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Home My WebLink About2219 PALOMAR AIRPORT RD; ; CB031688; Permit5 •. . Cityof.CarIsbad . -. 1635 FaradaAv Carlsbad, CA 92008 ' - 08-25-2003 - Commercial/Industrial Permit - Permit No CB031688 Building Inspection Request Line (760) 602-2725 4 .' ,' r• '-. - - .. Job Address 2219 PALOMAR AIRPORT RD CBAD Permit Type Ti Sub Type COMM Parcel No 2130701900 Lot # 0 i -'Status ISSUED Valuation $1000000 Construction Type NEW , Applied 06/18/2003 , Occupancy Group Reference # '- Entered By CB Project Title: • .WASHINGTON MUTUAL-'ATM DRIVE' .. ;Plan Approved: .08I21I2003 ' UP/ DEMO EXISTING DRIVE UP TELLER '- Issued 08/25/2003 inspect Area Plan Check# 'Applicant: - BILL HELM ' .. . - . -'• , MCROSKEY FAMILY- REVOCABLE TRUST 09-15-82 STE 170 695 TOWN CENTER .,,:-1 P BOX 13 , .:.: COSTA MESA CA 92628.' -•- RANCHO'SANTA FE-CA 92067 714-800-1977 :' -- / !,>\- \.,'' •. -..'" Ile Building Permit '....'$99 69 Meter Size , I ' .' Addl BüiIdingPemit Fee AddI Red. Water Con. Fee $0.00.' •. Plan Ceck-. '.- / / $64.80 Meter Fee '\ \.;. $0.00 •- Add I Plan Check Fee / $0 00 SDCWA'Fee .'. \ \ $0.00, Plan Check Discount / -.'$0 00 YD Payoff Fee \ \ $0 00 - Strong Motion Fee'. \ ç,' V $0.00.' Park Fee / "$0 00 PFF (CFD Fund) \ $0.00 , LFMFee / $000 LicenseTax \ $000 Bridge Fee-,. . - 1 $0.O0 Li6ense Tax (CFD Fiind) - 1- $0.00 BTD#2Fee ' '" :$000L .'Traffi lmpaátFee :,49 • so.00. . ;. BTD #3 Fee j $0 00\, '.,.Traffic Impact (CFD Fund) I J $0.n Renewal Fë'...' $0.00 ,. PLUMBING TOTAL ,J- I $0.00;.. .AddTRenewal Fee • $0.00 . ELECTRIC Lt.. ' J j$20.00 Other Building Feb • $0.00 ,ui.MECHANlCALTOTAL .7 /, $0.00 Pot Water Con Fee Ma $0 00 %, ster Drainage Fee $0 00 Meter Size ' .. . , '7' Seviér,Fee .. -/ / $0.00 Addl Pot. Water Con. Fee \ --.$0.00 .. .\RJé'vI?arking Fee" / /-$0.00' -. . Red. Water Con.Fee \ \ ..$0.00, Additional Fees / / . $0.00. ' It4tQF1tOTALTPERMIT FEES / $186.59 1-52 Total $186.59 '\TotalPay?nènts1To Date: $6480 'Baia'nce Due: - '$121.79 , *'' .- , --•• 2719 /03,600 o1. : 02 - - 121-79 ' 4'. ' r •(:-: z:-4e-:.: :' .' -. _,",'4_' .- 4 - .4,.. ' -, : - - .'-. -. -. •, - 'l 1. . '4- - , PERMIT APPLICATION ' CITY OF CARLSBAD BUILDING DEPARTMENT .. 1635 Faraday Ave., Carlsbad CA 92008 PROJECT INFORMATION .: . '"ZI1 '7AL6M,V2 by .V Address (include Bldg/Suite #) - - Business Name (at this Legal Description FOR OFFICE USE ONLY PLAN CHECK NOC-SOI(DS. EST. VAL. In / Plan Ck. Deposit (j941 Q Validated By Date -i23 01 02 T#of units No. Subdivision Name/Number Unit No. Phase No. ,A&JIc.. Assessor's Parcel # - Existing Use Proposed Use ..AQ p9W--ue ATI110 . Description of Work SQ. FT. # of Stories # of Bedrooms , . # of Bathrooms 'tl w- ti-'i 'tc OEi7o OTh p A, c4 1W Z Name Address City State/Zip Telephone #9I(4. buu I 11"ax # '7 i4 Srv'o 13 APPLICANT..,,EI Contractor 0 Agentfor Contractor. 0_Owner ,.2AgentforOwner - VVVVjjj Name Address V. City State/Zip Telephone # E4_PROPERTY OWNER .• . Ciqo 'r—L&,---r S(t Sut-rc I2c, r1tLcAo (1 17-Th r 1,0 .'IVF 12 Name Address City State/Zip Telephone # . I5CONTRACTOR. COMPANY NAME (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, commending 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 permiLsub cts the applicant to a civil penalty of not more than five hundred dollars 1$5Q0]). - p ç P 3rpj e. /JS4'Jt)s 04 2135O -2c4'-- V Name . Address City StatelZij V Tele one # State License # 55"() 7Y"7 . License Class C"i C'33 City Business License #. V ••/ lL., V Designer Name V Address V V - . V City V V V State/Zip •Telephone 40~' V State License # ' V V •V V V . V E6. "WORKER'S COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work' for which this permit is issued. . . • ' ,V 0 I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work for which thi permit is issued. My worker's compensation i suranc a cr and policy numbe are: ' V / ' / Insurance ComjEany tJtGlt(t35t)Pt'jC Policy No. /(,f,OO '7.