12-0531 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-00000531
Property Address:
53533 VIA PISA
APN:
772-530-045- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
27000
Applicant:
T,i&t 4 a v Q*&
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
PERRY
53533 VIA PISA
LA QUINTA, CA 92253
Contractor:
TESERRA
VOICE (760) 777-7012
FAX (760) 777 -7011 -
INSPECTIONS (760) 777-7153
Date: 5/14/12
tA\
III
P
.O. BOX 1280 MAY
COACHELLA, CA 92236
^ (760) 398-9222 CITY OF LA QUINTA
�1
Lic. No.: 656128 FINANCE DEPT.
LICENSED CONTRACTOR'S DECLARATION .
I hereby affirm under penalty of perjury th t I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busines and ofessionals Code, and my License is in full force and effect.
License Clas . C , 10, 27, 2 License No.: 656128
ate: / s .Z_tractor:
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 requkes a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she 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).:
(_ 1 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, 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 is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) 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 notapply 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.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I 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.
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 and policy number are:
Carrier EVEREST NATL IN Policy Number 7600006481121
_ 1 certify that, in the perfor ce of the work for which this permit is issued, I shall not employ any
person in any manner so a t become subject to the workers' compensation laws of California,
and a e that, if 1 sh, ul ome subject to the workers'. compensation provisions of Section
2NG:
7 of the Labor Code, I all forthwith comply with those provisions.
1Date: plicant:
WAR 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 1$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 Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 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 to the work being
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 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 thKgonstruction,
ation is correct. I agree to comply with all
city and county ordin cas and state laws relating to and hereby authorize representatives
of this county o e upon the above-mentioned prpurposes.
/eT:
17—S' ature (Applicant or Agent):
Application Number . . . . . 12-00000531
Permit
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
265.00 Plan Check
Fee
172.25
Issue Date
Valuation
. . .
. 27000
.Expiration Date'.
11/10/12
Qty Unit Charge
Per
Extension
BASE FEE
252.00
2.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
13.00
Permit. .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
0.
Expiration Date
11/10/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH FURNACE >100K
11.00
Permit
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45.00 Plan Check
Fee
11.25
Issue Date
Valuation
. . .
. 0
Expiration Date..
11/10/12
Qty Unit Charge
Per
Extension .
BASE FEE
15.00
1.00 30.0000
-------------------------------------------------------
EA ELEC PRIVATE SWIMMING
POOL
---------------------
30.00
Permit
PLUMBING
Additional desc .
Permit Fee . . . .
33.00 Plan Check
Fee
8.25
Issue Date . . . .
Valuation
. . . .
0
Expiration Date . .
11/10/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00- 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, INCLUDES 198
L.F. 2" GAS LINE.
LQPERMIT
Application Number . . . . . 12-00000531
----------------------------------------
Special Notes and Comments
-----------------------------
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS
ADMIN (SB1473)
2.00
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 369.00
.00
.00
369.00
Plan Check Total 198.25
.00
.00
198.25
Other Fee Total 2.00.
:00
.00
2.00
Grand Total 569.25
.00
.00
569.25
LQPERMIT
7.
INSTALLAT-1�1� CERTIFIeAT
Eoal And Spa eatin "Systems
CF-6R-MECrt-03.
`�ite/A-ddress:
S3 EnforcementA Agency: a e F of6
g` Permit Number:
FooE and Spa Heating Systern
Systems Ind Equipment. g reel t it-et�teeteg
�1. Heater has a thermal efficiency that complies with the Appliance Efficiency Regulations.
d32. Has a readily accessible an -off switch mounted outside of the heater.
. Weatherproof plate or' card containing operating instructions for the pool or spa he
Q'4. 'No electric resistance heating except for listed package units that has fully insulated e
covers that are insulated to at least R-6. Or if documentation is provided that at least 60 % of the annual head
energy is from site solar energy enclosures and tight fireing
I
Ce, energy
Heating system has no, pilot recovered energy. ng
I "
I§114(6}: Installation.
F - System is installed with at least 36" Of Pipe between
or• built-in or built-up connections for future solar hthe filter and heater, or dedicated suction and return Imes,
A cover for outdoor pools eating.
or spas that have a heat Pump
or gas
U'3- Poo[ system has directional inlets to adequately mini thepool water P ter
Ea'�4- Time switch which will allow the pump to b6 set or programmed to run during off -pea
I §ISUonly
(p) Put" SiEing and now rate specification k periods y
I
C6� 1 • The Pump specified is listed in the CEC database of certified pool pumps.
