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Home My WebLink About381 AVOCADO ST - Building PermitsPflOJECT ADDflE55: 3 S S AVOCADO ST OWNEfl'SNIIME: NEWPORT PACIFIC llEV nooxess: 4400 MACARTHUR BL 9TH FL NEWPORT BEACH CA 92660 (714)976-1234 11HCN/ENGINEEH: HEG.NO.: FOOflESS: UNI7: IINIT: PEflMITTEE: NEWPORT PACIFIC CONST ( 714 ) 476-1234 aooeess: 4400 MACARTHURBL 9TH F NEtJPORT HEACH CA 92660 LICENSED CONTXFCTOfl DECNBATION: I hereby aRirm ihat I am Iicense0 untler provisions af Chapter 9(commencing with Section 7000) of Oivision 3 oi ihe Business antl Pmtessions Cotle, and my license is in tullforce antl eflect. ci�ruc'.: '055922 STATEUC.:SOI3SO cu�s$, Date:� /�/�2- SignaWre:--c��y�� WONKEPS' COMPENSRTION OECLAHATION: I hereby atfirm that I have a certificate oi consen[ to self-insure or a cenilicate oi Workers' Compensaiion lusu5ailcl o[ }cxli�ied rapy �hereof (Section 380q Lab. C) Z� � 1� 9 2 aoucr no.: STATEon � 1 E%P. DpTE: 1 COMPIINY: ,.a� ❑ Certifietl copy is hereby furnishetl. L'7 Certifietl copy is fileU with I�e city Builtling �ivision. / 4 /i n /92 /� ' ..ate:�—r— APDlicant: ��:G��[�� .o � � E%EMPTION FBOM WONKENS' COMPENSATI�N OECLl�NATION: Qhis section need not be completed if the permit is forone hunAreO ($100) ar less�. I certi�y Ihat in �he performance of ihe work for which Ihis permii is issue4 I shall not ¢mploy any Oersan in any manner so as �o become su6lec� lo Ihe Workers' Compensation Laws oi CaliPomia. Date: Signa[ure: NOTICE: If, alter making ihis Declaralion, you shoul0 �ecome subject �o Ihe Workers' Compensa�ion D�ovisions af the Labor Cotle. you must �arthwith comply wi�h such provisions or �his permit sha�l be OeemeO revoketl, CONSTflUCTION LENOING RGENCY: I herehy a�firm �ha� �here is a cons�mction lentling agency tor the Oe�ormance o1 lhe work �or which this permil is issuetl (Section 3097. Civ. C�, �exoes: PREPARE FOR UPCOMING aooness: pgOJECT OWNER BUILOEH �ECIABpt10N: I here6y aflirm that i am exempt fmm the Contracmrs' State License Law for [he following reason (Sec�ion 7031.5 Business an0 Pmiessional Cotle: Fny ciry o� county which 2quires a Dermif [o construct, alier, impmve, demolish, or repair any SImC�ufe. prior lo its issuance. also requires �he appliCant tOr SUth permit Io file a SigneA 5ta�ement �ha[ he/She is lic¢nsetl pursuam �o �he pmvisians ot the Con�rac�ors' State License Law (Chapter 9(commencing wi�h Section 700�) of �ivision 3 0� Ne Business ana Pmfessions Cotle) or ihat he/she is exemv� �heretmm antl ihe basis for the alleged exemption. Any violation of Sec�ion 703L5 by any applicant for a Oermit su�jects ihe applicant to a civil penal�y of not more l�an hve hundred Aollars (5500�. I. as ownef o� �he propeny or my empl0yee5 wi�h wages a5 [heir sole compensati0n, will Ao [he Wofk, antl �he ❑ s�mcture is no� inlendetl or oflered for sale (Sec�ion 7044, Business antl Pmfessional Code: The Contractors' S�ate License Law tloes noi aODly �o an owner o� a pmperty who builOs or improves thereon, antl who tloes such work himselt/hersel� or �hrough his or her own employees, pmvitled tha� such impmvemen�s are nat imendetl or offered tor sale. It, however �Ae builtling or impmvement is sold within one year ot completion, ihe owner will have [he burden of pmving he/she did not huiltl or improve for the purpose o1 sale). � I, as owner o� the prope�y, am exclusively conVac�ing with licensed con(rac[ors �o cons[mc� [he projec� (Section 7044, Business ❑ antl Pmfessions Code: The Cantraclars' Sta�e License Law tloes no� appty �o an owner of propetly who bml�s or impmves �hereon and wAo coniracis for such pmjects with a caniractoqs�license pursuant to ihe Caniractars' State License Law�. I am aware ihat pmof ol Iheir Worker's Compensation insumnce shoul0 Oe pmvitletl to me. � I am eeempt untler Section: 8. 