0206-013 (SFD)LICENSED CONTRACTOR DECLARATION
I, hereby affirm under penalty of perjury that I am licensed under provisioris'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
,3a9.11� (.tallf2(
!`Date tr i" �' 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:
(; ) 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 rQQ��esionals Code).
as owner' of tFI� pA)ty, am exclusively` contracting with licensed
d ._
Code).contractors to construct thfbect (Sec. 704glBusiness &Professionals
O I am exempt under `ocLloq�J, B&P.C.,Yr this reason
Date ,SV�tre1 of Owner
WORKE COMPENSATION DECLARATION
I hereby affirm unde��p % tiy�"' perjury one lion
a following declarations:
k O' I have and will . Il 1 / r tificate of conto self -insure for workers'
,,compensation, as prowl Section 370the Labor Code, for the
performance of the wo�pj.M�for i h this permit is id.
-(1') : I have and will Xairitain workers' compens3, 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 .STA1`ia; FUND Policy No. 1.M29"41
(This section need not be co4pleted 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 �odf California, and -agree tha�if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions. •%
Xate: Ii _ :', Applicant nI ", Ak
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, "Z
1. Each person upon whose behalf this application is made & each person of
whose request and for whose benefit work is performed under or pursuantto
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 i
correct. I agree to comply..with all City, and State laws'relating to the buildin
construction, and hereby iauthorize,representative's o6his City to enter;,upo
the above-mentioned property for i+spection purposes-
Signature
urposesSignature (Owner/Agent) < t, -^4 •.+• ..'' "..'Date's �•
- PERMIT# f '^•.
-
BUILDING PERMIT -
t.' 0706-013
DATE % VALUATION " IVLOT 174 TRACT
JOB -SITE
ADDRESS Il r� -�1r:ALL,IK (�=o
APN
x
OWNER P
CONTRACTOR / DESIGNER / EN INFER
CIOR01INUIC, 1=014
.1-10 2307 3��
78.15.3 +Cl�►JX
LA QUINTA VPs 92253
LA QiI.A TA e"fib 9225.3
.{ W),564.4604 C',5L_ 2261
,
i
'USE OF PERMIT
gq�+ ��yr ��r(�`�'�yy'p � .••'{ ,
Y D A'. {�1.La{.SIG
C
2290 S.1r S FE"JT `.S NOT.1'IvCLU13Y, BLOC, is 'WAL-4 T'D-ol., 01"
JAIVEWAYARPROACH
f.4UCT10X Z290-00 $F
FO SS YIIE�A.T31i 167.00 Sty
fAGFXA-Rr;ZT 70100 O «-•,,. �..,..
-..>"... ,
1.61 E1:'aW CONT Ole CO11+STRUt;EWl`d'
142,150.110
7PKRRA ' Via' sff'%1t AL`!1'
C(443TRUC-'•TWN FEX 101.000.418-0011 M9100
PLAN CHECK ti'EZ 101-000-439.318 1649.74
ap inwoorr 10:1.00-439-310 42$0.00
PQP+�1'1��'d�ICA1.: �;iP.` 1t:11-(?Ct4-x'121-O�lti $t3g.Oto
.
FUM-TRICAL FSS 1p3 -0100-429-000 5140$
?LU 1£31'AfOOZE± %U1-.000-419-00.0
STRONG Mc, TION FER - R. MID 101 -000 -2,41 -WO $14,22
�lPi./!.I51AiO:E�i: 1!)i-CE:JO-X23-�)dY �1,">.fiEl
DEVEL43PER 1I&PACT Z'&1; �d0S,�33
1'4'EC ISPI, 161-bDO-441-345 ti9a.0
S'(133-:4"G1:AL C;C?MMMC11QH,a 144 1XLAN ,'C)93XXZ
$4,31 3. 5'1
IJ 'T1d'.L.A L�S'NiUl'�df.�A�l. '.N MIX.1�'VJ:�i.f o �H
r�4`�1•��r .�J.
