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0201-122 (RC)F- 04 N C/) W �CYLr) ' W o Z r` CDO.c H(D W N Z co ul N ON 0 O3 CL Q Lo Q 0 X W tL C10 o< O d rnH It Z_ cb 5 Q J LICENSED CONTRACTOR DECLARATION I hereby affirm,under, penalty of perjury that I ah licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business sand - Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's LicenseLaw 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). ( ) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). (t)° I am exempt under Section •- B&P.C;.forthis reason Date .!a 1 r; i I f > -!--Signature of Owner {'r, . ,1�sn ✓�.!' ._ . 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. 4 ( ) 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 Policy No. (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 provisions. Date: Applicant t. Warning: Failure to secure Workers' Compensation coverage is tihlawful • shall subject an employer to criminal penalties and civil fines up to $100,000 addition to the cost of compensation, damages as provided for in Section 3 of the Labor Code, interest and attorney's fees. ' IMPORTANT Application is hereby made to the Director of Building and Saf for a permit subject to the conditions and restrictions set forth on is application. 1. Each person upon whose behalf this application is made & each person whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemr4y & hold harmless the City of La Quinta, its officers, agent's and employee`s. 2. Any permit issued as a result of this application becomes null and void.if work is not commenced within 180 days from date of issuance of -.such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) �r✓�' ' �� Date, I " BUILDING PERMIT PERMITtS#f�cfe q �y DATE g YVALUATION 62kiM.00 LOT TRACT JOB SITE ADDRESS �% C:A%MAdI�Alll•r �Q1� APN OWNER CONTRACTOR/DESIGNER/EN INEER P AC71A UMMNIS +C WN1 :: • 131:1i.0 EV. 53-13355 AVMID.A. YR.ir'lM, USE OF PERMIT WMIii/ ERCIliLREMODIM COMIvMCAL 11 a -B' OM, ,• PAXIII,A'S 111S3.',AU?Aibf r (OCCUPr1r WAD 29.),649 SY. KS.ut01..e Y.cl.A01aeA ki1+0!. 1i 1� N..�•�l.� p:3 014.55. �'�D1+�i'fi�t;BJi`£��3'I'�' �49��OE�•R$�i"dYti{9 �, i 1tAWA/AKIC'AE, rEft APR 19 2002 F CITYOFLAQUIWA FINANCElj p :s L VIAL CCil�i�'1i l�Ut°"i ION AND FLM C$WX �! 84,53 *` a MAI.:FE&eJ I17 IYEFS DUE NOW e s4wo .t . RECEIPT DATE BY _TbAu FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O. K. to Wrap,� F.A.U. Framing (O - "� 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 Final Final g��ti K 6 BLOCKWALL APPROVALS POOLS -SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Einal Gas Piping PLUMBING APPROVALS ? Gas Test Electric Final Waste Lines Water Piping �� O JF-`� Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 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) COMMENTS: • din � �� Permit # 01-4 Project Address: A. P. Number: Contractor: X T'8� Address City. ST. Zip: )( Telephone: X State Lic. # : X, Arch.. Engr.. Designer: Address: City. ST. Zip: Telephone: State Lic. #: Name of Contact Person: 1{ Telephone # of Contact Person: # Submittal Req'i a. Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval 1 16 Pub. Wks. Appr School Fees City of La Quinta'n/yUE05 'macu�, (� Building ff Safety Division V V l iA ed` i V' P.O. Box 1504,78-495 CaHe Tampico % 8-G �O CAY;EFSTWo La Quints CA 92253 - (760) 777-7012 '3+,-- Zd i ' -1&0- iii--�t SG -1 Building Permit Application and Tracking Sheet �s ( Owmer's Name: X I lc G D Address: a `mt p City. ST. Zip: )< UigMa C/ Telephone: Project Description: X ( R)(Z �bFF City Lic. #: Total Permit Fees 1/23 C G14A �l/�- se(9V4fT 1.