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0108-154 (SFD)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 # Lic. Class f '' Exp. Date o9/30%C Datej 2�- - � � �"( Signature of Contractor � w• 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 & Professionals Code). ( ) I, as owner of tAe 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 Sianature 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. P,�') 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 STATEFUND Policy No. 1640366-01 (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 laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code i shall forthwith comply with those, hose,proviisions. fl ! 1 'at.• :--• 2-11 '0 t Annnnnt ? /. ,.I, / 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, dam' ages 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 person 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 relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspectionfpu�poses. Signature (Owner/Agent) , /t Date[ r • Ji • BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT fJOB SITE ADDRESS 7849() C.()�'r,��T 4��31'dY()�1 Ev() APN 7,70-240-013 OWNER CONTRACTOR/DESIGNER/EN INFER RT NYM JACK MIME, OL'.Em PO BOX 8963 V0 BOX 1802 RAN M. I SAN A.�'. CA 92067 ;IJAJ.a.1fi.DXq.F.. �',a. CA 92260 A))8:36-919' CM114 5123 USE OF PERMIT 8 1C?1 1< F ItAffl, Y DvXS'wwo. S.i+') - PERMIT DOES 'NOT ;tNC:1,1'r,SU)tifSW£:1�.VA7.ih.1 ,..r511:?R TV LI`iA!AY APPROACK COMP111AIVNC`C7. W TH AIJ., VED & I&'W1'1i;1tiANW4 r14CL k, -H ANC 1FX, ZD SPM, FS ACT OF IM IF APPLICATiL fi IS P.1C Q';D CUSTOM CONSTI UC' TION 4T"51001111 F'ORC HIP,A'!"I:O l,ti.woo sir CIARA0EICARPORT 1,113100 SIF rIkR41:�s03) COST'OF CnNSY.RTYC"�l'YN 415.7 .10 �+y. y�''y7,qq //��^^d gfq� �.v ,yv�I�'r'��//q�,,.AI, �p•A q3�q��9 C(IINVrRUC TION FEE 101-000-1,18.000 si:14515ff PLAN C'RE01C FEE 1011_000k439_318 1 $1,45113N FF.E0EPOISIT 301-000.439-318 -$1,000.00 MF.C".HA.NICA1LVP7, 101.000-421-000 $1 &CO :LEC:'! RIC.;AJ , M7, 101-000-420,-000 $2001-4 PLUMBING PEF, 101-0010-419-000 $316.85 STRONO MO7110N I%W - DOSIS 101-000-2 41-000 141 OFtADIND FE -F, 101--000-423-000 $70.130 VEs'V&OPQ IMPACT RE 11,9T1,00 :A42'! IN k UB1:1C; Pl.Al: PS -•ttf7��31I :730r0OO-443-000 DEC 2 8 20111 ___...-_ ---- t z w t RECEIPT DATE Y,� f' I BY 16� FIN4QED'C�� INSPECy INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs/L AUnderground Ducts Forms & Footings ( Ducts Slab Grade -- G� Return Air Steel Cn bustion Air Roof Deck • O Exhaust Fans O.K. to Wrap •O 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 2, _ Final 2 BLOCKWALL APPROVALS Final Z 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 Water Piping / /— L/ . Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection _ _ Pool Cover Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) r�� 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 6 Final 2 O Utility Notice (Perm) COMMENTS: -11 Building Address 764°10 6dq 6M � J �-f Ownerp) Q�7 MJ • >r MYS • j4C� M A Mailing d • g ) Address City Wto q sIc TAS£1'ji 20 G'7 Contractor , `a 6F_` e -r_ y� N �7 ! Aaares /` I ty State Lic. & Classif. \ / Arch., Engr., (X. Designer Address ty� AA f lt„ BUILDING: TYPE -CONST OCC. GRP.r7 P, -'s A.P. Number r -1- / 7Q'')_gLD_ 0I/ Legal Description L•-oT- 7� 1 ;Zbg7f0'' Project DescriptionLF_. I-1 r- Ir /A -r HI= n C U C, - b A./1 V4 A t,A F _ Lic. # Sq. Ft -.4674 • � No. I No. Dw. I Size• • Stories Units el. �2 MIT -Am Zip- State 077, jc.