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04-4515 (SFD)P.O. Box 1504 7,8-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT t A pplication Number . . . Property Address . . . . APN: Application description Property Zoning . . . . . Application valuation . . BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00004515 Date 10/08/04 52840 LATROBE LN 770-340-029- - - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 392985 Owner Contractor ------------------------ WOLVERINE ENTERPRISES ------------------------ STOKER CONSTRUCTION, INC. 56471 29 PLAMS 56471 TWENTYNINE PALMS HWY YUCCA VALLEY CA 92284 YUCCA VALLEY CA 92284 (760) 365-8691 WCC: STATE FUND WC: 1542853 01/01/05 CSLB: 435033 02/28/05 CCC: 'B -C9-053 -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 886.00 PATIO SQ FTG 442.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- FIRST FLOOR SQ FTG 4576.00 Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 1665.00 Plan Check Fee 1082.25 Issue Date . . . . Valuation . . . . 392985 Qty Unit Charge Per Extension BASE FEE 639.50 293.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 1025.50 Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 207.88 Plan Check Fee 51.97 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension 11::ii� P.O. Box 1504 • ��r�� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT / Application Number: V— q37_, ; Applicant: Applicant's Mailing Address: Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION Eby 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 , and my License is in full forcg_gnd effect. License No. Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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, 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 Contractors' 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 violafion 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).): 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date �V Owner WORK RS' 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 Policy Number _ 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 provisions. -- Dat --____ Applicant –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. 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 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 Ouinta, 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 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 county to enter upon the above-mentioned property for inspection purposes. Dat v _ U —D Signature (Applicant or Agent): .i Application Number 04-00004515 Page 2 Date 10/08/04 Qty Unit Charge Per Extension BASE FEE 15.00 4576.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 160.16 886.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 17.72 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ---------------------------------------------------------------------------- Permit GRADING PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extensiar ---------------------------------------------------------------------------- BASE FEE 15.00 :_ Permit MECHANICAL Additional desc 'Check , Permit Fee . . . . 157.00 Plan Fee 39.25 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 9..0000 EA MECH FURNACE <=100K 45.00 5.00 9.0000 EA MECH B/C <=3HP/100K BTU 45.00 7-.00 6.5000 EA MECH VENT FAN 45.50 1.00 ------------------------ 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ---------------------------------------------------- PLUMBING Additional desc Permit Fee . . . . 231.00 Plan Check Fee 57.75 Issue'Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 22.00 6.0000 EA PLB FIXTURE 132.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 4.00 7.5000 EA PLB WATER.HEATER/VENT 30.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0.000 EA PLB LAWN SPRINKLER SYSTEM 9.00 16.00 .7500 EA PLB GAS PIPE >=5 12.00 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Special Notes and Comments 4576 S.F. SFD PERMIT DOES NOT .,, Page 3 Application Number . . . . . 04-00004515 Date 10/08/04 ------------ ----------------------------------------------------------------- Special Notes and Comments INCLUDE BLOCK WALLS, POOL/SPA,COMPLIANCE WITH ALL FEDERAL & STATE LAWS, INCLUDING THE ENDANGERED SPECIES ACT OF 1073 ( 16U.S.C. 1531, ET SEQ. ) IF APPLICABLE, IS REQUIRED ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 482.46 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 108.23 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE 00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION.(SMI) - RES 39.29 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 2275.