)Cr
CITY OF
11-A
FINANCE EP TA I -
RECEIPT ' DA/7E ;
BY _
DATF_FINALED
INSPECTOr�, /'
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
—OL -Underground
Ducts
Forms & Footings
f
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
_ O
Exhaust Fans
O.K. to Wrap
- Q /
F.A.U.
Framing
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
Final
_
FinalZi
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
�L—G� (� �S'
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) fl -
COMMENTS:
CERTIFICATE OF COMPLIANCE J1.�FSc
Desert Sands Unified School District z000
47950 Dune
� Palms Road ¢ BERMUDA DUNES r
Date 10/3/02 La Quinta CA 92253
RANCHOIANWE LS tJ
Quinta, � INDIAN WELLS 'r
ALM DESEfzr
No. 23699 (760) 771-8515 �ZP
?LA QUINTAyy
QINDIO yr�l
Owner Coronel Enterprises APN # 770-173-010
Address Jurisdiction La Quinta
City La Quinta Zip 92253 Permit #
Tract # 0206-013 Study Area
Type Single Family Residence No. of Units 1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 174 51395 Calle Quito 2290 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments ?
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
i
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 2,290 S.F. or $4,900.60 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CCNIB -1sh COronel Check No. 270546
Name on the check Telephone 760/564-4604
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Monica Guillen $4,900.60 1$0.013
Payment Recd Over/Under
Signature i
NOTICE: Pursuant to Government Code Section 66020(d)(1),. this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
RECORDING REQUESTED BY:Y7 '1I
Southland Title - Inland Empire!!' J�
AND WHEN RECORDED MAIL TO:
CORONEL ENTERPRISES INC
PO BOX 389
LA QUINTA, CA 92253
M s U.
A.P.N.: 770-173-010-2
Order No.: 62600095
Escrow No.: IN2272-KC
A HR L
DOC a 2002-133927
03/18/2002 08:00A Fee:7.00
Page 1 of 1 Doc T Tax Paid
Recorded in Official Records'
County of Riverside
Gary L. Orso
Assessor, County Clerk Recorder
111111111111111111111111111111111111111111 lilli 11111111
PAGE I SIZE I DA I PCOR -1 NOCOR I SMF - 'I ' MISC. I
SPACE ABOVE -THIS GNE IS
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX IS $84.70
COPY I LONG I REFUND I NCHG
(x) Computed on full value of property conveyed, or
() Computed on full value less value of liens or encumbrances remaining at time of sale
() Unincorporated area: (x) City of la quinta
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged
SUNG CHA, a married man
hereby GRANT(S) to '
CORONE_L ENTERPRISESt INC. A CALIFORNIA CORPORATION
the following described property, in the County of Riverside, State of California.
LOT 174 OF THE DESERT CLUB TRACT NO. 5, AS PER MAP RECORDED IN BOOK 21., PAGES 61 AND 62 OF
MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA
Dated: February 5, 2002
STATE OF CALIFO IA
COUNTY OF � SS.
On before me
a Notary Public in and for said County and State, personally
appeared
-peFGo44ally-kae%w�--te-me. (or proved to me on the basis of
,satisfactory evidence) to be the person() whose name(
lisPaK subscribed to the within instrument and acknowledged
to me that tFQhe/Heiiay executed the same inis herAtneir
authorized capacity(les) and that by I L /tDre4r
signature) on the instrument the erson(k, or the entity
upon behalf of which the person(, acted, executed the
instrument. �1
VV!TNESS mWand an,,� ill seal.
Sig
4
of
SUNG CHA
(This Area for Notary Seal Only)
MAIL TAX STATEMENTS AS DIRECTED ABOVE
78-495 CALLE TAMPICO
LA QUINTA, CA 92253
(760) -777-7075
APPLICATION
nit: upon step z approval, ongiV goes In --rlooa rlaln uevelopment rermit" tile; copy goes to Applicant
F090 REV -2
7/00
FLOOD PLAIN DEVELOPMENT PERMIT
t
BUILDING SITE LOCATION
FLOOD ZONE "AO" - DEPTH 1
S� 39S • 'C'446C "f v., �
COMMUNITY- PANEL NUMBER.