8 P. C. for �his reason: Da�e: Owner. I tlo here6y certity �hat l am aware ol and unaersiand the requiremen�s oi Caiifornia Health antl Safery Cotle Sections 25505, 25533, antl 2553a antl t�at I or any fuNre builtling occupan� will/will not (circle one) need �o comply wi�h saia s�a[e co0es antl the requirements �or a permit �or wns�mction or modi�ica�ion fmm Ihe Nir Oualiry Managemeni DisficL ResiOen�ial cons�mctian aDPlica�ions are exempi from mese provisions. Date: ApplicanL I hereby cernty �hat I have read �his applica�ion antl s�ate �ha� the above information is correcL I agree to comply with all ciry an0 counry orCinancesanOSla�elawsrelatingio6uiltlingconstmctionandherehyamhonzerepresenta�ivesoi�hiscrtp �oen�erupon�hea0ove-memionetl pmpetly far inspection purposes. A� �ate: �- Signawre: � � "'� �a � � oriver's �icense or socia� security x: � ' 16a1-46 Whi�e—Builtlinp: Green—Cotle EnbrcemenL Canary—Aoolicant: Pink—Revenue: Goltlenrod—Asxessnr CITY OF �OSTA MESA — BUILDING PERMIT PERM NO; B US J 1 PERMIT NO; B 056941 PLAN CHECK NO: N (,'�T: !7—$'II1�F�; A� CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; DEM JOB DESCRIPTION ; DEMOLISH SINGLE FANILY DWELLII3G (SFD) S� FT: CLAYM VALUE; 1,000,00 CALC—VALUE; 1,000,00 GROUP OCC; R-3 / COMMENTS: P **�t**�t+�*************�t*****�t****�t***� *�***�*�**�+�x�x��****�r�*****�t***�e**�t*�r***�t*�* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN PARKING REQ• FROV: PARCEL: 91904202 2NE: REF NO: PLANNING NlST'ES> � aF iE if iF iE iFlE �E iF �E �F IE iE iE iF 3E jE iEjE iF iE 1E iE iF iE if iE �E iE iE iE �E iF iE iE �)E iP if iE iE jf iE ik if 3f 1E iE 3E 3F iE 1E if �f if 9E if iF iE iE 3f iFiF iE #�F if iEiE if iE if ik jf �lE �lf i!� iE �f iF D E V E L O P M E N T S E R V I C E S R E Q U I R 8 M E N T S ZONING APPROVED BY , DATE: HUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY; �YVL� DATE: �� iFiF�E3FaEiE�lfiFiEiFifiEif3Elf3EiF3fikjEifiE�FiFiF3FiF3F if �FiF�F �F3FiF3F3F 3F7F7Fi7'?FiFiFiF7FiFiFiF7F3F3FiF3EiF1F*iF�FiElF�lE�lf� 3P3f *�r******�r�****�r*�r***�***�****��r*��*�� **��*****+�********��**�**�**�r***x **** LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y _+ BLDG PMT PLUMBING ELECTRSC MECHANIC FIRE SMIP/RES GRADING YERMiT 25.00 :� PLAN v � SMIP/NO�N—RE5 ISSUE FEE � HUILDING—DIV—> PERMIT ISSUE P�AN—CHECK TOTAL �---PAID DUE TOTALS----> 25,50 0,00 �•,,_I 0,00 25,50 � 25,50 ,00 REVENUE DIVISION TOTALS--> COLLECT'fiD; 25,50 UUER/SHORT; 00 $�D25p00 PLUMBING ELECTRIC MECHA�C FIRE SMIPI/TOT� GRAPING FLAN—CHECK �1F iF IE 3E if 9E dEdt'1F iF 8f !F iF iF iF df iE if iF�X� IF 1E iF ik if iE iE iF 1E iE iE df iE iE iE iE iF �EiE �1E iE iF iF iE iE ik iE iF iE -0E iE iE dE ih iE-k� 3E iE iE iF df iF iE iF iF iE 1F iFlf # iP dE iF iElE iE iP iE i4 I N D I V I D U A L ;F E E B t� E A K D O W N TYPE QTY D E S C R I P T I O N' UNIT COST TOTAL.COST NO FEES WERE SELECTED FOR THIS PERMIT , l� : - , , F� � OI qM�l�t=n.�r�+G�... ' . '" �'F�Ic�: �. (;� _ � .- .. � C4NSTRUCTION AND'PUANNING - APPROVALS Permit# ' ' 11• 1. Temporary Electrical Service or pole ' i 2. Soil Pipe-U�drgrnd. � . 3. Electrical Conduit Utility-Un�gmd. 4. Electrical Contluit�Undrgrnd. � � 5.. Steel Reinforcement . 