-88 .00 .00 2275.88 Plan Check Total 1231.22 500.00 .00 731.22 Other Fee Total 3034.98- .00 .00 3034.98 Grand Total 6542.08 500.00 .00 6042.08 r . . t. R F STRUCTURAL CONSULTANTS. INC. 75-153 MERLE DRIVE. STE. B, PALM DESERT, CA 92211 PHONE (760) 836-1000 FAX (760) 836-0856 E- MAIL RAYMOND @:RFSTRUCTURAL.COM MAY 9, 2005 KRISTI W. HANSON, INC. 72-185 PAINTERS PATH, SUITE A PALM DESERT, CA. 92260 Attn.: KELLY LETECKY Re.: THE STEIN RESIDENCE 52-840 LATROBE LA. LA QUINTA, CA. 92253 FOLLOW-UP TO WALK THROUGH JOB NO.: 4226 DEAR KELLY THIS LETTER ADVISES THAT WE HAVE OBSERVED THE STRUCTURAL REQUIREMENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIME OF OUR SITE VISIT. _ WE BELIEVE THAT THE AS -BUILT CONSTRUCTION AT THE TIME OF OUR VISIT IS IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS AND RELEVANT CORRESPONDENCE ISSUED BY OUR OFFICE. WE OBSERVED THE BUILDING IN ITS FRAMED CONDITION PRIOR TO INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED THE VISUAL AND ACCESSIBLE STRUCTURAL REQUIREMENTS. ( EXCLUSIONS ARE ITEMS SUCH AS: FOOTING SIZE AND REINFORCEMENT, TOP PLATE SPLICES, ROOF SHEATHING, AND ANY STRAPS ABOVE THE ROOF SHEATHING). RESPECTFULLY SUBMITTED ,.. ?VOFESS/04 c NO.57958 rm C/VI1.. �� CF CAL1, ZEYAD FAQIH, PE t. 441 ng Address 640 LA Owner Address City Zip Tel. iA 6-44 I NSA Gly CoVraGrov_ tot STI�VLTI�N �` Address 4—&-1 ` , —rW, 1 Tel, ,L, I t t o OCA c►�� 6 �s�� " '.O. BOX 1504 APPLICATION ONLY Y i CALLE TAMPICO A. CALIFORNIA 92253 BUILDING: TYPE'CONST. �/ OC . GRP.0 E�W�AL— A.P. Number Legal Description ��II 1 /` p , _ Project Description S�i�yl If, i`G{/fM�(�tNl State Lic. City & Classif. Lic. q Sq. Ft. Arch., Engr., Size Designer' Address CM IA I(l k)Vr Fpl'V,l A -ILi�t#(`/i4Q�Q:1 LICENSED CONTRACTOR'S DECLARATION 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 I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, 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 Contractor'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). F., 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.) r1 I, 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 does not 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 1 am exempt under Sec. B. 8 P.C. for this reason Date Owner t `} WORKERS' COMPENSATION DECLARATION Ihereby 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 fl Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation cr less.) I certify that in the performance of lhp 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. Date Owner NOTICE TO APPLICANT., If, 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 Ihereby 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 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 a0plicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT No. Add ❑ Alter ❑ n PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL NoDw. Units Repair ❑ Demolition ❑ AMOUNT Sc� wl�li Mum Iyy�0 1 isttic� [!�w REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Validated by: Validation: Date Permit YELLOW = APPLICANT PINK = FINANCE P Date 10/8/04 No. 26506 Owner Wolverine Enterprise, LLC Address City Zip Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # Study Area No. of Units 4��1FiEDsc�o Q BERMUDA DUNES RANCHO MIRAGE (� INDIAN WELLS �PALM DESERT AZ t}1 LA QUINTA QINDIO 770-340-029 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 52840 Latrobe Lane 4576 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 patiostwalkways, 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: 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 $2.24 X 4,576 S.F. or $10,250.24 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 CC/pacific Western Bank - Rae Ellen Stoker Check No. 242897 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Shafqn MCGilvrey., Payment Recd $0.00 $10,250.24 Over/Under Signature NOTICE: Pursuant to Government Code Section 6020(d)(1), this wilrtonotifyu 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 DepartmentlApplicant Copy - Applicant/Receipt Copy - Accounting Oct 01 04 11:00a Dtison OCT -01-04 10:48AN FROW Southland Title - sw1h alma cow-lcn RECORDING REQUESTED BY: SOUTHLAND TRLE - DA AND EMPIRE (Title) AND Want RECORDED iiM T0: Sharon stain 7aTa Pine L& Quinm CA 92250 order No_ 64101001 Escrow No. YiSWAS A P.N.: 770.941102" 760-773-2650 P.1 760-200-4509 T-519 P.003/004 F-627 DOC a 2004-0000723 e2/31/211184 ea_aen iaa:te.ee Papa 1 of Z Doc T Tax Paid Rsaordad in Official fteards County of Rivaraide Gary L. Orso Aasaaaar. County Cl4rh a Rowwdor N 10111 w S I U PAM i arg w A w t. GRANT DEED T THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX IS $810.50 L.1 [ Xcomputed on full value of property conveyed, or t [ ) computed on full value less value of liens or encumbrances remaining at time of sale. [ ] unincorporated area [ X j City of La Qutnta FOR A VALUABLE CONSIDERATION. receipt of which is hereby adknowiedged- VW[Ilam Cintant and Marilyn Chdani , husband and wife as joint tenants hereby GRANT(S) to La Trobe Investments, Inc., a California Corporation, as to an undivided 50% interest and Wolverine Enterprises, LLC, a