T,AMPICO LA QUINTA, CALIFORNIA92253 Application'Number: BPLB2015-0072 Property Address: 48520 CASITA DR APN: •602112042 Application Description: JOLLEY / REPLACE (1) Property Zoning: Application Valuation: $1;355.00 Applicant: TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD#C3 INDIO, CA 92201 ""Z "Y COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760)'777-7153 Date: 5/8/2015 AOwner: PO JUNE JOLLEY 48574 VISTA PALOMINO WAT�72015 LA QUINTA, CA 92253 M CITY OF LA QUINTA Contractor: V DEVE DPMEW DEPARTMENT TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #C3 INDIO, CA.92201 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that l am,llcensed under provisions of Chapter 9 (commencing WiWSection,7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect.- License ffect:License Class: C36 License No.: 930133 , ,� Date!5—A ^ I —E5 ContractoN C (/1i 'I V \ `\ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031:5, Business and Professions Code: Any city or county that requires a permit to construct, alter, Improve, demolish, or repair any structure, priorto its issuance, also requires the :applicant for the permit to file a signed statement that herorshe is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 ofthe Business and'Professlons Code) or that he or she Is exempt therefrom and the basis for the alleged exemption. Any violatlon.of Section7031.5.by any applicantfora permit subjects the applicant to a civil penalty of not more than, five hundred dollars ($500).: (J 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or Improvement It sold within one-year of completlon.,the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). ( 1 I, as owner of the property,, am exclusively contracting with licensed contractors to construct the project.. (Sec. 7044, Business and.Professions Code: The Contractors' State, License -Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with'a contractor(s) licensed pursuant to the Contractors' State License Law.). "1 am -exempt under Sec. : B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjurythat there is a`construction iending agency for the performance of the workfor which this permit Is Issued (Sec. 3097, CM C:): Lender's Name: Lender's Address: (760)574-4444 Uc. No.: 930133 WORKER'S COMPENSATION DECLARATION I herebyaffirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' !hn tion, as provided for by Section 3700 of the Labor Code, for the performance k for which this permit is issued. I have and will maintain workers' compensation insurance, as required by 00 of the Labor Code, for the performance of the work for which this permit Is Issued. My workers' compensation Insurance carrier and policy number are: Carrier:_ Policy.Number._ I certify that.in the performance of the work for which this permit Is. issued, I shall not employ any person in anymannerso 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, l shall forthwith comply with,those provisions. Date:5 — ai — IS Applicant` 61 //1 Q LA WARNING:FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT' IMPORTANT* Application is hereby.made to the Bullding.Official.for a permit subject to the.conditions and restrictions set forth on this application. 