�7 fl�s t7 Gi ✓t 77 //z3 � � 7�. T - ,,, UM Construction Type: � Occupancy: -P Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: # Units: — Pj�j— Qsa Estimated Value of Proje �t� APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACKING PERMIT FEES Plan Check submitted 9 p Item Amount Reviewed, ready for corrections 111611;: Plan Check Deposit Called Contact Person �j 2 Plan Check Balance • Plans picked up f�,/� Construction • Plans resubmitted 411CIO2, Mechanical • 1 /, �p 22nd Review, ready for corrections/issue Q Electrical 649 •oZ t?.,q5 Called Contact Person Plumbing • Plans picked up SAI.1. Plans resubmitted Grading '"' Review, ready for corrections/issue Developer Impact Fee 1 Called Contact Person A.I.P.P. Date of permit issue Olt TD SsSt u„�a[ �©2of,r slliil/�s .H7i�.v /9ifitt?OMY SK/4f Total Permit Fees 1/23 C G14A �l/�- se(9V4fT 1.�7 fl�s t7 Gi ✓t 77 //z3 � � 7�. T - ,,, UM -5e,- Code) c&t!t 4 4 Qumrcv MEMORANDUM To: Greg Butler, Building & Safety Manager To CDD: /-1(o-0 a From: Christine di lorio, Planning Manager Due date:�� Statusls- N,1 - Building Plans Approval (this is NOT an approval to issue a Building Permit) The Community Development Department has reviewed the Building Plans for the following project: Description.- Address escription: Address or general location: '7e-).20 ( LIE ��T,4 90 APN and/or legal description: Applicant Contactu L A /�C (��n1Ne sS The Community Development Department finds that: ❑ ... these Building Plans do not require Community Development Department approval. I� ...these Building Plans are approved by the Community Development Department. ❑ ... these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant. When the corrections are made please return them to the Community Development- Department for review. �1 y Christine di Iorio, Planning Manager 0 /-18 COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY ASSESSOR'S PARCEL NUMBER DEPARTMENT OF ENVIRONMENTAL HEALTH APPLICATION FOR WASTE WATER DISPOSAL APPROVAL APPLICANT: Submit this form with four copies of a SCALED plot plan (1"=20' to 1"=40' SCALE) drawn to County specifications as indicated on the attached check list. A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of payment. LMS # Agent, Contractor, Contact Person Address City State Zip Telephone Q Own/!err 1 M ? �1 SIA rp. A ^ n i Address /� City a /}� State Zip � � h l7 l�A a � C1 t i m4♦ C ""1 , �T.�elyephon{e / I - L K� ! Z O Job 11 Property Address t t n `} �'�y} w1 1 O ca 966 v'4 ✓1,1, loll City ` ^ I—c" �y1' ZiD ^j 9 ol.^7C.,'M-.) 41 F l� Lot Size Water Agency/Well Use of Permit, P/PL SUP, PUP, etc. Leg/all Description DBA IU U) int '. k , �v1 t 5 Dwelling, MH Site Prep., etc. �� 1 V{ Signature of' A—pplic nt / Date / FOR OFFICE USE ONLY CHECK BOX IF REQUIRED If any box is checked, this application shall be considered rejected until the ❑ Detailed Contour Plot Plans Required (1 to 5 foot interval) information is provided and the fee paid. Resubmittals later than 90 days after date noted below may require repayment of fees. (J Other m C3Holding Tank Agreements Completed ❑ Staff Specialist Lot Inspection Required Z ❑ Certification