&) "3 Expiration Date 1' 61/0 t&f - (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED. DOLLARS [$100] OR LESS) " V 0 V CERTIFICATE OF EXEMPTION:, I ify t at in the pe r ance 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 ns on Law of Califomi . .' • WARNING: ure to se cur workers mpen tlon covers unlawful, and shall subject an employer to criminal penalties and cIvIl fIne up t o on hundred thousand - dollars 00,000), In addltl to the: of c p aatlon, da as are provided for In Section 3706 of the Labor Code, Interest and att., eea. SIGI I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 ' I, as owner of the property or my employees with wages as their sole compensation, will d the work and the structure is not intended or offered for sale (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 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). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct 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 contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). - . V S , • . S 0 1 am exempt under Section • . Business and Professions Code for this reason: - - 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES 0 NO - I (have/have not) signed an application for a building permit for the proposed work. • V I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / ëontractors license number): - - I plan to provide portions of the work, but I have hired the following person to coordinate, supervise -and provide the major work (include name / address / phone number / /ontractors license number): I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number /Vtype of work): PROPERTY OWNER SIGNATURE DATE V , WHITE:FiIe YELLOW: Applicant ,PINK: Finance - I - / - , I - ' •" - . ' . V ,, V V.- 'V. 'V ,, 4. . .4• - ,, V 4 . V ' •l . V PERMIT APPLICATION , V V .. ' ,V , - V '•, I V CITY OF CARLSBAD BUILDING DEPARTMENT 1635 FaradayAve Carlsbad CA 92008 - " . 'V ''1 - ... - V - Page. 2of2 - [COMPLETE THIS SECTION FORNON RESIDENI1ACBUILDING PERMITSONLX_4 J Ii ' ' Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO ' • ' V , ," . V " Is the applicant or future building occupant required to obtain a permit fi'ôm the air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 NO IF ANY. OF THE ANSWERS ARE YES, ,A FINAL CERTIFICATE OF. OCCUPANCY. MAY NOT BE ISSUED. UNLESS THE APPLICANT, HAS MET OR IS MEETING THE V ., REQUIREMENTS ORTHE OFFICE OF EMERGENCY SERVICES AND THE AIR'POLLUTION 66NTROL DISTRICT. [8CONSTRUCTIONIENDINGKGEN'CYT ,, .- V.• ,I I ." ' ,* :.:- - -. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(l) Civil Code). V V 4 I , • -V. . . . . 4 ' .. LENDER'S NAME . - ' - LENDER'S ADDRESS V V. V.•V. .' Y' - 'V.4, ,V. .4,j [•. ''4 .9.'. •,. .-r-_-' L9TAPPLICANTCERTIFICATION' JV 777 S '. IV certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City. • ' ordinances and State laws relating to building construction I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for Inspection • purposes.. I ALSO AGREE TO SAVE, INDEMNIFY AND. KEEP. HARMLESS THE CITY. OF. CARLSBAD. AGAINST ALL LIABILITIES,' JUDGEMENTS, COSTS J' '1 , EXPENSES WHICH MAY. IN ANYWAY. ACCRUE AGAINST SAID CITY INCONSEQUENCE OF. THE GRANTING OF. THIS. PERMIT. .. - OSHA: An OSHA permit is required for excavations of 50' deep and demolition or construction of structures over 3 stories in height '• V V V ' -' I . , , V Vl 1 EXPIRATION: Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized V by such permit is not commenced within 180 days from the date 9 f such permit or if the building or work authorized by such permit is suspended or abandoned at any time after' .' , the work is commenced for a period of 180 ys (Section 106.4.4 Uniform Building Code). . '4 ".4 •' '' , V , - APPUCANTS SIGNATURE DATE A 41 • .7(4 VV, •, • '•' . : 1 i "4 " ' - V • ,, C I p ,"V 4 4 4 4 - . .. ' 0. , V ' . .4 V. - .., 4.A • '4., .' . - ' & , , V. , ' , .•.