# 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 OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a permit to construct, atter, 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 the provisions of the Contraetor'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 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). l'! 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, 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.) 1 1 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law doesnot apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License law.) 1! 1 am exempt under Sec. B. & P.C. for this reason Date owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to sell -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 1`7 Copy is filed with the city. 0 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need nor be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thQ 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., H. after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. fSec. 3097, Civil Code.) Lender's Name Lender's Address 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. 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. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip New)( Add ❑ Alter ❑ Repair ❑ Demolition O 1 n IEstimated Valuation *700000 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOU ZONE: BY: Minimym Svtback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line St de Street Setback from Center Line 1 2_0 Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Notice: Document Cannot Be Duplicated Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE Date 12/19/01 No. 22775 Owner Name1W & Mrs. Jack Smith No. 78-490 City La Qunita street Coyote Canyon APN # 769-162-001 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Tract # Lot # Square Footage 4875 Type of Development Single Family Residence No. of Units 1 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 or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.05 X 4,875 or $ 9,993.75 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 CC/La Jolla Bank - Joe Portolesi Telephone _­ Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Payment Received $9,993.75 _ Check No. 841901 Signature NOTICE: Pursuant of AssaImbly Bill 3081 (CHAP 549, STATS. 1996) 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 runfro the date on which the building or installation permit for this project is sssued or on which they are paid to the Districts) or to another public entity authorized to collect them on the Disbj (s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting Tradition August 28, 2001 Mr: Narendra Patel, Architect 69-730 Highway 111, Suite 118 Rancho Mirage, CA 92270-2873 Re: 78-490 Coyote Canyon Dear Mr. Patel, The Tradition Architectural Committee has reviewed your submittal of construction drawings for the Smith residence. The plans were approved as submitted. The