060709 0005 B
n
/is rSl���s 404 x �/Q '%7� ��73 1�
�!'
Map Fevised: 8/19/1991
^ .• APPLICANT INFORMATION SECTION .
APPLICANT NAME
C' 0,PV,,570eUGTGOiL/.
APPLICANT
' ADDRESS
THE BUILDING SITE)
���✓
(MAILING ADDRESS, NOT
DAYTIME TELEPHONE NO.
—%Lp
INSTRUCTIONS
1. A Flood Plain Development Permit is required by LOW Section 8.11.040(A). The Appli--ant should complete the
Applicant Information portion of this application_ and submit it to the Engineering Department along with the-.
required documentation noted hereon at the same time the Precise Grading Plan is submtted to the Building and
Safety Department for plan checking.
.2. Documentation required for STEP 1, OF 2 APPROVAL prior to receiving clearance for Building Permit.issuance .
• Copy of the proposed Precise Grading Plan for review and approval containing E71 information required. by
the checklist shown on the back of this application.
3. Documentation required for STEP 2 OF 2 APPROVAL prior to receiving Flood Plain Development Permit approval.
Note, this approval occurs after forms for the lowest habitable floor are set and before tie Building & Safety
Department authorizes foundation construction.
• Submit a completed FEMA "Elevation Certificate" form to the Engineering Department.
• Submit 95% relative density soils compaction certification to the Engineering D.:partment.
STEP 1 OF 2 APPROVAL
The Precise Grading Plan submitted for this application has been
STEP 2 OF 2 APPROVAL
All requirements have been satisfied. This Flood Plain
reviewed and found to contain all data required to satisfy the
Development Permit is approved.
requirements of LQMC 8.11 The proposed dwelling is eligible to
receive a building permit upon satisfying all other Building &
Safety Department requirements.
y,.O?�
AUTHORIZED SIGNATURE DATE
AUTHORIZED SIGNATURE DATE
La Quinta Engineering Department
La Quinta.Engineering Department
nit: upon step z approval, ongiV goes In --rlooa rlaln uevelopment rermit" tile; copy goes to Applicant
F090 REV -2
7/00
CHECKLIST
FOR
PRECISE GRADING PLANS
e
IN "AO" FLOOD ZONE
1. Prepare Precise Grading Plan in accordance with Checklist for Precise Plans
and the following additional items.
2. All elevations shall employ the NGVD-29 convention.
3. Show and label elevation of "Highest Adjacent Grade" next to the building
footprint. This refers to the highest existing natural grade next to the
proposed building prior to constructing the elevated the building pad.
4. Show and label the "Highest Existing Elevation on Lot"
5. Show and label the "Lowest Habitable Finished Floor Elevation". Note, this
elevation shall be at least ONE FOOT higher than the "Highest Adjacent
Grade" elevation.
6. The following grading note shall appear on the plan:
All fill material placed under the structure shall be compacted to
ninety-five percent (95%) relative density.
F090A 10/99
FROM : Feiro Engineering, Inc. FAX NO. : 760 346-254E Oct. 18 2002 04:06PM 131
FEDERAL EMERGENCY MANAGEMENT AGENCY ^{j M,D, No. 3067-UO't'T
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 002
ELEVATION CERTIFICATE
Important: Read the instructions or. pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION For insurance company Use:
BUILDIG OWNER'S NAME
Co )n I_Q-1 11 (V
BUILD IN STR ADD (F2E Including
CITY1! �
RIPTT N (Lot and Bloc
�.YO �2
B 1NG
es en
Non -res
C lel. Jar 1+
LATI'rUbF_/LOIJGITUDE (OPTIONAL)
( ar#' - ##' - ;#.w or ##.#####')
and/or 81dg: No.) OR P.O. ROUTE AND BOX NO. I Company
area.