• - V. V , 'V. , 5 ••. .1 •*, V VV. 4,, 4' '' "" •. - ._ . ' V - V V ' - P4, ,? . _t. '_' 4 . . V. V. 4 4 . . ;4- '4 . V. " -. . ' , ..• V V , " • '' 4. '. . . . .' V. V.5' '4 .4 V. ', '. . .4" ._,,,., ••V V 4 4 II.,. V , 4 ,,j4, - • V V :- -... , a. ' '. . . y '4 , , • '' _ &V.VV. , 4 V VA' •.,4 , & 'V. • '4,V. ,': ',,. ,",'-' ('',. "I •,; . ' I ' I ' VV.•V I_4 . ') ' " * ' .. V. ' V.4k, ' V."4/ • . V. .: ,. , 4W'. . . V • 4 V. , . • I' . '4.'' ' V.. ' ' V ' V V. ' V VV. 4' V .4 ....'4 V 4 , 4 V 5 •. .1 • ,V. •4-_ ,7 V ....V. ' . '4 •' 4 1 ,,,, A .4 4 4, 4. 4 V. , , ' V 4', :. '. " 4, . , . ,• .-' ' "V.. 4, . 'V. , ' ' S 4 .41 7 IT Ir 4 . , '. ' ' ', '. • -I ' • , - .7' , 4 4 • ' •" •t .4 :" •' , 4 IV. ' ' V 4'. ' ' ,,'4 ' '7 • V , , •V. • , V. 1' '- . 4. ' ' . ' ' . , 4'.. '•?' ', '4. , . . ' . ' . V _', 1 V 4,,, - ." ', ' • '.'.' -. !' .. V., 4 . . - ,, .' .4 •'4• ' 'WV. , VV V ' .4. ,, '.4 V. V.. ' S - '1 .. - •,, V. 45.4 .4•, ' ' *4 V. - , i ' .4 ,. 4 S ' -'4 •.V.'.'$ ' 4 , I , • ' ' V. V. V• • '-V. '4 - - , 4. ,. . '.., ,, , - - " . V. , , i.4 '. , - _ r - V ' - WHITE File YELLOW Applicant PINK Finance ' V . 'I.- •$ -1 4. V.t. 'I 0. City of Carlsbad Bldg lnspectidn Request : .V. For: 01/05/2004 Permit# CB031688 Inspector Assignment: 'TP Title: WASHINGTON MUTUAL- ATM DRIVE Description: UP! DEMO EXISTING DRIVE-UP TELLER * Type: TI SubType: COMM Phone: 6615103180 Job Address: 2219 PALOMAR AIRPORT RD Suite: Lot 0 ' Location: Inspector: if APPLICANT BILL HELM Owner: MCROSKEY FAMILY REVOCABLE TRUST 09-15-82 , V Remarks: . •. V , . - , -,' Total Time: Requested By: CARLOS V V Entered By: CHRISTINE - V CD Description Act Comment . V 19 Final Structural AP 29 Final Plumbing 39 Final Electrical V VV • V - 49 Final Mechanical ,,.. / .. V •V - Associated PCRs/CVs V Inspection History -• •• V Date Descrition • . Act lnsp comments V • V •• V 12/30/2003 89 Final combo .' co TP ELECT N.P.P. V' - V 11/25/2003 Vu FtglFoundation/Piers AP TP ATM BASE V - 11/25/2003 12 Steel/Bond Beam - • AP TP V • V 08/27/2003 31 Underground/Conduit-Wiring AP TP •• V • V V . V V •/ - V . -- • . - V •' •• V ,, V V V ,,- . V - . -• V / -. . • V -- - • 1' - •'- V . 'V -• . a ' .V• - V . V V , • • V 4 EsGil Corporation In Partnersfiip with government for Bui1d'ing safety -- DATE: 8/19/03 V U APPLICANT JURISDICTION: City of Carlsbad U EVIEWER E3 FILE PLAN CHECK NO.: 03-1688 SET:!! PROJECT ADDRESS: 2219 Palomar Airport Rd PROJECT NAME Washington Mutual Drive-up ATM - TI Z The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes LI The plahs transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. -' LI The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck LII Theapplicant's copy of-the check list is enclosed for the jurisdiction to forward to the applicant,.- contact person. LI The applicant's copy of the check list has been sent to Esgil Corporation-staff did not advise the applicant that the plan check has been completed: Lii Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: V Telephone #: V V V Date contacted: V (by: ) V Fax #:: Mail Telephone Fax In Person LI REMARKS By Doug Moody Enclosures Esgil Corporation V LI GA LI MB [1 EJ LI PC V 8/11/03 V V trnsmti.ciot V • V V • V V V 'V• V 9320 Chesapeake Drive Suite 208 • San Diego California 92123 • (858) 560-1468 • Fax (858) 560-1576. V . V V • - ,. V V V •i V EsGil Corporation In (Partnership with Government for Building Safety DATE: 6/26/03 0 APPLICANT JURIS JURISDICTION: City of Carlsbad ci PLAN REVIEWER ci FILE PLAN CHECK NO.: 03-1688 SET: I - PROJECT ADDRESS: 2219 Palomar Airport Rd PROJECT NAME Washington Mutual Drive-up ATM - TI LI The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. - LIII The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed checklist and should be corrected and resubmitted for a complete recheck. 