1. Each person upon whose behalf this applicationis 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 application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related'tothe workbeing performed Under or following Issuance of this permit. 2. Any permit issued as.a result of this application becomes null and -void if work is notcommenced 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's have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and stateaaws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned bove• mentioned�rpproperty for Inspection purposes: Date-u�)^ 15 Signature (Applicant or Agent) •• • DESCRIPTION. ACCOUNT CITY AMOUNT. ' PAID. PAID DATE.' BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT f CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 -DESCRIPTION ACCOUNT QTY" AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 PAID_ BY 'METHOD RECEIPT #' CHECK:# CLTD BY - Total Paid forPERMIT'ISSUANCE: $91.85 $0.00 DESCRIPTION ACCOUNT QTY' AMOUNT' PAID' PAID=DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 'PAID, BY METHOD RECEIPT # CHECK;# CLTD BY. DESCRIPTION; ACCOUNT_ QTY AMOUNT* PAID .PAID DATE WATER HEATER/VENT PC 101-0000-42600 • 0 $7.25 $0.00 PAID BY METHOD RECEIPT•'# CHECK # CLTD BY Total Paid forPLUMBING.FEES: $19.34 $0.00 O�� Description:,JOLLEY / REPLACE (1) 50 GALLON GAS WATER HEATER Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 5/8/2015 SKH Approved: Parcel No: 602112042 Site Address: 48520 CASITA DR LA QUINTA,CA 92253 Subdivision: TR 27835 Block: Lot; 6 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,35S.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories:0 No. Unites: 0 - - ADDRESSI Details: WATER HEATER CHANGE OUT - 50GALLON/GAS 12013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. Printed: Friday, May 08, 2015 3:52:10 PM 1 of 2 CRWIYSTEMS CONDITIONS. CONTACTS NAM E.TYPE 11(AME - - ADDRESSI CITY STATE, ZIP' PHONE FAX . EMY41l. APPLICANT TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #C3 INDIO CA 92201 CONTRACTOR TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #C3 INDIO CA 92201 OWNER JUNE JOLLEY 48574 VISTA LA QUINTA CA 92253 PALOMINO FINANCIAL INFORMATION DESCRIPTION ACCOUNT Qllf' AMOUNT PAID PAID DATE. RECEIPT # CHECK #' METHOD PAID. BY� CLTD BY BSAS S81473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Friday, May 08, 2015 3:52:10 PM 1 of 2 CRWIYSTEMS ESCRIPTION AC °. , . QTY AMOUNT . PAID: PAID;.DATE RECEIPT# CHECK`# ME PAID BY CBTID`. .. PERMIT ISSUANCE 30140000-02404 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 WATER, HEATER/VENT 101-0000-42401 0 $12.09 $0.00 WATER HEATER/VENT 101-0000-42600 0 $7.2.5 $0.00 PC Total Paid for PLUMBING. FEES: $19.34 $0':00 • �� :)FCTIC, SEQtD. E , I.COMPLETEQ: RESULT,,.' REMARKS' NOTES INSPECTION TYPE INSPECTOR ' SCHEOUL _ DATE DATE` PLUMBING FINAL" BLD PARENT PROJECTS - -' - Printed: Friday, May 08, 2015 3:52:10 PM 2 of 2 CIFW.IYSiEMS i 06/06/2,013 TRU 15:09 FAX.La Qui Ata 81dg 6 Safety ; �OOif001 • i I CrayV7' tunta ' ' Bulft@ :arSafety R - hermit P.O,: Bax 15041 78.4.95 Cafe Tmr#06 o l�� 1 a Q116V4 C4 9=3 - (760) 777.70 BuikMg Permit ApplfCatiotl and Tip Sheet ""Cal . 