of Existing S.D. System Required Thomas Bros. Page Grid W❑ WQCB Clearance Required ❑ Date Lot Inspection Completed: Initials U) (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: ❑ Soils Percolation Report Required ❑ Maintenance Booklet Provided ❑ Special Feasibility Boring Report Required ❑ Final Inspection by Department of Environmental Health is required. ❑ Rereview Required Initials Date Please call 24 hours PRIOR to inspection. C/42 / Soils Percolation Boring Report By Lic/Project # Date Soils Map Page Soil Type Approved By Date No. of Systems Type of System(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand ❑ Holding Tank ❑ Replacement Bedrooms, Fixture Units Grease Intcp/Lint Trap ❑ New ❑ Addition ' onnect 1 ❑ Existing to Sewer Gal. tA IllJ-f t1 Gal. Sq. Ft. Total Linear Sidewall Allowance Leach�B–ed sq. ft. Bottom Area Ft. ft. rock/ sq. ft. running ft. Install Line(s) ft. long ft. wide of Bottom Area Inlet Tested Depth ❑ N/A with min. inches rock below drainlines U Proposed Bottom Tested Depth or Z Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (131) Seepage Pit Maximum Other: O Applicable Total Depth Allowable H Depth N/A Overburden Factor ❑ 5' ❑ 6' TD IU Well Review Approved: Date: Well Drilling Permit# SIGNATURE Grading Plan Approved: Date: SIGNATURE Plan Check Only Approved: Date: REMARKS: ��1 P0,<. r *,A(;Q rj:-a\ 3 , \P�\ r T 3[5 T-,, I ) This application is APPROVED/DENIED for the category checked in SECTION B above regarding the design of a disposal system as indicated on the accompanied plot plan, using the requirements set forth in SECTION c q q C above. A building permit is necessary for the installation of the above- Revenue Code .� ..1 Fee $ f . + designed system. No construction is permitted in the required reserved 100° expansion area. Check # i (1) Septic Tank must be 100' minimum from any wells. 0 I J Z (2) Leach lines must be 100' minimum from any wells, including expansion ! Date Initial / O area. 7'- (~) (3) Sewer lines must be 50' minimum from any wells. W (4) Seepage pits must be 150' minimum from any wells, including expansion RIVERSIDE: 909-955-8980 area. Fr INDIO: 760-863-7000 SOUTHWEST: 909-600-6180 Signature \ Date DEH -SAN -122 (Rev 8/01) Distribution: WHITE—Office File; YELLOW—Applicant; PINK—Bldg. Dept.; GOLDENROD—Plans/Records OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/ you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law' to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations including State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Stare Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-7011 'IJA I, -- OWNER'S SIGNATURE/ DATE PROPERTY ADDRESS LI) aai- 4 9 - PERMIT NUMBER(s) r. - RIVERSIDE COUNTY FIRE DEPARTMENT FIRE PROTECTION JOB CARD THIS INSPECTION RECORD MUST BE AT JOB SITE WITH AN APPROVED SET OF PLANS, i z Owner_ ?.-:,,� Date Location Case No. SD? 7bb • loBQ Sprinkler Company cr Fre PSS ;��'• 5� Un a ground Static bate Inspector (200 PSI For 2 Hrs. Prior to Inspection Time) (Center Load Pipe Only, Joints and Thrust Blocks MsttB Exposed).Qum I 7 Underground Flush ate 1pectcr Overhead Static Date, Inspector (200 PSI For 2 Hrs. Prior to Inspection ,Time) Overhead Final Date Inspector Fire Main Installer Underground Static Date Inspector (200 PSI For 2 Hrs. Prior t11ns ctiori Time) (Center Load Pipe Only, Jnd Thrust Blocks Must 3e Exposed). i Underground ush Date Inspector Extinguishing System Final Fire Alarm Installer Date Final Date Inspector I P II COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY DEPARTMENT OF. ENVIRONMENTAL HEALTH �p ENVIRONMENTAL HEALTH SERVICES SUPPLEMENTAL REPORT TO SAN. FORM # // DATE _ I SUBJECT �� 0 01/.