1171 The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck I LII The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person The applicant's copy of the check list has been sent to: Bill Helm 695 Town Center Suite 170, Costa Mesa, CA 92628 LII Esgil Corporation staff did not advise the applicant that the plan check has been completed. Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted Bill Helm L41 Telephone #: 714-800-1977 Date contacted L,/.2/0 (by z_) Fax # 714-800-1978 Mail --'-Telephone - Fax , In Person - - LI REMARKS I - . By Doug Moody Enclosures Esgil Corporation LI GA [1 MB LI EJ I] PC 6/19/03 trnsmtl dot 9320 Chesapeake Drive Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576 City of Carlsbad 03-1688 6/26/03 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO.: 03-1688 OCCUPANCY: N/A TYPE OF CONSTRUCTION: N/A ALLOWABLE FLOOR AREA:• SPRINKLERS?: N/A REMARKS: DATE PLANS RECEIVED BY JURISDICTION: 6/18/03 DATE INITIAL PLAN REVIEW COMPLETED: 6/26/03 JURISDICTION: City of Carlsbad USE: ATM ACTUAL AREA: N/A STORIES: HEIGHT: OCCUPANT LOAD: N/A - DATE PLANS RECEIVED BY ESGIL CORPORATION: 6/19/03 PLAN REVIEWER: Doug Moody FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and access for the disabled. This plan review is based on regulations enforced by the Building Department. You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department, Fire Department or other departments. Clearance from those departments may be required prior to the issuance of .a building permit. Code sections cited are based on the 1997 UBC. The following items listed need clarification, modification or change. All items must be satisfied before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3, 1997 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law. To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet number, specification section, etc. Be sure to enclose the marked up list when you submit the revised plans. TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC) tiforw.dot City of Carlsbad 03-1688 6/26/03 Please make all corrections on the original tracings, as requested in The correction list. Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760) 602-2700. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments.. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the.City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. Please provide panel schedules, indicate the new circuits feeding the ATM. Please indicate on the plans. the location of the electrical panel. Please note on the plans "AC Cable is not allowed in A, B, E, H, and I occupancies. NM cable is restricted (without City approval) to one and two family dwellings. Note on plans that an equipment ground conductor is to be installed in all flexible .conduits". Indicate wiring method, i.e. EMT, metal flex. To speed up the review process, note on this list (or, a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, . calculation page, etc. Please indicate here if any changes have been made to the plans that are not a result of corrections from this list. If there are other changes, please briefly describe them and where they are located in the plans. Have changes been made to the plans not resulting from this correction list? Please indicate: Yes L1 . No L3 ,. The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Doug Moody at Esgil Corporation. Thank you. City of Carlsbad 03-1688 6/26/03 VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PLAN CHECK NO.: 03-1688 PREPARED BY: Doug Moody DATE: 6/26/03 BUILDING ADDRESS: 2219 Palomar Airport Rd BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: N/A BUILDING PORTION AREA (Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) TI N/A City Valuation - 10,000 Air Conditioning Fire Sprinklers TOTAL VALUE 10,000 Jurisdiction Co cb By Ordinance de 1994 UBC Building Permit Fee I $99.69 1994 UBC Plan Check Fee vi I $64.801 Type of Review: Complete Review LI Structural Only LiOther LI Repetitive Fee Repeats Hourly Hour * Esgil Plan Review Fee I