California Limited Liability Company, as to an undivided 508 interest as tenants in common the following described real property in the County of Riverside. State of Canfot"a Lot 29 of Tract No. 28887, In the City of La Quanta, County of Riverside. State Of California, as per map recorded in BookXre. Page(s) 89 through 19 of Miscettansous Maps, In the office of the County Recorder of said County. Dated: January S. 2004 STATE OF CALWO RMA COUNTY OF Qtp'--w a ,:01k, SS. On O before me a Notary Pub Ic In and fof said County and State. personally appeared� - petswspy known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whm names) lsfere subscribed to the wANn moment and acknowledged to me tW helsWlhey exemted the same in hisftwitheir authorized capaaty(ies) and Mat by I iWherRheir signatures) on the instrument the person(s), or the entity upon behalf of which the peman(sb acted, executed the b>sdument. William C'mtani M Cintan WITNESS hand end otflaat ase/al. am KI LON -� Signature '"""' tyo m►ftriC.ffi,2006 Signature of Notary (This area for official notary seal) MAIL TAX STATEMENTS AS DIRECTED ABOVE I P.O. Box 1.504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 October 7, 2004 Jeff Stoker 56471 29 Palm Highway Yucca Valley, Ca 92284 SUBJECT: MINOR USE PERMIT 2004-537 (GUEST HOUSE) Dear Jeff: (760) 777-7000 FAX (760) 777-7101 The Community Development Department has reviewed your request to establish a guest house on property at 52-840 Latrobe Lane (Lot 29 of Tract 28867) within The Traditions development, and has approved your request subject to the following conditions: 1. Only one guest house (attached or detached) may be established per lot, . in addition to the primary residence. 2. The guest house shall be .architecturally compatible with the main residence on the property. 3. The height of the guest house shall not exceed seventeen feet in height and not be more than one story. 4. ' The floor area of the guest house shall' not exceed thirty percent of the existing living area of the primary residence and not result in violation of the lot coverage maximum. 5. There shall be no kitchen or cooking facilities within the guest house. 6. The guest house shall used only by the occupants of the main residence, their non-paying guests, or domestic employees. 7. The guest house shall not be rented or otherwise occupied separately from the main residence. 8. A deed restriction shall be required for recordation against the property to prohibit the use or conversion of the guest. house to a rental unit, a c J. Stoker - I MUP 04-537 Page 2 unit for sale, or to add a kitchen or cooking facility. The attached deed restriction shall be signed, notarized and recorded at the Riverside County Assessor's Office by the property owner(s). 9. The guest house shall be hooked up to the existing sewage disposal system for the.property. 10. The City may elect to add Conditions to this application request to mitigate any problems that arise.not previously addressed herein. This decision may be appealed to the Planning Commission by anyone provided they submit the necessary' paperwork and filing fee of $175.00 with this office within 15 days of approval of this permit, which is the appeal period established under Section 9.200.120 of the Zoning Code. Should you have any questions or need additional information, please do not hesitate to contact me directly at (760) 777-7068. Sincerely, OSCAR ORCI, INTERIM COMMUNITY DEVELOPMENT DIRECTOR 'N MARTIN MAGAA Associate Planner. C- Building &'Safe_t'y Department Chron file MUP 04-537 Stoker I TANDY'S INSPECTION INC. PO BOX 13766 PALM DESERT, CA 92255 SPECIAL INSPECTION DAILY REPORT OFFICE/FAX 909.769.9717 PAGER 760.776.3339 TYPE OF INSPECTION PERFORMED } p �^� 1,�6 SAMPLE INFORMATION DATE r I U / PHYSICAL ADDRESS - �W- 9 L ATRv b -e. LtA (—A QL, 'vim i PERMIT NUMBER JOB NAM �Tt✓ i tJ TYPE OF STRUCTURE ARCHITECT oo (�1ST1 ENGINEER \ 5 _ i.A �z U�� GENERAL COMRACTOR�ek COYTRACTOR ACT-rcs DESCRIPTION OF WORK INSPECTED ��' .Sim '(� __ d► S 412__(A a e -4L -b LA PA - 1 HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK, UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY ABILITY I HAVE FOUND THIS INSPECTORS SIGNATURE WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS 8 APPLICABLE l r' BUILDING LAWS. /moi \J cc; INSPECTORS CERTIFICATION AGENCY AND NUMBER SAMPLE INFORMATION SUPPLIER TICKET NUMBER MIX NUMBER TIME SAMPLED AIR TEMP STEPPE SLUMP TIME IN MIXER LOCATION - WELDING INFORMATION PROCESS WELDERS NAME CERTIFYING AGENCY AND CERTIFICATION NUMBER 1 HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK, UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY ABILITY I HAVE FOUND THIS INSPECTORS SIGNATURE WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS 8 APPLICABLE l r' BUILDING LAWS. /moi \J cc; INSPECTORS CERTIFICATION AGENCY AND NUMBER