�2. The Pump flow rate shall be calculated based
I �3-
The pump is capable of opera ng at 2 or more speeds on pool sizing table below-
ti
4- Each auxiliary poo[ toad is reeved by either a se (no
t applicable `-f pump is less than 1 horsepower).
Pool sizin
parate pump, or the system is served by a muni -speed pump.
aEtfes are based on a erssr_imum allowable turnover rate of 6- haters
Max Pool
Volume Min Pipe D or Greater
j allons) Min Filter Area or more
inches Max Pump
Returns uare feet Sand Flow m
13,000 1-5 Suction Cartrid e DE
17 000 [ .S 100 2 4
1.5 2 20 36
21,000 2 130' 3.1 25 47
28,000 2 I60 3.9 30
2 2.5 59
42,000 2.S 210 5.2. 40 .78
48;000 3 320 7.8 60
3 3 117
Note: For purnps greeter than I hp. 8.9 70 133
p The rmaxamum P 360 ump Flow is the lowest speed default filiratio,
Calculated volume of poo[ Z
(gallons).
6. Return Pipe Diameter % s"
ET"7. Suction Pipe Diameter (inches).
11'8. Filter Type 2 (inches).
9. Filter Surface Area p (Cartridge, Sand., DE).
50 0 %o,
------------
9'10. Mak Pump Flow
g (gpm).
2006' Residential Compliance Fo,,,
August 2009
iRjSTkl.Lk F TON CCFxTIFFCye � E
co! %gad s a >`3eatin st
etrts CF-6R-l�C,g 03
{ 3+te Address:
3 E fOrcement Agency:
�a e i of 2
' Permit Number:
System piping
QUI JC74
Cl' 1. The suction side pipe is straight for at feast 4 pipe diameters before entering the pump ('See table below for the
required straight run lengths for various pipe sizes)
2. The design uses low pressure drop fittings (sweep90's)
Pipe Diameter Required Pipe Length
inch leaditi into um
i I S inch
i 2 6
8
I 3 12
Filtration Equipment
D�1. If a backwash valve is used: The diameter of the backwash multi_ ort,v�
circulation pipe, whichever is greater p alve 'is 2 inches oras large as the
^//ie
OECLARATION STATEMENT
iI certify under penalty of Perjury, under the laws of the State ofCalifotnia the information provided on this form is true and correct.
jam eligible under Division 3 of the Business and Professions Code to accept r
representative of the person responsible for constnecdon (responsible p °nsibility*for construction, or an authorized
e I
certify person).
fy that the installed features, materials, components, or manufactured devices identified on this certificate (the installation
r conforms to all applicable codes and regulations and the installation is consistent with the plans and specifications approved
i enforcement agency. )
° f reviewed a co by the
copy of the Certificate of Compliance (CF -I R) form approved by the entorcemene agency that identifies the specifac
I requirements for the installation. I certify that'therequirements detailed on the CF -IR that apply to the insthat adeno
€ will ensure [flat a completed, signed co
ve been.
pet'mit(s) issued for the building, and made available to the enforcement agency fol all applicable inspection..aI u derst et:
pyo this €nstallation Certificate shall be posted, or made available will, the building
that a signed copy of this Installation Certificate is required to be included with the docurneatation the builder provides
the building owner at occupancy. rind
ComP�y Nares P es to
Qnstelling Subcontractor or General Connector or Builder/owner)
R risible Perso — arn
?luo _ Responsible Person's g tore:
CSLB License:
M.I L
Z 8 Date S ned: Posit' With Com
/Z Z / 2 any (I rile)