4 - r OWNeSWaMY X011 �` A. P. Nutaba Address: , Cfly, ST, Zip. Q Contractor: � � . T ..�.•� Addeiess a► —3 Ab'. S1; 7ip: C T40phom u o $brta Lia 4 iFcaWylum Addim ft*d ;m (cit* ow)_ No �Q'u At* ii 0 3�1�. ui W/f1i�Y'r riBULi �y.i•4.: A UN11S. . Tto� F of t�taCt Peeppn: �' lJ.� mated Vsfue q2 t?tnj� j ,� s . !M APM NOT.Wkrm mAW'THIS .I,�Iig ' 9abtettfal 'd! ttee�d- l TRACICNG raw t t'ffia Se>s 1'18a Cbieck" a►JtteA I lir .lmouuE . . Sb%damlCalsf, I �ted,r�+ky6prec�reettteae _ Platt ham t)epocit lives CSelra. Cet1�d Ca»1CPeraOtt Ptah 1t B®laaee Tided 34'CakL ply ' Flood pealed phut Ptatu t:ltxl . _ i Gradi'stg pies � Deview, .9 Wr oorreeue . $ti6tbutactorLlat CAed t4raen ng Gran! Deed >Msut pie4ed p $.3 i ti.0`A" Approval Plwts reeob I'ttyd ' iMii0111�;.. . '"'8e�vlet�, • I tOseoreeetlottaligeae � perTmpactFce _ tndvg�ippal c` lied tpdsoa Pub WlL Agpr Date',ot cbm • rata htnitFeea � 1, PLUMBING WORK.ORDER/INVOICE 5' 0 NO arm' MUM - 5'... U -� 'AII aear!' CA 1-1110.9930139 Out', 50 8TI1ET '48wh CITY n $_ TSE ZIP f�P -70 MAKE MODEL MAIAL N TOTAL MATERIALS 0 SERVICE CONTRACY C1 NORMAL K RES. p COMet. ❑ NOT COMPLETE � f - : - ,.►::cam -: _ �� i TOTAL LABOR ❑ WARRANTY 0,5 Day ❑ 1 Year Q SMarilh Q NO Q SlManlh WARRANTY CALLS ARE SCHEDULED 1=R0%I*P8AM-6PI9 X Initials I ❑ CASH ❑ C.C. ❑ BILL ;RGHECK # ■ TOMMY ROOTER 20395 HELPING THE DESERT ONE FRIEND AT A TIME CO. &.� phowng Drain.ct"ft&ietterspel: owt Inv.#ykQ77z0 80973 IndEo Blvd., #89 AUIh # ,47 -MA 0 Indio, CA 92201 750-574-4444 FAX 76D444-2717 W W W TOMMYROOTEP I'MAl �^ `7 'AII aear!' CA 1-1110.9930139 Out', 50 8TI1ET '48wh CITY n $_ TSE ZIP f�P -70 MAKE MODEL MAIAL N TOTAL MATERIALS 0 SERVICE CONTRACY C1 NORMAL K RES. p COMet. ❑ NOT COMPLETE � f - : - ,.►::cam -: _ �� i TOTAL LABOR ❑ WARRANTY 0,5 Day ❑ 1 Year Q SMarilh Q NO Q SlManlh WARRANTY CALLS ARE SCHEDULED 1=R0%I*P8AM-6PI9 X Initials I ❑ CASH ❑ C.C. ❑ BILL ;RGHECK # ■ TOOURCflSTOMERS:8ervkoemenerarequlra tohaveworkefipsigned; Thta is. done In order to prosect you.lhe workmen, and ourselves end Io enable us lo give you absdule saddactcryservice. You are respectr* rsqueeted 10 examhe material andfabor alalernentbefpre woknen leave the Job, aed.lf you ind.erYmr)Witg s2IIslaClary,;okalr this Hakes. It service is unsellsfaoiory, In any %VW please phone our offbe immedlaieiy. APENALTY WILL BECHMGEDATTIERATE (IF 10%PER IONTHWUNPAID uuNGf8AFIERwaAYSOPitmDm, Atilt rlilltCEiaaRATEuv. II MINIMMI(REESrt'M DRAIRCLEANINO .A11D1 FOOTAGE C ADO`L FIXTURE$ PLUMBING LABOR PAS PR0011C17S1fREfRA1EHT - - VJDEOINSPEC11ION I Jlnd the t%ma and malnetfal charged abom satlelactory and agree b pay for same an presenWIcn of b4ce, and furtberagree to pay reasonable charged for collection including idtorn ys teres In We event of my defauB. HYDRO,IETTER MINI JE TER LINELFAK LOCATION 410TWE TO OWNER" 118aca4n 7aleConftetora [Ioenes lad ued[r an illgnrlK' um Lw w4m aft, skooveem, lolxw. moadd mala ourywogn who", brnpram_Ynr nd Y wwoj eno PIN for No wr. Wilna voakU� a n�rl m erloroe nor dna badw Yiv properts Under to b1GM low*16ot ywcall twill! akin cwrorr ar oft, bekwaomIFISIDadlaodor]npq�ll[eu,'sladrdmde[elfa Irewodr of EppwyturRaa modiealbi- ihYa dNoldurba[advor-lnooaAjrAioalwproperryyk�9ragrderd i�q[1lYgtlte - itJgk - IbhereoadWinaudlo16e.8eldb[Mahllhrinananeml mdoo nor ken Dana l le j ra pdOW erell h addrim to aq mrdlkra.lor lw• panne a of Irp mel �e Orel kr 1116 permat h !H of ft [w A dl pgrmIn nees"nolow a 4 rm ,bu lv lbo ODA FW h qa odWsel. GhTE wowKonlxaener. primpsEPTICaRFASE OTHER _ TAX - TOTAL PAYNEVTRECEIVED — PAYMENT DUE WATER HEATING °s Dalantloa Statement) • l certify tl+at this Ccrtiivatc of Compliance documentation'is accurst and compida. : 441 �ie►vty•ii sialied'smer1heaters and boilers for Moth domestic hot xwater he<ticrs (DWN) an DWH heaterr and boilers•tnu t be- us, p the: e.0gringqve. livr/ronk space heating. Newly Installed Woter Heater Dim*vdur Type Naa�ber in link TyprlFual Type` tRa fin System Capaeiry (goq � Energy Feeler ae F.ftieaey R.xteww . R -V laeton • I c atify that the energy katuses-and pnfbrrtnu►ce specifications fo'thvbuilding design id:' ified on this CordlIcaoe of Cwhpliance conform to, the m irement9 of Tide 24' Pard and' B of th c"Caiifotrtia Code of Regulations. '. • 1'he building design features identified:on This Cert likato of Compliance are consistent with the information provided itrdomawnt-this building &ftin oa the other applicable complknee farms, wotksitwm calculations. -plans and specificadom submitted to the onforcementmMy for sPwqK# with this buildin pMicapplicatlom Nanra 1. lnSkate Type (Storage Cjm'flea! PumVF lnsigatarieo*% etc_) ; 2.'Reciirui4tiirg systems serving mWtok .46�elling units shat! chest The recir umdon rc 4dreowwi -of requirenrepls do not allow the installation of a elnaloting uwwer heating system for single dwiellirtg units 3. TAt external wat+brhemin tank and s shall,be Insubted to »Iter there mutts OfIl ne .PZriPr ve Coaftctor or Homeowner (Decu�et ta�ion Autho AIResponaibk Buggy Des' °s Dalantloa Statement) • l certify tl+at this Ccrtiivatc of Compliance documentation'is accurst and compida. : • 1 em eligible under Division 3 of the California- Bruinm and Professions Code to act .pt responsibility for the building design identified on this Cutificate of Compliance. • I c atify that the energy katuses-and pnfbrrtnu►ce specifications fo'thvbuilding design id:' ified on this CordlIcaoe of Cwhpliance conform to, the m irement9 of Tide 24' Pard and' B of th c"Caiifotrtia Code of Regulations. '. • 1'he building design features identified:on This Cert likato of Compliance are consistent with the information provided itrdomawnt-this building &ftin oa the other applicable complknee farms, wotksitwm calculations. -plans and specificadom submitted to the onforcementmMy for sPwqK# with this buildin pMicapplicatlom Nanra Compaur. urr)Au4 rC lv. mb ic-, late: a= -� ` TI am q ,-. i 06/06./2013 THU 15:09 FAX La Quinta.Bldg & Safety 0001/001 B16 City Of La Qulnta Btdkgng.