1J NAD 1927 jJ NAD 1983 111 USGS Quad Map U Other:
SECTION B - FLOOD INSURANCE RATE MAP (I -IRM) INFORMATION
gl. NFIP COMMUNITY E 8 COMMUNITY NUMMI $? OUNTY NAME 131 STA
N
64- MAP ANti PANEL
85. SUFFIX
66- FIRM INDEX
BTAPOW
B8. FLOOD
BASE FLOOD EL1VA) IZ)N(S)
NUMBI=R
I
DA
V ISED DFTE
Z E(S)
iZoneAO, use d pih of flooding)
�� Q
Bi 0. Indicate the source of the Base Flood Jevali n F#) data r bas flo depth entered in 69.
1_1 PIS P rofile Ix FIRM jJ Commttni Determined " Other (Describe): _
811. indicate tt a elevation datum used fot the BFE in B9: P NGVD 1929 IJ NAVL• 1988 l' 1 Other (Describe). _
F112. is the building located in a Coastal Barrier Resources System (CSRS) area or Ott en -vise Protected Area (CPA)? "Yes No
Designation Date:
SECTION C - BUILDING ELEVATION 1NFORMATIOh (SURVEY REQUIRED)
C1. Building elevations are based on: Construction Drawings` LjBuilding Under Construction' 'JFinished Construction
`A new Elevation Certificate will be required when construction of the building is complete, - � I
C2. Building Diijgram Number __t_ (Select the building diagram most similar to the bi iildin>efb%A ch this cenif �t.is,MCA ig completed - see
pages 6 an:9 7. If no diagram accurately represents the building, provide a sketch cir photograph.)
C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, Vi -V30, V (with BFE), AR, AR/A ARAE, AR/Ai-A30- AR/AH, AR/AO
Complete Items C3.a-i below according to the building diagram specified in Item C:'. State the datum used. !t the datum is different from
the datum Used for the 5FE in Section B. convert the datum to that used for the BFJ--, Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Sectior G, as appropriate, to document the datum conversion,
Datum_ Conversion/Comments
Elevation reference mark used Does the elevation rete rhe mark used appear on site FI Yes j I No
O a) Top of bottom floor (induding basement or enclosure)W� �0
O b) Top o' next higher floor Q` �- _{t -(m) n Q@
0 c) Bottori of lowest horizontal structural member (V zones only) ��h.(mj 4�' D
O d) Attached garage (top of slab) £ 9
0 e) Lowest elevation of machinery and/or equipment l W " /
servicing the building (Describe in a Comments area.) Lfl J _ft,(m) E a r0� C-24176 �
0 f) Lowes- adjacent (finished) grade (LAG) - —ft.(m) Q EX, 1213fl05
O g) Highe!;i adjacent (finished) grade (HAG) _ _ff.(m)
Q h) No- of permanent openings (flood vents) within 1 ft, above adjacent grade_ J 4 C VIL
0 i) Total a -ea of all permanent openings (flood vents) in C3.h sq. in. (sq. cm) �F p�1Fo
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certifiratien is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certifyelevalion information.
l celTify that the information in Sections A, 13, and Con this certificate represents my best efforts to interpret the cata available,
1 understand that any false statement may be punishable by tine or imprisonment under, 18 U.S. Code. Saction ID01_
LW
17FTAA Frxrm ilf1.%1 ,till nn CFF RF\/:RCF CI
NC.
rr)NTINI iA-WW RFP' nr,F:CAI I PRFVini IC:i1r'r1r1NC
FROM Feiro Engineering, Inc. FAX NO. : 760 346-254E Oct. 18 2002 04:07PM P2
{MPDF2TANT: In these 5113c", copy the corresponding information from section A.
Fa In. ur-dnce Company Use:
9t1iLU{NG STRE E. ADDRESS (including Apt., Unit Suite, and/or Bldg. No.) OR P.O. ROUTE ! ND 130x NO. Pcticy Nu'nber
ZJP CODE Cctnparry NAIL Num{xsr
SEE I C�
CITY ° +� ���
SECTION ►"- SURVEYOR, ENGINEER, OR ARCHITECT C1:RTIFiGATION (CONTINUED)
Copy both side of this Elevation Gertificatefor (1) community official, (2) insurance a aenUcompany, and (3) bidding owner.
a r • (� n °
check here if attachments
C� l Lam.