6
2008 Residenrio! Compliance Forms
August2009
Bin.#
City of La Quinta
Bu11d1119 8I' Safety Division
P.O. Box 1504, •78-495 Calle Tampico
1a.Qufita, CA 92253 -:(760) 777-7012
Building Permit Application'and Tracking Sheet
Permit #1
J `
ly
Project Address: J 5 33 1 1 S�Owner's
Name:. --
A. P. Number.
Address: S 513 I 64Legal
Description:
Contractor:'
A
City, ST, Zap: (_A �1NT CFr Z$ 3
'
Telephone:
Address: 1b /00 A
Project Description:
City, ST, Zip• %i'r.LL-, 22 3`�
4 "L G 'r044E LiWE:
Telephone: �(p 3/ 8 y2 ZZ \•
V O ISM
State Lie. 4: s �/ CityLic. #,
Arch, Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lia #: '' x
Name of Contact Person:qLA
N .0M Z
Construction Type: _ Occupancy:
Project type (circle on New Adan Alter Repair Demo
Sq. Ft.;
# Stories:
# utdt$:
Telephone # of Contact Person: C O .Z. S O 2-3 /,4
Estimated Value of Project Z2Z -0(00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRACKING
PERMITFEES-
Plan Sets
Plan Check submitted
Item Amount
Structural Cates
Reviewed, ready for corrections
Plan Chcct Deposit. .
Trus Cates.
Called Contact Person
Plan Chect Balance_
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechariicd
Giading plan
2•' Review, ready for correctionstissue
Electrical
Subcoatoctor List
Called Contact Person
Plumbing
Grant Deed
Plans plektd up
S,M,I,
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'" Review, ready for correctionstissuc
Developer Impact Fee
Planning Approval.
Called Contact Person
AJ-P-P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Peron Fees
POOL EQUIPMENT 50 AMP SUBPANE L
WITH 30' CLEARANCE AT FRONT AND SIDE
POOL EQUIPMENT: 400,000 BTU HEATER
'ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED
ELECTRIC CONDUIT
198' - 2• POLYPROPYLENE GAS PIPE
AT10N OF POOL SYSTEMS AND EQUIPMENT WILL COMPLY WITH
4114 -MANDATORY REQUIREMENTS
4RMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS
POOL
EATERS / PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURERS
NENDATIONS AND IN ACCORDANCE WITH LOCAL REGULATIONS
:KING EXPANSION JOINTS FOR REPRESENTAION ONLY,
WOUT WILL VARY
r
I
I
Ems
ivy
LLLLLLLLLL�
TAMB®s�iN
iDCAp B NO
MASONRY
41
2010 CALIFORNIA BUILDING CODE (BA®ON211060C)
201 O CALIFORNIA MECHANICAL CODE (11ASEDON2DISUNC(
201 O CALIFORNIA PLUMBING CODE (BABEDGNO7BUPCITm K—.
201 O CALIFORNIA ELECTRICAL CODE (BASE)ONMOSM)
201 O CALIFORNIA ENERGY EFFICIENCY STANDARDS
5 '
DOPING
.
GOV6GdB/r000E SEMIONAN82 (0 (1) EI CEPT [ NAN BdROEICY, NIYPEFtBON RANQOTDOOIDUCT
ANY BT.IVATON &RLL CONTACT THE APROMATE PMONAL N011RGITION C81TEP4 AT L EASE TWO
TRO =DAY&BIRNOT LOFED"UCALBQNGAY&Pr"MMAOC)DTINTMAVATONFnE
OUVATMML M CMUTM NANARTATMTIBOOWIL OR REkwvaY MOLD BEONOAWL N
CONTAIN &IB&I6AM SBTALIATONSOTFBNTFNN THEUNDOMMIND FAC IUTIES OWNED ORCPEWTFD
BYTIEDMATORANOFPPJCTIGLTF BMVATOL&WLDELMATEWRN\SEIEPAWDRGF R
SUABLE ILWIPJOS 11E APE M BEE)=VATED
cEwM ND
8& FALIRI
RA&
•
STONE
SALES FIELD
SPtLWAYTYFF
SPECIFICATIONS
n
!7 p
+LISTING LANDSCAPE LIGHTING IN REAR YARD
KISTING OVERHEAD UTILITY LINES IN REAR YARD
PL
AT p•
SEVEN SPILLING POTS AT +15'
GILDING SETBAq(UNE
TYPE dINIIE s17E �d x �
N ,
01
a
BD�A(f A� � P ONLY
PSP 1 TNs ux 48 MAX
FURNITURE FOR ILLUSTRATION PURPOSES ONLY
POOL MP JANDY So 2.0 HP VARIABLE
—�-
LPOOL
" AT 0' PLANTER POTATO' P'
COMBINEDU-N
� 11��
6 m
aO
jrn
SPA SPECIFICATIONS
TILE
PLANTERPOTATO'
BUILDING SETBACK LINE
SPA AT O' NTH TILE
DAM WALL --- ---
18-2• SB
38 WD
11'-1' SB
----- --- - - - - TANNING SHELF AT 1Y WATER DEPTH
ILIEXCAVATION
Sff 13$ x &8IXETYK
sOFr.�IxFL�L
IED OF ETS 8
T.B.D.
