0108-351 (BLDG)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
.0 C:�0311 C
Date Signature of Contractor (' -
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following Feason:
( ) 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
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
eotion 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.
C:J' L IHDT!;iYF:iJITYP�3t 'lI. 74
(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 hall f9rthwith comply with,those provisions. ; . , ,
Date/ 'Applicant A t...*;
Warning: Failure to secure Workers' Compensation coverage is unlawful and
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 the 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 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.
. r
Signature (Owner/A! ent)-" .! - % ! "' Date
BUILDING PERMIT -
DATE / VALUATION LOT 010111-1351 TRACT
JOB SITE /
ADDRESS
APN
`�G
OWNER
CONTRACTOR / DESIGNER / EN INFER
PG diTi';:>'1':ft3+° xT�:l':x'3`T'i:N:l.. :t�:)a:''r:S`[i:)i`•�
TA"'J.,MAR :EI'.Ar:''IRC:'ti..{•014b.l pJ:.l(10NII(.A.>v°!'C:if:
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��:Si{`i�:d% • rit,t{Y t.:i.1}..�fl! :F i��i
USE OF PERMIT
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D Q 0
SEP 10 2001
CITY OF LA QUINTA
FINANCE DEPT.
f7••I_ l_G11 �ft,
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t.'K. t 1
:11-da`AI;i..,!t':N.}'A 13i sPOW
I .
RECEIPT
DATE j"
BY
DATE FI A D
I PE
�d
..
4 .-, ANSPECTION 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
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath 6
Drywall - Int. Lath
� t
_
' Final
BLOCKWALL APPROVALS
Final
p0CIL S - SPAS
steel T
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover l - ---
i Eauipment Location j
v
Underground Electric
_
Undercround Pibg. les; i
Final
_
vas ?ipin:»_-
PLUMBING APPROVALS
Electric Find
Waste Lines
Water Piping
_
neater Fina!
Piumbing Final
Plumbing Top Out
cEauipment Enclos are l
Shower Pans i
O.K. for Finish Plaster
Sewer Lateral
! Poo! Cover
Sewer Connection
Encapsulation
Gas Piping
——
Gas Test
Appliances
-
{
Final -+}-—
Final
Utility Notice (Gas)
. ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Nottage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
/�6/%f'y`� T/�da
DAVE STEAVENS
PROJECT} A �F ST t�N A sE t
ADDRESS
Inspection Services
BLDG. PERMIT #
ENGINEER .5-a4 Jo iE mdc-
INSPECTION TYPE
Page of >�
PROJECT # ' aao a o 3
CLIENT f G A LA -)E;-:97
DATE 1% APiZt L- Zoo
ARCHITECT _<So4.,814 AkCd4
CONTRACTOR,DEL M A&
INSPECTION REPORT
LOO w�a �L� - r �2a .�. t . �H a rta L4-1)Ae.AF-ra�SS,-L-F. T tr-,, — C-l)M
M
CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, r
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� S✓�l� 7 �U INSPECTOR NAME \ 1A JC -S:�/q JtLkiS
DATE l ��!'��. [� aO Z INSPECTOR SIGNATURE {
+v!'Ps.�:etrttsi3w"'w+.•ii�n�.l;jjia*�Jf "'. ""�rvF'tit�� _ �9"iVi"�arv7sn 3�fy{v���+�.c�r•4--c.: ..^--. s ,. ms`s
Page of
-DAVE : STEAVENS �s
'P.
'Inspection Services "Al
PROJECT 6 fl W E 5T -17W A S.0: (I tb _ PROJECT'# 1. ;200 Z- u 3
ADDRESS S'4,=oq3;0,Aq DjeS. 0 1; l •CLIENT F'C A W C -S K Nko fit
0.4kRit-1. P40f k)9 DATE • / / AtOiZIL .Icy,2
BLDG. PERMIT '# ARCHITECT 6.,04-6 A A2Ct�-�
ENGINEER " A do i it I AJ C_ CONTRACTOR JCL. AA
INSPECTION TYPE
INSPECTION REPORT
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. DSS 2 1 e ` s e) INSPECTOR NAME ` JC�i�tJ S
(Prin early
` DATE �� ��(� L- o7U�Z INSPECTOR SIGNATUR \ (�
tS L0 Gil W 0 8 _ fJ L Y. nJ A I sJ ,( -`-
•_I
' •4-47-4
N.L\/'{�,^
Vf�'[•f
AJO 6�qY /
14
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. DSS 2 1 e ` s e) INSPECTOR NAME ` JC�i�tJ S
(Prin early
` DATE �� ��(� L- o7U�Z INSPECTOR SIGNATUR \ (�
.d!'�Y+1Ptic`•y.�.er:.-,:La::c.
Page 1 of
DAVE STEAVENS
Inspection Services
PROJECT u3e Si' - _�NAS 03 PROJECT # c;L v Z - p 3 '
ADDRESS �� Lr 5-1 c b CLIENT e(�- IA ala 5T �Ao
B' isLDG. PERMIT #
ENGINEER LL &JJ 5 #L� J 01 e Z nJ c_
INSPECTION TYPE
DATE (c) A ID R rt 2oo Z
ARCHITECT (f -_,OL ibA
CONTRACTOR
INSPECTION REPORT
A. �.S - 2-1
3 y S -q - LVe-le ,�)C pl 3 - 00w�
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A - 3 5 -s , L. - ->o'
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CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, uhless 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. Q �Q 3 4 ' SC, INSPECTOR NAME 1
DATE 20 XIOW L, 19,02.. INSPECTOR SIGNAT URE �
1514
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ly/.
o -I 7
` OAKNr.LL
did`
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/l
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CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, uhless 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. Q �Q 3 4 ' SC, INSPECTOR NAME 1
DATE 20 XIOW L, 19,02.. INSPECTOR SIGNAT URE �
�., r „. _� •. .. '.*.$w,+.•�'•, ,� .... .. �.�•. r .«v, �` _�_• __rr..:?�v'xir'idrlva"-+W:
DAVE STEAVENS
Page _1 of Z, -
Inspection Services
PROJECTt� A `.� g�T - r�W R� sr t �,PROJECT # ;10 c Z - 0-S
ADDRESS$'14-0_93'004,y8T, o8 l CLIENT S EST a.{a
DATE /J AN14- zoo z -
BLDG. PERMIT #
ENGINEERJu Qh) SA 6� - =.-)c-
INSPECTION
.1LINSPECTION TYPE 9 -Po )r- Y
ARCHITECT CnpL A A A 2c L -k
CONTRACTORL (M ►4 tZ }7i4ct n- C -
INSPECTION REPORT
r �-7-joA 1:5 t fro k Y TF XP, P7-03
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I`11, 1 /Q-, **b \ A
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..
NO. SJ
CERT.6,573 �q " t-0INSPECTOR NAME JI`�G •C ✓E.
n rim Clear
M
DATE / /C► P2/ L_ 'Zoo Z- INSPECTOR SIGNATURE