SECTION {_ -BUILDING ELEVATION {NFORMATION (SURVEY NOT REQUIRED) FOR ZONE AD AND TONE A (WITHOUT BEE)
For Zone AO arab Zone A (without $FE), complete Items E'1. through E4- if the Elevation Gertif icale is intendedfor use as supporting
information for LOMA or LOMB -F. Section C must be completed.
E1. Building Dir gram Number �� (Selectthe building diagram most similar to the tuiiding for which this ceri3�cate is being completed —
see pages 6 and 7. tf no diagram accurately represents the building, provide a sk Ach or photograph.) t t� above or below
ro n.
E2_ The top of tile ft.�e bottom floor (including basement or enclosure) of the building is jJ j ft-( ) j _U!— { ) !—�
(Check one; the highest adjacent grade. (Use natural grade, if available-)
E3. For }3uildinr piagrams Cr$ with openings (see page 7), the ne)d higherfloor,or ele,•ated floor (elPvation b) o' the building is
1J-1 ft.(rn) L"in-(cm) above the highest adjacent grade- Complete items C:i.h and C3J on front of form.
E4. For Zone A0 only. if no flood depth number is available, is the top of the bottom fl.)or elevated in accordance with the commvnity's
floodplain management ordinance? j Yes j No j.�/,j Unknown- The local )fficial must certify this in:ormation in Section G.
SECTION F - PROPERTY OWt4 R (OR OWNER'S REPRE>i=NTATIVE) CERTiFIGATiON
The property owner or owner's authorized representative who completes Sections A, B, C (Ilems C3 -hand C3a only), and I= for Zone A
(without a I= EN•A-issued or community -issued SFE) or Zone AO must sign here. The stafemenrs in Sections A. B. C, and E are correct fo
the best of mE knowledge•
PROPERTYC)V N�R OWNF�R' q� HT1 1 )ZEU i�£PRESE ATIYE'S NAME.
COMMENTS —
Check here if attachments
SECTION G - COMMUNITY INFORMATIOl7 (OPTIONAL)
The local Official who is a••lth°nzed by law or ordinance to administer the community's floodplain management ordinance can complete
Sections A, B. t: (or E), and G of this E=levation Certiflcale_ Complete the applicable itt;rn(s) and sign below.
G1. )_j The irtormation in Section C was taken from other, documentation that has bean signed and embossed ay a licensed surveyor,
engineer, or architect who is authorized by stale or local law to certify Qlevation information- (Indicate -he source and date of the
elevation data in the Comments area below.)
G2. j—j A aorrunuoiv ficial completed Section E for a building located in zone A (witioul 2FEMA-issued or community -issued BEE) or
G3. j�') ThR otlpv gan%gnation (items G4 -G9) is provided for community floodplain management purposes.
C-4. PERMIT tJl )AtStR VS DATA PERMI ISSUCD G6. �AJTE CSR rIPICAI r_ OMPJOCGUPAN Y
tSSt_ ED
G7. 7nis perms has then issued for: j_j New Construction jJ Substantial Improvement y m Datum:
GS- Elevation c9 as-buift lowest floor (including basement) of the building is: �rt {m)Datum:
G9. SFE or (in Zone AO) depth of flooding at the building site is:
I_ zOFFIC NAMe 71TI 1=
COMMUNITY IiAME T)✓LEPHCNE
51GNATURE DATE
C OMMENi�
y Check here if attachments
-T - W!P1 Ar =q Al i ppp\jlnl tc FnITInNS
FT=:UA i n nn
AVID LI & ASSOCIATES
i1LA4ai997RiVCr &4L =
$4,i8 N San Gabriel Blv&, Suite B
Rosemead, California 91770
• o sw.trer sartno� ci► scorn
N
tD
F.?OJF CTp
AACIIIIII
v, - ler-
STRUCTURAL STRUCTURAL
('To be used in addition to
(M) 318-2616
JOB N—B
0.