Comments: Sheet of I - macvalue.doC Carlsbad Fire Department 031688 1635 Faraday Ave.Fire Prevention ' Carlsbad CA 92008 (760) 602 4660 Plan Review Requirements Category: Building Plan Date of Report: 06/27/2003 Reviewed by: Name Callison Arch Address 695 Town Center Drive #170 City State: Costa Mesa CA 92628 Plan Checker Job # 031688 Job Name Washington Mutual Bld:c5TB0316887 Job Address 2219 Palomar Airport Rd Ste or Bldg No Approved The item you have submitted for review has been approved The approval is based on plans, inforriiation and / or specifications provided in your submittal, therefore any changes to these items after this date, including field -. modifications must be reviewed by this office to insure continued conformance with applicable codes and standards Please review carefully all comments - attached as failure to comply with instructions in this report can result in - suspension of permit to construct or install improvements I c Approved The item you have submitted for review has been approved subject to the Subject to attached conditions. The approval is based on plans, information and/or specifications provided in your submittal Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements. Please resubmit to 4 this office the necessary plans and / or specifications required to indicate compliance with applicable codes and standards Incomplete' The item you have submitted for review is incomplete At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and / or standards. Please review carefully all comments attached. Please resubmit the necessary plans and / or specifications to this • office for review and approval , V -- Review 1st 2nd _________ 3rd Other Agency ID FD Job # 031688 ED File # • . * 4 * •,. .0 •., , 4 . • . - 4. .1_ ,. - 44 7' . . State of 'c A ' ' RIGHT THUMBPRINT (Optional) : 1' County of 1_5 On / — 03 before me , 14 v'eys (NAME/TITLE OF OICERi... E OOE.70T y PuBUC) 'personally appèared \.Jt# _J2i~6ICII/ 0/:T E(S) OF SIGNESII . 4 z;L._7/ 'CAPACITY B'( SIONERS OCORPORATE E3"personally known to me -OR 0 proved to me on the OFFICER(S) 4 oasis of satisfactory DPARTNER(S) OLIMITED . . ',.', ,• evidence to be. the OGENERAL . - • person(s) whose name(s) DATTORNEVINFACT.' 4- is/are subscribed to the •. DTRUSTEECS within instrument and DGUARDlANCONSERvAToR--'. acknowledged tome that DOThER: .-. ------------------------------------------------- he/she/they-executed-the----- -- ---- ____ ____ same in his/her/their ii SHARON K. MYERS 11 authorized capacity(Ies), SIGNER IS REPRESENTING: H ! COMM #1246965 cn and that by his/her/their (Name of Person(s) or Entity(io.)' NOTARY PUBLIC CALIFORNIA 2 signature(s) on the - • . - .4 LOSANCEIES COUNTY instrumentthe person(s), M! Comm. p1______ 25_ or the entity upon behalf .4 . . . of which the person(s) acted, executed the S instrument , RIGHT Th , UMBPRINT (Optional) ' . .,. •' Witness my hand and official seal. ISEAL) (IOAIuMcVrI1VIpy 7 . .4 ' CAPACITY CLAIMED BY SIGNER(S) ATTENTION NOTARY H The information requested below and in the column to the right is OPTIONAL. Recording of this document is not required by law and is also optional. It could, however, prevent fraudulent attachment of this certificate to any unauthorized document.. ,. . THIS CERTIFICATE Title or Type or Document ' MUST BE ATTACHED TO THE DOCUMENT Number of Pages - Date of Document DESCRIBED AT RIGHT: . - Signer(s) Other Than Named Above .4 - . • . , .. 4' .444 - WOLCOITS FORM 63240 Rev. 3.94 Ipe,c. cisu 8•2A1 01994 WOLCOTTS FORMS, INC. ALL PURPOSE ACKNOWLEDGMENT WITH SIGNER CAPACIr(mEPRESENTATION(rwO FINGERPRINTS DINDIVIDUAL(S) OCORPORATE OFFICER(S) - miusi - OPARTNER(S)' OLIMITED OGENERAL DATTORNEY IN FACT OTRUSTEE(S) *4 • - DGUARDIAN/CONSERVATOR - ' DOTHER: -.-. ' (• - - 4 .1•-.-. SIGNER IS REPRESENTING: - (Name of Porion(s) or Enthy(ies) I -. -. :4-- 4 - - DhIIIIIIIII 11111 I 11111111111 ''' 7 - . - ilIlillIllIll 11111 I III II (11111