landscape plan is in process now of being reviewed. I will contact you with the landscape review comments when I have them Thank you for your submittal and patience in our review of the plans. Construction cannot begin.until the $5,000 construction performance deposit is submitted. The check should be made payable to: Tradition Community Association. Please call me at 346- 1161 if you have any questions on this information. Sincerely, M Mindy Gutierrez, Property Manager Tradition Community Association cc: . Mr. and Mrs. Smith PCM/DESERT RESORT PROPERTY MANAGEMENT COMPANY POST OFFICE BOX 4772, PALM DESERT, CALIFORNIA 92261-4772 • 73-550 ALESSANDRO, SUITE 5, PALM DESERT, CALIFORNIA 92260 PHONE: (760) 346-1161 FAX: (760) 346-9918 KNAPP & TANG STRUCTURAL ENGINEERS, INC. 408 S STODDARD AVENUE SAN BERNARDINO, CA 92401 (909) 889-0115 Fax (909) 889-0455 July 18, 2002 To: City of La Quinta Building & Safety Department Re: The Smith Residence Lot 55 Traditions C.C. La-Quinta, CA= - 7Y►- ygo co `csi �e c �� � On july 17, 2002 I performed a structural inspection on the subject residence. I found the construction to be in substantial compliance with our structural plans, and of quality craftsmanship. I therefore, am recommending that the contractor be allowed to install the finishes. Respectfully submitted, �Q Q�ESSIO4j;-"! C - k� C 3(577 m l/ c� No. zo Exp- 3-31 04 �r Leonard C. Knapp CMS- Engineer of Record T'�TF OF CA`\COQ' CITY OF LA QUANTAaK SUB -LIST 4741 C PALM CANYON, VALLEY POOL & SPA PALM SPRINGS CONTRACTOR ADDRESS OWNER SMITH JOB ADDRESS 78490 COYOTE CANYON DR This form shall be posted on the Job with the Building Inspection Card at all times in a conspicuous place. It is the responsibility of the General Contractor or the Owner/Builder to monitor the sub -contractors that are on this list are the same persons performing the work. Any changes to this list must be approved the City of La Quinta Department of Building & Safety prior to work being performed by a changed sub- contractor. Failure to comply will result in a stoppage of work and/or the voidance of building permit. LATHING C-26 ....:...::.. ...::....... DRYWALL SUB -CONTRACTORS TYPE:OF .::.... S: A'IE:'::>>RK T..::..>:;:..::...;:;.: E R..S: U51NES& ` 18 . TRADE :. NAME:; : ::....:....LICENSE:: 8/7/02 HVAC C-20 ELECTRICAL lGenerall GATTUSO POOL C-10 6 7 2 8 5 0 816A ROOFING C-39 SHEET METAL. C-43 FLOORING C-15 GLASS/ GLAZING C-17 INSULATION C-2 SEWAGE DISP. C-42 PAINTING/ DECORATING C-33 TILE C-54 CABINETS/ INSTALLATION C-6 FENCING C-13 LANDSCAPING. C-27 POOLS C-53 OTHER J & L 472187 Qq P'ti 11�_ 12/9/2001 0_5:36 8369197 ORANGE COAST 7603406455 AJPORTOLESI PAGE 02 12/07 101 11:43 NO.417 02/U4 .:'�.�s�!f:„••.,.w�►+�wr.wrwirtr/1��w.�wnoa+llM ,.wr w.w.v►rww...w.•� � .r..�.n • •ue.��.^ ..... ....�o.�....,.�.--....,.�.�...,.,.�..�.� ,w..-.�..r.�--.w—�•� ..• .....-►..«,.fir. i..-. tj taw .1 .. .. .... � -- - .. . ,. ,. ...��a•.. x'10 -:-y�o -,.o� � R@Cbldirlq Requested BY NO COR FILED 4659 6 y T NIatMII■1a111� �qoa Comp�lb _ arra. zos�o3s-�� �c � a NIL 19 1817 AAD IN RSOOAMAML TO. PAID DECG 4 fI tr o . Sa t c h 000. TtEtsIM To � 0. Box 8941 r Z� aeho Sant* re, CA ' 92067 �� � , POCt1MEKTARY TILUREM TAX $. .