pATBDdE
w .. O
xx •
Q 4 Z
a N m
n 11,
P U
tjP3
aS0
p
FAMO
UOMT 1- BOOVY-LED
R88 TIE
mm rm 7u
sPPTflrLIOtB
DECKING
TOECLM DANDY RSI2
/ STEEL
TYPE
TIMSQ
AMSSifldl 5�lOf
E7FAIBIOIILMB
18' 8'
28 S
O -1 B.
CAMTREWER
�at�
D0icO0TOAN
CUSCOIE
^ r
n •
Da
BEAaToI BA
D®SEAT P
IDYEFi1T NO
cOMPETEFOWAL NO LOAM
MALIMA tans
SCOS3'$'AD
Fi1LUE AUTO
17 YIO
S VD \I
�
TPEEP
TREE fIBOYAlB/ �
HIBFAIf
OSRWTONFBOIRLBY NO
SQOOA710PIRBVR NO
TRE BVIE
eANDAOVISMIEE1
POOL EQUIPMENT 50 AMP SUBPANE L
WITH 30' CLEARANCE AT FRONT AND SIDE
POOL EQUIPMENT: 400,000 BTU HEATER
'ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED
ELECTRIC CONDUIT
198' - 2• POLYPROPYLENE GAS PIPE
AT10N OF POOL SYSTEMS AND EQUIPMENT WILL COMPLY WITH
4114 -MANDATORY REQUIREMENTS
4RMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS
POOL
EATERS / PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURERS
NENDATIONS AND IN ACCORDANCE WITH LOCAL REGULATIONS
:KING EXPANSION JOINTS FOR REPRESENTAION ONLY,
WOUT WILL VARY
r
I
I
Ems
ivy
LLLLLLLLLL�
LOT 280 TRACT PAGE BODK
YAP BOOK PAGE N0. CTTY
MAIL ADDRESS
CONSTRUCTION OFRCE NOW NO.
SCALE DATE DESIGNED BY PROJECT MGR
6.= 1' 0
5
-10-2012 JT. PAUL Y.
me# REVISIONS
i
SOC7EWFOnWMAMUATSMSORTMAMBVMSOCMTYOFk*CWpALENOR.vzw
TAMB®s�iN
iDCAp B NO
MASONRY
41
2010 CALIFORNIA BUILDING CODE (BA®ON211060C)
201 O CALIFORNIA MECHANICAL CODE (11ASEDON2DISUNC(
201 O CALIFORNIA PLUMBING CODE (BABEDGNO7BUPCITm K—.
201 O CALIFORNIA ELECTRICAL CODE (BASE)ONMOSM)
201 O CALIFORNIA ENERGY EFFICIENCY STANDARDS
5 '
DOPING
.
GOV6GdB/r000E SEMIONAN82 (0 (1) EI CEPT [ NAN BdROEICY, NIYPEFtBON RANQOTDOOIDUCT
ANY BT.IVATON &RLL CONTACT THE APROMATE PMONAL N011RGITION C81TEP4 AT L EASE TWO
TRO =DAY&BIRNOT LOFED"UCALBQNGAY&Pr"MMAOC)DTINTMAVATONFnE
OUVATMML M CMUTM NANARTATMTIBOOWIL OR REkwvaY MOLD BEONOAWL N
CONTAIN &IB&I6AM SBTALIATONSOTFBNTFNN THEUNDOMMIND FAC IUTIES OWNED ORCPEWTFD
BYTIEDMATORANOFPPJCTIGLTF BMVATOL&WLDELMATEWRN\SEIEPAWDRGF R
SUABLE ILWIPJOS 11E APE M BEE)=VATED
cEwM ND
8& FALIRI
RA&
•
STONE
SALES FIELD
SPtLWAYTYFF
ISA
DIG
LOT 280 TRACT PAGE BODK
YAP BOOK PAGE N0. CTTY
MAIL ADDRESS
CONSTRUCTION OFRCE NOW NO.