& Safety DMSIM P.O. Box 1504, 78.495 Cie Tarr# La Qubta, CA 92253 • (760) 777-701 Building Permit Application and T'rackn Sheet PMk PtnjartAddtgrs r OWn«'st '-CY AL P. Number. Address: L4 .la a Leo Dwlow CRYS Zip. O Tal bone: �, � Adm: q 7:1: rojecbDescrlption: city. ST, zip: Telephone: O State Lic # : \ Arch.. Bagri, Designer: L city Lle. C. Address: City, ST. Mp: Telephame State Lic :#: Name of.Cotttact Person: Construction Type: Occupalcy: Pmjca type (circle one): New , dd'a Alter Repair; Demo !Y-, Sq. Ft:#.Units:Telephone0 of CwW Palm. I �, Bstimabed Value of Project APPI1CAldT: ala Nor-wFtrrE Bnow'CHIS LINE tl 8abmtttal 'd Ree'A �II TRACMG P$Rwr no Plan sets Pian Check aitbtoit_ Item { Amonat 01 8ttuctaral Ades. l3evl Wvc ready for torrscttoaa .Pfau t Deposit Tans Cala, Celled Coataat Peraon Pfau CI'hetk f%tauee , Tide 24 Cdcs. Platy pielu--d1IIup Coast 'A's Flaod plain plea iMacs restb4itted Merl aftaf GradbtY plea 2' Review, ready for aw ectiouwUm Elecd�Ical $ulnwntector Ilat Caged Copta�Ct Person t'iawlfiag Grant Deed Plans picked $,M.I,I H.O.A. Approval Piave reavbr f ted Gradfag M AO115R+ °nt I.9.vkw, y W eoMcdona/iwae Devef wImpact Fee Plawdog Approval Called Coata�etPeraoa PtdL Wks. APPr Date of tissue 3ekotif Feu � � ' I i Total Permit Fea 1 Prescri tive.,,Certificate of Com fiance: Residential I CF-IR-ALT-DHW Residential Alterations Page i of.2 WATER HEATING • I certify that this Certificate of Compliance documentation is accurate and complete. List'hewly installed water heaters and boilers for both domestic hot water healers (DWH) and hydronic space heating. Newly installed DWH heaters =d -boilers must be as. pro e, or use.the existing I I Diterstribution Type Water Type/Fuel�Typet (Standard. Number In Recireuladn Capacity (gal) Iltamal Efficiency Tank E=W Factor or tency External Tank Insulation R-Vahtd r building design on the otter applicable compliance forms, worksheets calculations, plans and specifications submitted to the enforcement'agency for. approval with this building it appIlicatiOn., Name: i C\ Y I Date Address: I o � -rf)J �'o ' )Vj � � f i Cityistatilzp: 1. Indicate Type (Storage Cas,'Heat Pump, Instantaneoux ere.) 2. -Recirculating systems serving maUiple dwelling writs shall meet the reciirulation regi irrments of 0150(n). requirements do not allow the Installation of a recirculating water heating, system for single d;> Iltng, curies 3. The external-water,heatin tank and pipej shall be Insulated to meet the requirements o ' 15 The Prescriptive Contractor or Homeowner (Documentation Anthor's/Responsible Building Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California• Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance 24, conform to the requirements of Title Parti. and 6 of the California Code of Regulations. • The building design features identified on this Certifi ate.of Compliance are consistent with the information provided to document this building design on the otter applicable compliance forms, worksheets calculations, plans and specifications submitted to the enforcement'agency for. approval with this building it appIlicatiOn., Name: C\ Y Company: --urns Date Address: I o � -rf)J �'o ' )Vj � � Ucense: I q v ( 3 � Cityistatilzp: Phone: Tt� q �� a5 -q L- C)V PLUMBING WORK OR®ERANVOICE TOMMY ROOTER 20395 4 , HELPING THE DESERT ONE FRIEND AT A TIME Co.� g.`. , • DESCRIPTION • ITEM • • PART AMOUNT M. v Plumbing, Drain Cleaning & letter Specialist I nV.#yf0971�0 80975 Indio Blvd., #B9 Auth.