�.. fix.. as a ainvidwadoft a WON erptopaq ey OR %Ma AS ABOVE w Me awWwadw er tduf bac Uns or mteme�.v*oM aa�risbj to tlm cf elb 7 70 - zw 413 *�+ r<o..Iw>.� Ayntt ddtt nut.P$to Nami ►= o2aols a�IAlrre>e� t A VALUAMI CCNi>1DJMAT K me* at mWeb In ben by .ergo«Wg4 LDrrMN CLUB ARROCIATU = a Dwk.ran Hmbtd IbWft aWnpwy b`v)t0 Jack C. smith Jr. and Christina A, Smith. Trustees vt the trh ra,t&Zy Tru#t UPOT dated Babruar•y 5, 1997 +•l ply bt dw MY of Ld Quin" OW of Ithwai* fto stwhMik da "Red u Lot -3-5 'Ram 2f*70.1 (ape IlXM* W- AMO&W HMto) December 6. 1997 r of C LUANaw ) ) o. ) malty blew+ m me (Of peeved Is is op 4r a 0+itt6atory neat) to bo dw pmoeolq wlpw rton(p Wwn mr>wter{"d to the b+ f�toet as/ aAmevrlwipd b ore dW 6o/�tYey arsenbd the t to bislWAI.k rahedpd eapaeity(LML am am by hk4w ek. tUM+q) a do bAw !o patroa(0) w do wuq �rpon b bdir of ih du Ponce scM4 tlowoted �r irsva+rm. TitAO LLC eK Aur / te� Its,, Aaiun g N4/ aviagaor DR t t . (M MM fm GMW MMEW Mal) Orders MC-0000o09MITA psscriptionr 1997.463956 Page 1 of 3 CoiQment. t 12h9/2..001.05: 36 ORANGE COAST 8369197 • 7603406455 AJPORTOLESI PAGE 03 12/07 101 11:44 NO.417 03/04 .�..--.+r..�.-•'--•-•.r... �- � .r.�r-•--.�.....�, wr..� v �.-�.4�w,� r rte. _ �....._� .�.V � ii vt._ . ...I. r..� .. ... ..� �... � .... �.N.�I. ... .. ... .....-. r• ...� �.---� �.�- ..' IIS ..� 0r wool"juee�ad BY 465956 T ? .. ..�....�.,�., rte COR MED•'_ .� Un ss --of Traet 29470-1, a 9imm by map on IDe in b6ok 263 papa '76 through 90 of maps, neon of Riverside County. Cali fomla. T81S DEED 13 MADE AND AMPTII:D SUBJECT TO THE FOLLOWINCt 1) NozmMhtqutttq rod "ate UX -8 spassmanta. 2) AU nutters of record, including without limitstlon, that 611111 DMInatlon of Covsrgants, Cotod Oona, ReWiction turd ReWvWon of East MIts !br tit Ty'o 6011 Community, recoMed ou )uly 25,1997 ss Insu unarm No. 262677 tlrtd re-recordcd August 13. 1997 u Irutim"an no. 292116 both of Official recank of Rlvmide County. Calir*mK which Is Incorpototed by TIAN Once; berein a if 11g11y at forth at lettdth (1116 "Doolarstion'7. T%g Dsctat'elion includee, mnons other matters, certaln architectural gold development guidelines and restrictions L vddvh will apply to the conrTtruatien or a trrsidat+a on the above-described lot. Ordarr MC-000000SMITH Description: 1997.4689$6 Page 2 of 3 t7orssmontl ,12AM/2001 05:36 8369197 AJPORTOLESI PAGE 04 ORANGE COAST 7603406455 12/07 '01 11:44 NO.417 04/04 • •w,lu.� .r,�• ,rr_.•��_....�n.ti e... .. �. r. xttnt.•1,.:�arr-:.n'N'•Irr�.T.�Y1'S'. vv:-'s--aerr.dr••• w::rse�r' .�-w-6t-� ., �:'Ir Under the pro.►isiou of Government Code V361.71 1 cerftty under tate penalty of perjury that the notxty teal on the doeuffWt to which this stat Wra t is attsehed reads as follows: Name of Notary 091, Data Coma4slon Expb= ...