,� (?60)6IWAnh=
'
Awt
neseRVE _ --Tlw
PRMV= _—_FirPAE V19rr
Jn --
tA —
-3cHOALc9MUfSREG E)II146PROW;ESSOFVlD.il AND
0014PUAN GE YAINI TN E STFPJCTIJRAL pLa
YES NO F+fA
TWOF�uRsperDteee._..___......�.._._._.__._._--•--•----j1Y O. —O
FblesFbrA otseoloveldrlYefL ._. _❑—_-- O
Ezra id2t oreleoNCoerdtxttlDklltle _ --0
9N sits Site at a4earwa_.
Defeo 64A 8 tlemarl's
:=� 6
.a
:c b ES O AA
1st
Stud%Ie�retasrrdtulrbearing_....._..._.....__._.._. ❑____{Z
:'c'
awk in sit" at eels vw *V405
ed� .._._....._...
• o ay u Eara wpods et wide cpe6ngs......... .. _ .._._—_ _D_O _ D
C.- Header 6 Dv Sim prepaty cl
Xing awdloan arldtopplan aelkrl/onrerred..-__-_—• ,,Q D 0
Ask* waft
• N CaM9uaue ids a1 taY vralLs.
c Slaa' 1troOs lalft.etl.� fn-�fQ�,�#' tad F1r. f,j OWL
M-.-Occa.YwAr•h _nrty.o� r,� Kf`Mn4MP�.+
o rty' . .
OBSERVATION
grand Safely forms)
/z, - 03
.►*19 M*edelbeeftsgnrta.-.W__w..
Simic n011+d tr dWw n Ivvi oe in claw diol_ _.
,JoFgs be++gea ane prgpan �r?®arrH oxo grs ...._ _ •-_ __.--�--....__D..,,.. _._Q'
rale aqd__
81=1113 Instated adagstrapbcecros.___ __. ._._Q.__w.
llddeaJafualpare1Olw+tswaar+)fons...____...�, —.._fl _.Q
Fbat�lealfli►g�T3+G}aCtodmdSproPalOna._.._. �.._.{,.__-(,._�_�$01*
/
E,+ejo6�soasna,tfi�etcener�fjo-sawerVea__._____Gl_.._O__.
"cd edge rat wMad toibWertlotla
sbew wall bstow
Froe1 frertdnp
shagdngtnicfim" Galla
Defect tooeien dAarq ft
S11earTansher.._._..�_..._._—.__.••--••��•••• -__
Aatssrs grope ytut Far fig baaane..___. _d.i�41�2—. _ _....._._
cavd two me vActeaa of 0=1*1g_
Ftbdringpr b�lrlpAreFatod belwaeeljDitt__._.._...._.._......
FI 7yF.o'Y.Ir Sw k" 40 "40
Aosffita=r .'_:_..fi�_.
gceh4 tkY'--f-O—
Grade
Deftal lca&&&d Rvaairk*
Meand*wspaopaydad errdsIlo.._,.._..,.__
prerido e. aorifteus ab betwesn eMevwalk
030d me mon eepatimcwtof taco/ant
.�pl
properlylad tc""
Defe51 tacalton d Rem-
YES NA
--0 (]
IkMS&$
P�110Mr+Y�tQw�rW, V -C ro— wwc1 tiM
N
FROT': : JR*S C ' ORLAND CE
J
Sp
i
FAAY'NO. ; +310 545 3035
P.
Jun. 07 2@81 08:58AM PS
IA"
N
1
1 1
{
1•
i
l i
��pOOOg
C]O�00o
TTf�
STJtVCrURAL aAsE:R v rrrpAV' 3 'a s S PAN-ELS
- �' azu,�,u� miecoexa
SAO= rorarrXAM
5 �,Aptr��ODnu�tfa�wrt6wn�srs .. - .
WRrDs7`Ar1r�IKaM�1E
,ott�i�r�i���s,t�usttt��ga�x��•
rnr�toac� r-AO-s 0�0�rG� `-BSf� Oaf
+ • C��.A1u4COM�'701�5 •
MffAP rtX&L 1WWXG
'T, ,TQ`��j���orgvslna�•�tta» - - .
�I�OdaDbMIV aQLl9 llOBrtJVIA -
�[e// 6DQa�6tILlMCiTbI/DLaDOiWPOtST .
. .�xsocerrar�s oN corcR�r� .