�� ) PERMIT NO. ADDRESS REMARKS: INSPECTOR ( . -T i Arl) 246 e /�r�� ✓/Y: _a t 42 4w e o •, s^ 1 l / J DEH-SnH-118 (Rev 2/ss) Distribution: WHITE—Office; CANARY=Owner, PINK—Office : THE CONDITIONS LIS'TEO"B,tL'OW7'C'OR''RESOONbTO V i -AS - INDICATED -.B*Y.THE*.ENFORCEMENT OFFIC'ER. TkE.D TEMPERATURE, CONTROLS 1 Maintained at. 41 OF, or. below/.diligent preparation� 13995b, c 2.- Maintained at 140°F or above -113995b ' 3. Maintained at 45°F or below. - .,a.) serving lines, salad bars -1 13995c b) pasteurized milk [Milk - priJducts=fl 3995.d c.) raw shell eggs -113997 .4. Proper -cooling of foods -114002d 54 Proper reheating of foods=l 1 3998a 6: Ground beef cooked to •155°F for 15 sec; .Pork 145°F; Poultry•165°F; Eggs 145`F-113996 7..,Proppr thawing, of foods / frozen foods. maintained frozen- 113995b,114085 81 Thernometers in - each 'ref rigerato'r­1'1 39-9'5d Probe thermometer available=l 13995d THAGENCY EALTH Mi*bilMiho UTENSILS` ANO: EQUIPMENT . in 5 [2.5_'6sils clei 1:1:4050; vi,469 quip ment / ote... , . . 0 '5"/ 2.5 Major/Minor ]-24..Utensili-properly'g.tored-1.14090 2/1 5/2.5 - 25'. Equipmentin d-r6pai- "1140�0, .0 goo r� 2. 4 ].2 . 6. "Utensils,/. equipment app roved--�l 14U . 65. 1,10. "Protected from dirt/6ontaminatiprVvermin; not reused; PEST CONTROL Maior/Minar 27.- Rodent -insect infestation-. 11-41030: 4 /2 4/2 28: Live animals, birds, dr'fowl _" 114045 4. 29. Outer openingsAnsect an ' d rodent proof,: `self-closing doors/ "I f.36. Food workertert. cards=Co. Ord. 8,:44* air curtains .. 1.1 - 4036' 2 130. Approved pesticides rodenticides_l 14025 p 137. Food.Manager Certification -113716 1.5 -FOOD -GENERAL Major/Minor 1. J 131. No sulfites added to foo.dw 14 970 .5 1-32. ,Outdoor food properly protected --114145: .5 FOOD PROTECTION Major/Minor 1.33. Clean/soiled linens separate,, adequate storage -114160 .5 1 9. Food free of -contamination, adulteration, spoilage7---113980 4../2 j 34. Operating pursuant to approved HACCP plan -1 14055, .5 1,10. "Protected from dirt/6ontaminatiprVvermin; not reused; .4/2 114056 prepared food * s reheated properly -114010, 114015.s 135. Sleeping / living quarters separate=l 14.175 .5 11. From approved source/properly wrapped/labeled-, not from 2J1 f.36. Food workertert. cards=Co. Ord. 8,:44* 1 private home; no harvest tags -113985, 114003' 114.005,. 137. Food.Manager Certification -113716 1.5 114015, 114057- 12. Adequate/suitable storage -114080 FLOORS/ WALLS./ CEILINGS- . Major/Minor ; 38. facility fully enclosed -114145:: .5 :WASHING -/-SANITIZING Maior/Minor 39. Floors /walls [ceilings clean -114040 1 13. Utensils washed sanitized property, . machine - 50ppm-. --.5./2.5 Floors/ walls [,ceiling in good�rOp 14150'.14155 F 140 air­�l .- -1 114090 114. Proper manual sanitization -114060 5J2 5 ao* 100 ppm chlorine,for 30 sec . LIGHT AND:VENTILATION Maeo r/Mino V25 ppm iodine for 60 sec' - : 41: Adequate Ve'ritilation.ih: resirooms kitchen; etc! -.1 14140 1 c. 200 ppm quat.ammonia for 60- sec emworking.' 