6. Electrical UFEfi G�nd. 7. Footings � 8. Foundation a' 9. Water Pipe-Undrgrnd. . , 10. Structurel Floor System �%' 1 t. Property Sewer Line & House Connection 12. Sewer CaP �. � . 13. floof Dreins � . 14. Rough Piumbing 15. Rough Electrical•Conduit i 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electrical�T Bar Ceiling 19. Rough �Heating & Air Conditioning 20. Rough Factory Fireplace � 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe=Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T•Bar Ceiling (Structural) & Monocoat 27. Freme and Flashing 28. Lathing & Siding � 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat , 32. Electrical Power Mster�Final 33. Final Electric 34. Final Heating & Air Conditioning. 35. Final Gas Pipe-Test 36. Hood ar Canopy 37. Final Factory Fireplace. 38. Final Plumbing . 39. Water Service-Final 40. Gas Service�Final 41. Solar pomestic-Final 42.' Backflow Preventer ' 43. Backflow Irrigation 44,. Landscape Irrigation System� � 45'. Sound Attenuation 46. Handicap Regulations 47'. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cc 51. CERTIFICATE OF OCCUPANCY No. Date Date - � Inspector N 0 u POOL A APP.ROVALS Permit # 52. Pool & Equipment l�.ocation 53. Steel Reinforcement 54. Forms 7 . � 55. Efectrical Bonding 56. Raugh Plumbir�g & Pressure Test 57. 'APPFiOVAL T0 COVER GUNITE 58. �Electrlcal ConduibUndrgmd. , 59. Gas Pipe, O U�drgrnd., Test 60. 6ackwash Lines, P-Trap, O Undrgrr 61. APPROVAL TO DECK 62. BackwaSh & Receptor�Final 63. Heater & Vent=Final , 64. •Plumbing System - Final. 65. -Electrical�Final 66. Solar SYstem-Final � -� 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPA SYSTEMS FINAL FIRE DEPT: REQUIREMENT APPROVALS Permit # 70. Undergcound Hydro �1. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. S[orage Tank' O Gas ❑ 74. Overhead HYdro . 75.,Dry Chemical . 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78.. FIRE PREV. FINAL HEALTH DEPT. REQUI{ 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: (L/ �� -�� .�., � NT Date Inspector .' .. ' � 9 PHOJECT AO�BESS: 3 S 1 AlyOCADb S T OWNEfl'�NAME: NEWPORT PACIFIC DEV aooness: q400 MACARTHUR BL 9TH FL CAw9�2660BEACH (714)476-1239 AXCM/ENGINEEN: NEG.NO.: II�OflESS: UNIT: UNIi: PENMITTEE: NEWPORT PACIFIC CONST ( 714 ) 476-17.34 nooxess: 4400 MACARTHURBL 9TH F NEWPORT BEACH CA 92660 LICENSEU CONTBACTOB DECLARpT�ON: I hereby aflirm [hai I am iicensed under pmvisions o� Chapier 9(commencing with $ection 7000) ol Division 3 of ihe Business antl Professions Cotle. and my license is in luliforce and eile t. arv uc.: 0��2 STATE LIC.;501350 cus^: H�� / pa�e: � gnature: WOflKEflS' COMPENSA ION OECIABRT10N: I hereby aflirm Iha� I have a cerli/icaie oi consen� �o sel6insure or a certificate o� Warkers' Compensation swa c � c ifie pY Ihereof (Section 3800. La6. ). Poucv xo.: � G`� �& g t�— �� E%P. �FTE: �. 2� O 1 I 9 2 comraNr: � TATE ❑ Cehifietl copy is here�y �uf�ished. � ertdie0 copy is fletl with ifhe ncity ^Builtling �iw io� ate: � ApplicanC—=��i%�� Q1 _ � E%EMPTI FflOM WOPKEPS' COMPENSATION OECIAflRTION: (ihis secUon need not be wmpleted if �he permi� is lar ane huntlred ($10� or less�. 