►? Q-0 -- f Place of Execution let `'rralIP L.,0> Dom Slestiat�rc � �Ar • L� - r �� j a Orders MC-000000OUXTH DWscription: 1997.465956 Page 3 of 3 Comment: VERIFICATION OF SQUARE FOOTAGE STREET ADDRESS OF JOB: 78-490 COYOTE CANYON APN: 769462-001 DESCRIPTION OF WORK: SFD SQUARE FOOTAGE: 4875 SF OWNER'S NAME: MR & MRS JACK SMITH CITY OF LA OUINTA BUILDING & SAFETY DEPT. APPROVED DATE Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA92253 760 7718515 SCHOOL FACILITY FEES COLLECTION HOURS 9.00 A.M. -11.30 A.M. 1.30 P.M. - 4.30 P.M. PLEASE NOTE FEES MUST BE PAID IN CASH OR CASHIERS CHECK Any questions regarding this letter, please call. Ed Randall, Permit Technician, Building & Safety Dept., 760 777 7012 EGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE STRUCT. STEEL ASSEMBLY ❑ FIt,$(l A--**) ❑ POST TENSIONED CONCRETE O ASPHALT ER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LO TI (] /' CA� o REPORT SEQUENCE NO. TY O�SJTURE /'� PERMIT N0. DA O AY OF WEEK MATERFFff111�,/ALESC${PTjON -A-5-3 � ��� . ARCHITECT IN MRS. CHARGED �`� D �/ , ^ ��• CJ ENGINEER N ii ^ (/- ASSISTANTS MRS. CHARGED INSPECTION RAL oArO e'& ( CONTSUB DATE CONTRACTOR ` CONTRACTOR RACTOR i -\ w J C Al 16 r— ' ' s6LA 0-r, ICA -een- 641 LA.) e-,- 8 AI;� e.c�S w o�e.s EJ Cow-,06/Ax O COPY SENT TO CLIENT ❑ CONTI ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS SI ATURE OF REGISTERED kPECTOR DA Tq Of REPORT REGISTER NUMRFR G REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED 0 REINFORCED CONCRETE 0 POST TENSIONED CONCRETE 0 REINFORCED MASONRY O STRUCT. STEEL ASSEMBLY 0 O ASPHALT 0 OTHER 0 FIRE PROOFING JOB y�A1Q�N� i1i1F�StliYJ1(YiE-S /( n ,07 � LA au `n REPORT SEQUENCE N0. 7vS�� RE! ` ,, n � `IKEA PERMIT N0. DATE DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT INSP C HRS. CHARGED ip_-? -Q ( V ENGINEER o• oo ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL ��.1 CONTRACTOR R' J QI �S ( SUB CONT RACTOR w f4 &TSS ib S l e, ALSS J: 03 COPY SENT TO CLIENT 0 CONTI E ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. I IGNATURE OF REGISTERED IN PECTOR o leo Via- >" ATE F REPORT REGISTER NUMBFR lots 3.1 It ®R W ME = 0 &1 i i -10 REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE '9_§TRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING ❑ ❑ OTHER JOB LOCATION -76-Lf /6-Lf Ro C4DVOTC e Y) o4d LAG/`J ^u it.., REPORT SEQUENCE NO. TYPE OF STRUCTURE a SSD S'xdW S ®77`�� r� D! ®��' PERMIT NO. DATE 4- DAY OF WEEK MATERIAL DESCRIPTION E -7v 8 ARCHITECT F-siro DeVEiOmWT INSPECTOR p-,1�, HRS. CHARGED ENGIN R _ „ ^ • ` ' ( ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL SUB CONTRACTOR CONTRACTOR e 1 6"t-'716- �a-rr we���•�rG �`C/Cf f /.a. D e -7-A ► -S-3, ► l W E)Q-4 P XrS S. hd o- moo?" o C9 uP.S 1--7-75 COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE J OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. -0- 5�>' b O -L - SIGNATURE OF REGISTERED INSPECTOR �- r - o z ==Cao / Ir/1.71.(. -8s DATE OF REPORT REGISTER NUMRFR s REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE STRUCT. STEEL ASSEMBLY ❑ -% (�o 40 ❑ POST TENSIONED CONCRETE ❑ASPHALT HER ❑ REINFORCED MASONRY O FIRE PROOFING 1N JOB L T _ f 0 Co f ' --p- w �_ _ KANO. + `1T REPORT SEQUENCE NO. T E fF SLId URE �` /� _ PERMIT DATE DAY OF WEEK MATERIAL DESCRIPTION / `n'Y-►��•'Ca� A , ^3 N J ARCHITECT R HRS. CHARGED _'"'') LL,� ^'` ��• ENGIj ASSISTANTS HRS. CHARGED INSPEg SUB DATE CTION CONTRAGENECTOR ?o IKr\ O C es' `( CONTACTOR 1. S (-=12 - 2 kS e'-",4 Bb l 6.1 CouS— A- i 4. wN-�- OOZE, -o , w�.5 U •T� LA--'A-be- C l A C - -MA CJftk--' SIJs &M () 7, U ?iC.A e,(A. 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