# N7XIIS 0 2 )g s,1 (-= Indio, CA 92201 �_ 760-574-4444 S- T _.; _�. Fax 760-444-2717 1n ' y7 "All Chari WWW.TOMMYROOTER.COM a CA LIC. #930133 Dm P 50 C -S I� aS X NAM61 DATj SCHEDULED y= ; �rt. : - STREET y s.20 CC`a5 i I � s7 � bh r s Y06 6 �J S-- �C CITY L Q C X ZIP4Zzr3 ❑ WARRANTY ❑ CONTRACT i 'T +7(o ! MAKE MODEL SERIAL NUMBER ❑ SERVICE CONTRACT C p NORMAL TOTAL MATERIALS p RE& p COMM. NOT V COMPLETE DESCRIPTION OF •• AMOLINV 4o � o 4b o l l Iy % /ce- �I F , S V -1<'S a 6-c- :5-s LAB • • • , • TO OUR CUSTOMERS: Service men are required to have workslip signed. DRAIN CLEANING This is done in order to protect you; the workmen, and ourselves and to enable uslo absolute satisfactory service. You are ADD L FOOTAGE Q give you respectfully ADD'L FIXTURES 0 requested to examine material and labor statement before workmen leave the lob, and H you find everything satisfactory, okay this ticket. If service is PLUMBING LABOR, unsatisfactory, in any way, please phone our office immediately. PARTS A PENALTY WILL BE CHARGED AT THE RATE OF 1 ft PER MONTH ON UNPAID pFtODUCTS/tRFATMENT TOTAL,LABOR BALANCES AFTER DAYS OF INVOICE DATE. ANNUAL PERCENTAGE RATE 18% RETURNED CHECK FE $28.00 VIDEO INSPECTION ❑ WARRANTY • • • 01 14VIIIIIIII 1 find the time and material charged above satisfactory and agree to pay HYDRO-JETTER p S.Day ❑ 1 Year for same on presentation o1 invoice, and further agree to pay reasonable- MINI JETTER ❑ 3 Month p NO charged forcollection including attorneys fees in the event of my default. LINUEAK LOCATION 1] 8 Month "NOTICE TO OWNER" (Sectlon 7019-Contractore_ License Law) under cre PUMP SEPTICIGREASE WARRANTY CALLS - _ - - - - - - - - _ Mo0wims'.Lion 4w, any ooNreiior. aimoonUaclor. tabourer, ratledel man or other penin who Mos m k mve your property end is not pend for his labor, senrim or nnmedd, hes a right to ankace his OTHER ARE SCHEDULED gyA1 a you, y �r the MM you may Woyp s MaInal � � b, A taloa eornmermbng such work T hpvvsmenL a akpbel emu" b the Bark of Nprovemenl or a FROAF M -F 8AM-5PM modification d r^e to ofthe c unl rewrderof the countywtiere the pmpedyIs equated and roquirbg Iha1 a adorh Doral M recorded b nsrfioake. Bab bore elmg binan emouN TAX - - p prke and *4 In addition to arty cot dtions la the non leap than t.t I thek,for parlonnarpa of I - rad, nthe payment. in lug of the daft of sit persona -j �frnishing tabor, se sfs For the work b dam conked. TOTAL m X. X PAYMENT RECEIVED Initials []CASH EIC.C. []BILL CK - EJX DATE woaxoAoeaEoev: PAYMENT DUE Feta W03 (IWaNC1S • - Addees� Qt �. � . ' �V `� i'!t�Q{�otAcscrlptiw� L0 : TO :00 NOIivdn4 Cry. ST. 29p14 l5 95IZZ LOIN 3WIl`3lVa 'LapLom SWe Lia # cR I.1 Ate, JW, BeaiBoa: AMMW - T 7L " (makaare): New �Wfi Allo Rq* bgav igWWmlMdd Numa trPCOa►{gctPereoa; • � # Uait� Tetep6aaaFoiCFe: i 'VWiWOrPM APP.l2t:ANTE NW WPM B=W TM.I mg 1 'd '1 iG Pawn= 17od tied i Plea Ckeek l�cnt � . A ' i1eg1d. Sbtielnest (filet, f 6pe't+bttleflees Aeppa4t T Gelq, �ailcd Palm ' Ph- wk Be�uee M24 Cda Plea P M- P� Phu Pboat . CndtngA}en B°'Deviaw, YWreor� eded . • Sdbdom�elor Utt cried p am • 6aut Deco ILOA. ARVO W Pkw*gAppw4d tct$cisos�. M wkL AW DaOt aL iewe Feta W03 (IWaNC1S MOW >10 I-nS3d co (S) 39Vd L0 : TO :00 NOIivdn4 TIOLLLL09LI 3WCN/`ON Xt/d 95IZZ LOIN 3WIl`3lVa TOE.TtiTNZ3TOLZ91l * •Z13S • 131 XV -4 3HVN LS:ZZ.STOZ/LO/50 3WI1 180d3a NOIIVOI-AI83A NOISSIWSNV81