1 certity thal in th¢ peAo�maace J� lhe woB �oo which this permit is issuetl. I shall not employ aPy persan in any manner so a5la herqme suble�� o the Workers' Compensation Laws ot Calilomia. n, i Date: Signature: NOTICE: If, af[er making [his declaration, you should 6ecome su6ject to the Workers%•Compensation provisions of ihe Labar Goee. you must fohhwi�h comply wi�h suc� pmvisiuns or Ihis permil shall be tleemed-revoked. CONSTHUCTION LENOING AGENCY: I hereby affirm �hat Ihere is a coretruction lentling�ency 1or ihe peAormance al ihe work for which �his permi� is issued �Sed�on 3097. Civ. C). �eNoee: PREPARE FOR UPCOMING nooxess: pR0.7ECT OWNEfl BOILUEN OECIABATION: I hereby aifirm �hai I am exempt �mm the Coniractors' Sta�e License Law for �he tollowing reason (Section 7031.5 Business antl Professional Cotle: Any ciry of caunty which re0uires a permit ro consimct, alter, impmve, demolish, or repair any s�mcNre. prior lo its issuance. a�so requires t�e applicant �or such permii to file a signetl 5�atemeni [�a� he/she i5licenSeA pursuant m the pmvisions of the Coniractors' State License Law (COapter 9(commencing with Sectian 7000) af Oivision 3 of the Business and Professions Code) or Iha� hd�she is exemp� Iherefmm antl the basis for tne allegetl exemption. Any violation of Section 7031.5 �y any apD��cant tor a permit su6lecis Ihe appiicant m a civii penalty ai not more than five huntlred dollars (SSW�. I, as owner oi tAe piaperry ar my emplayees with wages as their sole compensation, will do the wark, ana t�e ❑ simcwre is noi intentled o� offere0 for sale (Section 7044, Business anA Pmfessional Cotle: T�e Caniractors' State License Law does noI aDO�Y ro an owner of a pmperty who builds or impmves thereon, and who tloes such work himself/herseii or thmugh his or her awn emDloyees, pmvided ihat such impmvements are not intentletl ar offeretl for sale. II, however ihe builAing or imD�ovement is sold witnin one year of completion, the owner will have the burtlen ot proving he/she tlitl not hui10 ar impmve 1or ihe purpose oi sale). � ' I, as owner ot ihe proper�Y. am exclusively contractinA �+��h licensetl conVactars to consiNct tAe pmlect (Section 7044. Businass I❑ antl Pm/essions Cotle: 1 he Coniractors' State License Law Ooes not app�y to an owner oF pmperty who bwlAs or impmres thereon antl who contracts tor sqch pmjects with a contactor�s�license Oursuant ro the Contractors' State L¢ense Law�. I am aware �hal pmof o� �heir Workir's Compensanon insurance should 6e provi�ed m me. � I am exempi untler Sec�ion: 0. 8 P. C. forihis reason: �ate: Ownec I tlo �ereDy cenify �hai I am awale o� and unders�antl Ihe reQuiremenls ot Califomia Health an0 $a/ery Cotle Sections 25505, 25533, antl 2553d antl ��at I or any IUWre builtling occupan� wilVwill no� (circle one) need lo comply wi�A said state coEes and �he requiremenis for a permi� lor consimc�ion or mo0ificalion imm �he Air Oualiiy Managemem Distnc�. flesi0en[ial consimction applica�ions are exemp� imm ihese pwvisions. Daie: p001ican�: I hereby ceriify that I have read Ihis applicalion 0 stale Natihe above inlormation is correcL iagree to comply with all ciry and counry ortlinancesantlsta�elawsrela�ingloGuiltlingc stmc�ionantlhere6yauthorizerepresentativeso/ihisciryto} nteruponlheahov¢-mentio e0 pmperiy lor i 5)0ectinn urposes. /�j� l�'y�n // Dale: [/ro � Signalure: ' / /'�ZAu�� / � �i�G�—a� _— oriver's License or 5ocial Secudry N: � � tfi41-a6 Whi�e—Builtlina: Gree�—Coae Enlorcement; Cana�v—Aoolicant: Pink—Revenue: Goltlenr�—Assessor CITY OF COSTA MESA — BUILDING PEkMIT PERM NO; P Q5693_ PERMIT NO: P 056939 PLAN CHECK NO: N , , CONSTRUCTION TYPE: 5—N PERMIT TYPE; PLU PURPOSE; OTH JOB DESCRIPTIOI3 ; DEMOLISH SINGLE FAMILY DWELLING (SFD) SQ FT; . CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: P �****��******x�**��**�***********x*��r**+�******x*�*�*x***�*�***�*x*********�**�* Z O N I N G R E Q U I R E M E N T S S E T B A C K 5 ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV: PARCEL: 91904202 