142. Exhaust syst [clean -1 40 .5 d. water at 1801 for 30 sec 1.43. Adequate lighting I shatterproof --41 4170 .5 15., Testing -114060 equipment materials provided .5 , PERSONNEL.''Maior/Mi6or '.Propek RESTROOMS [JANITORIAL. Toxic :'�ubstan6es;labeled /.stored sep66tely i14025 Major/Minor j 1 16. employee h.andwashing; employees shall .not * 512.5 .144.. --114 65 ].45: Cleaning. equipprient-properly sfore&� I contaminate food excessive or prover food handling;. - .:.. - , 146.. Moo. sink provided:/ proper 'waste water .5 • em u icable.diseise­1 1' employee with comm n 4020,114022* ' .:' repair /.rio:gdod s or4ge- 147' Restr6dmis clean./* in 'good, t 17 ployb6s smoking .-using tobacciJ�l 14020 . JI& Clean outer garments,: hair restrain! -114020 • 114105, 114120;1144125 j .116. Per'§'6nl'effects / changing!.area, separAte�fl 4115; 148 . Self closihg restroom .' door -114105 .5 1,20. Soap./ paper towels it.ha6dwgh sinks -11411.5 2 'REFUSE Major/Minor WATER AND SEWAGE., . '-ftorlMirior �i 149�, Contaiiers, properly. stored/covered/clean.; adequate 1 21. Potable water supply hot water=1 14095 '4,/..2 number -.114035 j 22. Plumbing in good. repair prpper, sewage disposal;.. no cross '4 J. $0. Storage area clean -114035. tbrinections­l 14100 INSPECTION TOTAL NUMBER.OF GRADE A J `SUMMARY .' MAJOk'WOLATIONS A. 9 ENVIRONME TAL HEALTH SPECIALIST. -1 BADGE TOTAL POINTS TOTAL NUMBER OF SCORE e POSSIBLE = 1'00j POINTS DEDUCTED /V DEWSAN-029:(Rn 9[0 Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning 4. Beaumont Calimesa g - Canyon Lake -;- Coachella Desert Hot Springs Indian Wells 4. Indio Lake Elsinore La Quinta Moreno Valley Palm Desert 4. Penis 4. Rancho Mirage 4. San Jacinto 4. Temecula Board of Supervisors Bob Buster, District I John Tavaglione, District 2 .Tun Venable, District 3 Roy Wilson, District 4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 210 est San Jacinto Avenue - Perris, California 92570 - (909) 940-6900. Fax (909)940-6.910 I August 15, 2002 City of La Quinta Building Department Fire and Life Safety Clearance Murray's Hotel and Restaurant Supply - The Riverside County Fire Department is granting a fire and life safety clearance for the following address 78-120 Calle Estado, La Quinta. , Respectfully FRANK KAWASAKI Chief Fire Department Planner By Terry Des o,Y Fire Safety inspector EMERGENCY SERVICES DIVISION - PLANNING SECTION - INDIO OFFICE CITY OFLA QUINTA SUB -CONTRACTOR LIST /�,� , JOB ADDRESS �8J120 L FSS' 1 PERMIT NUMBER OWNER BUILDER 11" This form shall be posted on the job with the Building Inspection Card at all times in a conspicuousglace. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of buildinq permit. For each applicable trade. all information reauested below must be comDleted by anolicant. "On File" is not an acceDtable response. Trade / Classification Contractor State Contractor's License Workers Compensation Insurance City Business License Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) CONCRETE (C-8) � FRAMING (C-5) STRUCT. STEEL (C-51) MASONRY (C-29) / PLUMBING (C-36) tYl E �� Urr1 C- �� 7_51805 131 03 �� n F C A b VIXCL o O1 01 0316' Imo/ rJ LATH, PLASTER (C-35) DRYWALL (C-9) HVAC (C-20). ELECTRICAL (C-10) Ql L.L_%ms E�F_cmI n C' 10 V©© � 9 (1 02 1& 1 .'un ROOFING (C-39) SHEET METAL (C-43) - - FLOORING (C-15) GLAZING (C-17) INSULATION (C-2) SEWAGE DISP. (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C=6) FENCING (C713) LANDSCAPING (C-27) POOL (C-53) c�"