Loading...
0108-352 (BLDG)LICENSED CONTRACTOR DECLARATION 'i hereby 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 Code, and my License is in full force and effect. License # ' Lic. Class Exp. Date ?331 Bt , Date ��, .� > Signature of CSontractorLLL !0.'�1 r ✓� ��r+ OWNER -BUILDER DECLARATION 1' C I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law 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). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ' ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O 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. (Cr,hhave 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:: FA Carrier Policy No. ,r CAL 'IPplM01IT'f ;PF31td�1 �rE, (This section need not be completed if the permit valuation is for $100.00 or less). `4 () 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 X3700 of the Labor, Code, I shall forthwith comply with those provisions. l „7 Date: f; . <<< l Applicant,) I, .I ! z F. ! >, ,d , . n / 4/ < �,r..-«f"'f.4s: �.{.:.5.. °4�! a•.,a .. v rt,,. - �r v f M ""Warning. Failure to secure Workers' Compensation coverage Anlawful4and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to th,; Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 thatthe. 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((OwLrJAn`/f f / /- fge). 4 PERMIT PERMIT# r j/BUILDING DATE / VALUATION LOT 011,3:12 TRACT GJ l!%% i{Ei�liias JOB SITE -� ADDRESS 0AXAM _521 APN OWNER...' CONTRACTOR / DESIGNER / EN (NEER PGA DM MNR PAY..3.14 c,10RUMM, cCONTRA>✓TC.t:.1t PX)),%' 1060 462 WEVE 3 AV& 4302. CA 92253 SC3Z..,RNABEAM CA 12•075 ($58)792«1500 CDO 582 140E:AL C��-ICE USE OF PERMIT dY147C 'LJ:W`J)�fd".R,JWt7. [ylAdf?.:WACATE014 73-160 all" �..~I'L:i'Ti'lUts P-1 U4Q'7I _ -OZ, 54.09 a 5+1.065 OAK ti1t,L - HUI1, 1,D 1140 l9, TY 1K.' OL[11+1'1'ARY STRUCTURAL MO13ftCA.TIONS VALUATION 2P,Of '00 bs Z "UM rT� G*09r d,"►�' C.`C�3dFI RU+L'"9IUN 20,OQi3dV ... ,&�'W0TRm C"•TI0N ME11P. 101-000,41 8-OCIA! $207.00 o Q o SEP 10 2001 CITY OF LA QUINTA FINANCE DEPT. WD- 10TAL C.ON19M lO.."JO AND PU9 (21- ECK Uss PREPRAW FRE00 $Cwo TOTAL PERMT11 YKES DUE VOW RECEIPT DATE) / BY DA FI L %) LV� SPECTOR ""S 1) rl 1 r INSPECTION RECORD OPERATION DATE INSPECTOR BUILDING APPROVALS Set Backs Forms & Footings Slab Grade Final Steel PLUMBING APPROVALS Roof Deck Waste Lines 0. K. to Wrap//��1-140-60. Framing el iwi-&-clool- Water Piping Insulation-- Plumbing Top Out FireplaceP.L. Shower Pans Fireplace T.O. Sewer Lateral Party Wall Insulation Sewer Connection Party Wall Firewall Exterior Lath Drywall - Int. Lath _ i OPERATION I DATE INSPECTOR MECHANICAL APPROVALS Underground Ducts Ducts Return Air Combustion Air Exhaust Fans F.A.U. Compressor Vents Grills Fans & Controls ( POOLS - SPAS BLOCKWALL APPROVALS-'', steel Set Backs %; F Electric Bond bona team i a: proval to Cover t.rt[+,ivA ..gt Location UNftround Electric Underaround' Plbg.: Test , Final Gas Piping - PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover,, Sewer Connection Encapsulation Gas Piping Gas Test mnar COMMENTS: Final ELECTRICAL APPROVALS Temp. Power Pole Underaround Conduit Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) r-J�fi• .�. .`� tel. :,'r'r•'_ n.:-�'y s'_. = 4{ ___ ..�'_____, iu'�••-,'-'-�. ',�t:;,6 :`�$);f:ia�:>_:.Yx:-w.i�_. DAVE STEAVENS Page I— of Z Inspection Services n PROJECT #� (2 QF -51 -3 -\21-:)e 1 i1 PROJECT # ADDRESS 07 -1.0-1 0(C_ OCo 5 CLIENT-} (,A LJ EST bk o ijp,, ©�4bC N t[,� 3��G `tt9 �iA►J I 1 DATE Zc�o z. BLDG. PERMIT # ENGINEER�Oi,3 .SAJvI c I til C— INSPECTION TYPE ARCHITECT CONTRACTOR l�'L_ t�,' INSPECTION REPORT LC)LJ 'W ALL5 S ►� �, AvZ A L:. ►..