ZNE: REF NO; PLANNING N15TE5> i **�****�r**�r�**�**��r*�*�*�**a��r*�*��*�r�r�r***�**�r��±�*+��r*�� *�*��-�r**�r*�t+r�t�x��*x��a�t*�** D E V E L O P M E N T S E R V I C E S:+ R E Q Tl I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: � DATE• `I l� � L iFitiElFiE�F#ifiEifiEifffaElEiFjFiElEifiE1(� IEiFifiElEiE�FiEjh# t r if�lE 9E iE iE iE iF it iE iEiE dE iE IF iE 3F 1! if �! if 1E jf iE iE ff 3f �E iE �t iE iF iFiE jt �E 1E it iE �F if if it if �f IF iE ik �E 3E #E jf iF it iE # fE iE iE iE ik iE iE �E iF if iE iF jf iF iE iE �E iE iE iP iFjE 3EjE if iE LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N HLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRAD7NG PERMIT PLAN ISSUE FEE 2.00 25x 3.00 SMIP/NON—RES BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 2,00 3,00 0.00 5.00 5.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 5,00 OVER/3HORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADT_NG PLAN—CHECK cJ,�Q 3f iE 3F it iF iF 1E iE iE ik ik if ik �E IE 3E iE iF �lE iE iF if ik ik �F iE if if if iF 3E iE iE if iE iF if if iP �)f �1E iF iE iF iFlF aE #E if iF 3E �F iF iF iE iE if !t �E 1E iF jE 3E iE iE iE ie aE iF fF if iF iE if �F iE 1F ff iE I N D I V I D,U A L F E E H R E A R D O W N TYPE QTY D E S C k Z P T I O N UNIT COST TOTAL COST PLU 1 SEWER CAP / DEMOLITIQN EACH 2,00 2,OQ END OF FEES u U�n1=6di� I.'�:1�_ j - � .� D�+'E: 0-/1U r^ T:I :. :. •-. CONSTRUCTION AND PLANNING-• - APPROVALS Permit # � �Date i: Temporary Electrical Service 6� Pole � 2. Soil Pipe•Undrgrnd. ._ ' ' 3. Electrical Conduit Utility�Urtdrgrnd. - 4. Electrical Conduit-Undrgrnd. 5. Steel Reinforcement 6. Electrical UFER Grnd. 7. Footings 8. Foundation - 9. Water Pipe•Undrgrnd. ". .,• � -. 70. Structural Floor SYstem 11. Property Sewer Line & House,Connection -;.� �, 12. Sewer CaP . . , , _'y 7i�� 13. Roof Drains � 14. Rough Plumbing . � 15. Rough Electrical-Conduit 16. Rough Electric Wiring , 17. Rough Wiring Sign . 18. Rough Electrical-T Bar Ceiling - 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace � 21. Ducts, in Structure 22. DuMs, Ventilating 23. Gas Pipe�Rough & Test � 24. Roaf Framing 25. Roof Sheathing ' 26. T-Bar Ceiling (Structurall & Monocoat . 27. Frame and Flashing , 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter�Final 33. Final Electric 34. Final Heating & Air Con�'I�ning . 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace � 38. Final Plumbing ' L/ jJj'�e 39. Water Service-Final 40. Gas Service-Pinal 41. Solar pomestic•Final 42. Backflow Preventer, 43. Backflow Irrigation 44. L.andscape Irripation SYstem 45. Sound Attenuation 46. Handicap fiegulations 47. FINALSTRUCTURE&BUILDING 48. FINALPLANNING 49: Electric Release to Edison 50. Gas.Release to Southern California Gas Co 51'. CERTIFICATE OF OCCUPANCY Date Inspector '� a �n POOL Z A Y APPROVALS Permit # 52. Pool & Equipment Location 53. Steel Reinforcement � 54. Forms 55. Eiectrical Bonding 56. Rough Plumbing & Pressure Test 57. 'APPROVFlL TO COVER-GUNITE 58. Electrical Conduit•Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P�Trap, O Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Peceptor�Final 63. Heater & Vent-Final 64. .Plumbing System � Final 65. Electrical�Finai - 66. Solar SYstem-Final 67. Fencing & Access Approval 68. APPFOVED FOR PLASTERING 69. POOUSPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oi 74. Overhead Hydro 75. Dry Chemical - 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIRE 79. FINAL INSPECTION 80. FOOD CEflTIPICATE ISSUED Notes: 0 Date �Inspector � � '