SCALE DATE DESIGNED BY PROJECT MGR
6.= 1' 0
5
-10-2012 JT. PAUL Y.
me# REVISIONS
i
SOC7EWFOnWMAMUATSMSORTMAMBVMSOCMTYOFk*CWpALENOR.vzw
TAMB®s�iN
iDCAp B NO
MASONRY
41
2010 CALIFORNIA BUILDING CODE (BA®ON211060C)
201 O CALIFORNIA MECHANICAL CODE (11ASEDON2DISUNC(
201 O CALIFORNIA PLUMBING CODE (BABEDGNO7BUPCITm K—.
201 O CALIFORNIA ELECTRICAL CODE (BASE)ONMOSM)
201 O CALIFORNIA ENERGY EFFICIENCY STANDARDS
5 '
DOPING
.
GOV6GdB/r000E SEMIONAN82 (0 (1) EI CEPT [ NAN BdROEICY, NIYPEFtBON RANQOTDOOIDUCT
ANY BT.IVATON &RLL CONTACT THE APROMATE PMONAL N011RGITION C81TEP4 AT L EASE TWO
TRO =DAY&BIRNOT LOFED"UCALBQNGAY&Pr"MMAOC)DTINTMAVATONFnE
OUVATMML M CMUTM NANARTATMTIBOOWIL OR REkwvaY MOLD BEONOAWL N
CONTAIN &IB&I6AM SBTALIATONSOTFBNTFNN THEUNDOMMIND FAC IUTIES OWNED ORCPEWTFD
BYTIEDMATORANOFPPJCTIGLTF BMVATOL&WLDELMATEWRN\SEIEPAWDRGF R
SUABLE ILWIPJOS 11E APE M BEE)=VATED
cEwM ND
8& FALIRI
RA&
•
STONE
SALES FIELD
SPtLWAYTYFF
BOULDERS -
DIG
PLUMBING
STEPS
'
UNDERGROUND
FLTpt JAIM Lm 580 SQ Fr.
RFOP. Exr.WUR
SIGNATURE
DECK
POOL MP JANDY So 2.0 HP VARIABLE
PUV(TBIVML
BDOSi Kw MtgK SDE 2.0 HP STEALTH
IETAININGW RIS
.
r DA
N3xpMNDY SM 20 HP STEALTH
—
eaw VOW
FWPPT HD
A Rw SUE —
,I'm _IRYmIYI iiB ".0" -V
TOECLM DANDY RSI2
SWPANEL JANOY RIRELM
ADOIounETs
&DOMTYF6 DWIPORT
Fi1LUE AUTO
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6A9IJIE 11? aTUB9
-
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tBIWE.ItBWN6
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—
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DEPT.
APPROVED
uwt6HS1 FgOLANO SPAooPVJc
•.T..o».,.,,o»
VEDHER
JAFDYSALTINAT
FOR CONSTRUCTION
OWNER RESPONSIBILITIES
6-%i•
=� A
f) TiEAPPM WTE EEVATON OF FO OR BPAATLAWITON DAY OF
OWIERDATE
MTAREWnMTMTPOM"Wine/TL=MM ME&BEOTTOmXe,rAM
UYRMS PUtM
j-
WUDOI NC=WAR%MAT FMTT%rED
F\ OEf0011NCONONETE 8HBIATIFAHfTWICE OAAY FOR BEVBIOAYBAFTBI&E
(NI MMINATTESS MIBMFIEUM&IB EFOR LI DDIMOIAD OOIOITIONB OR,
AIDAWOAIIAMTOOMS, ME'X&%DFRVEWAM LAWK OROTI@t IIEMBIN
(d) SEETMI AILFBMA GILTMM GW.k%DOM M7 LOOM. CODER FORAFOOL
PRIOR TO PP13♦AMM I)OWTION.
(D FLLPOOLOe®WT6YKTBiRAOHt(FOLLOWWrR =PDNs-DONOTuRERIIBI
(7) TAKE wnCETFWTTMWAWM ISTHE SOLE PR0PEPIN OF TESH3tAADTNATANY
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