� <� A ,j X04 PP I til G -- Cr,, M D L t 7- E . AAiLI,Jv A--T'C-S" ! �-,. AA)0 [3Lockl AJA1L►0Cz L C Tc' CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, -1 substantially complies with approved plans, specifications and applicable sections of the building codes. This report covers l the locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. 08 4/9 - INSPECTOR NAME JJft1Jtr� �C+JS n Pri BATE �� �{/-� �•- aZ 007 Z - INSPECTOR SIGNATOR �„ 7 DAVESTEAVENS-. Page of Inspection Services PRPJECT�G ADDRESS Sri-U77.-O'73,0q.0 5— IJI BLDG. PERMIT # ENGINEER 3]u-,iJ SAJo(e we,_ INSPECTION TYPE PROJECT # cP 00 Z - CLIENT � K DATE 1r7, APR -(L `:L00-2_ ARCHITECT GO L 3 A A tZ c t4 CONTRACTOR . b L M Iq (Z PA C*_ 10 1 r /C - INSPECTION REPORT' CERTIFICATION OF COMPLIANCE:To.the best of our knowledge, all of the reported work, unless otherwise noted, substantially complies with approved -plans, specificationsand applicable sections of t ' he building codes. This r6pbrt covers ,r,) the locations of the work inspected only and does not constitute engineering opi n*ion or project controL CERT. NO. INSPECTOR NAME jA J L DATE l 7 AlW4 ;kw Z' INSPECTOR SIGNAr;�U�R DAVE STEAVENS Page t of _I Inspection Services PROJECT �e,& W C. -S-7 - t A 5 C r 3 PROJECT # .249O Z -(=)L4 ADDRESS n- O'7'l 107 3.061 _ oma— CLIENT ,IN t S R GANGA % Lk_ -� L J)C �' J I l DATE Wig 4,PR I L 01&-70Z BLDG. PERMIT # ENGINEER L& 0 rJ "' A dt) tE = itJL INSPECTION TYPE EPOA- y ARCHITECT DOLS A- A,C L 4, CONTRACTOR �e-G ^49. DA ci r<< C INSPECTION REPORT f"ocL0WtjJ(- Ln ATio 1s EPv)<Y Siem t)s.,#j ETA tXP, I-oy,.'7-63* t�' 4LA rzW i ACJ L) C-LdDA&J OF Oe3lZLS A P P L l C 1l�"T , ot,-) A IJ I) X nJSTA LL.A-T 10 AJ As iPO/Z -2-c& D q 9 Y Q Ak-K 1 LL- �t_+ \ �-1• Q �lp_ � r �1 • �t.c;Yc S 11 / -C)L�S - �i�vt (, ►�,ra 005- lZ _t_t�1cH f3' ��A__ u AR- EfLST �tt� • a I.ocg - Nc�LES• I1 D�t�r+-t l �� f� �� -� s - I ? C..�.�c. i t EY .m'� 7- S" 4- v'? 3 a Ai -1 �4 I L L. - '1-LuC�--1��5-� �i�aT� i��i,A Zt ods- 11'�L=►..�C�-r� ���,•D1� 4�L-A2 C�a'T �� • a cvc5 - I�1vLcs • 1 �.� Pi'► -1 3 ��+111 � A ��S-1 S� �L� J t;?� S�S �I tai �1 q - RE ENS -1 AoL.ts- (L i EPTH L 314" 1vAt70 fS"GEU4,Tr1 /t3r�t),,A sti OA I,)4 I t -L. PLA I c? I, "`0 '14" ZlAn weir �,�- a CvcS ir�o�cs- �S/B" 12 RA- fly:, �c��a�`a.-���c.5.4•lv�c.S- l� Dti?tw it1D��,, IZo�S- 1"i�+c..E►..>,c.�l'H %81�DrA . CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, substantially complies with,approved plans, specifications and applicable sections of the building codes. This report covers the locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. �1� ��' SQ INSPECTOR NAME✓'-' DATE If- R I �- o? t70 Z'' INSPECTOR SIGNATURE Page �_ of ! DAVE STEAVENS :. InspectionServices PROJECT (,fl c,Jp-5 � • PHflSE /!3 PROJECT # x.002 - y y ADDRESS "? / 8 ' Bc Dy 5 CLIENT ?G A r. es -7- +4o4 4 BLDG. PERMIT # ENGINEERIU0►J SAJoic Aje.- .INSPECTION TYPE. DATE ARCHITECTLBfE 2 C►-/ CONTRACTOR ,QL-L /n q 2 INSPECTION REPORT :Sy=0'7 7 n 73 oc.9 ori t:', e,:;�,a V H i L t_ i� ST�2/9 P/ r tiJ 6 apM TE LA -r4 Art i� S r-1 ie c.�r✓. CERTIFICATION OF COMPLIANCE: To_the best of our knowledge, all of the reported work, unless otherwise noted, substantially complies with approved plans, specifications and applicable sections .of the building codes. This report covers the locations of the work inspected only and does not.constitute engineering opinion or project control. CERTNO. 09_z;_9.3 �f3 -SO INSPECTOR NAME Q ?A LJt Pj DATE �Sv L p!yU Za INSPECTOR SIGNATURE