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0108-350 (BLDG)..' , I hereby affirm under penalty of perjury. that I am licensed under provisions of t.: l��<,• I— Chapter; 9 (commencing with Section,7000) of Division 3 of the Business and Y.N W Professionals Code, and my License is' in full force and effect. M,-- License # Lic. Class Exp. Date f� Q, to X X31 �2 ,� or�lt2c d Z r` Date Signature of,Co . raFtdr' fay p O'►- OWNER -BUILDER DECLARATION C r s-!��.-{• WW I hereby affirm under penalty of perjury that I am exempt from the Contractor's CL N License Law for the following reason: Z ( ) 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), ` ce) . - • : O I'am'exempt'under. Section B&P.C. for this reason to N Date Signature of Owner „r O Q, 1 ` a' Q WORKER'S COMPENSATION DECLARATION Q I hereby affirm under penalty of perjury' one' of the' following' declarations: to,r H O O I have and Will maintain a certificate of consent to self -insure for workers' X, W u- compensation, as , provided for by Section .3700 of the Labor Code, for -the : performance of the work for which•this.pertnit is issued. Q';U I, have and will maintain workers'' compensation insurance; as required by 0.9."1-:1 QS Ion' 3700 of the Labor Code, for the performance of the work. for which this d H ;,pbrmit is issued. My workers''compensafion,insurancei carrier & policy no. are: r rZ Carries' Policy No. coK. i:) CALIND.RMk ITY slfdl$2174t*� �tl.g (This section need"not be completed If the permit valuation is for $100.00 or less). 1 _ O 'f certify that in the performance of the work for which this permit is issued, 11shall not employ any person in any manner so as to become subject to the t>; workers' compensation laws of California, and agree that.if I should beoome subject to the 3workers' compensation provisions of Section -3700 of the Labor ; `z Code, I shall forthwith comply w•ith,fhose,proyisio S. Dated Applicanof t e 4 �, n ng: Fatlure;to'secure Workers. Compensation coverage is Uhla�'vf(J�t�ah6= shall subject an employer to criminal penalties and civil fines up to $100,000, in f ;addition to the cost of compensation; damages as provided for in Section 3706 - . of theLabor Code; interest and attomey's fees:- l� 3IMPORTANT Applicatlon is hereby made to.the Director of Building and Safety � for, a: permit,7 subject to':,the conditions;., and restrictions set forth on his .application: 1. Each person upon whose behalf this application is made & each person at 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 'harmiess the City of La Quinta, its officers, agents and employees. ' r }° 2 `,Any permit issued as a result of this application becomes null and void if + work isnot commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. certify that I have read this application and state that:the above information is `4 *correct. I agree to comply; with all City, and State laws relatingto the building 9 construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for ins action purposes. 4 Signature (Qwne1/Afit1.. Date i . BUILDING PERMIT..4_ :.Q. DATE VALUATION - • ' " LOT OiO1� SS0 ' `- TRACT a P JOB SITE •' �� ADDRESS OATC aux; APN OWNER CONTRACTOR / DESIGNER / EN INEER 1XIA'WEST REMEWfTAL A.SSt3CiA7I0Ai DEL MAR PAt; W D&' R 1l: COMMA C'1�0 POBOX 1060 -162 UrEV04SAVE. 0302 LA QUfNT,,,+s CA 92233 SOLANA BRACH CA. 92075 USE OF PERMIT I. -OVAL O.FFt'C F, INFORMATION :faUSCEL N.ECIUS 73.160 SIP. CfiARLF i PI, '� S �I0-% 5,4101 a 54.09? U1tK. HILL - LiUIMIN0 17, TYF 9 I IC. VM11N`I'ARY 3T,RUC"1 UR.A1. MODIFICATIONS 'S!.,4i,'tJ.A.�'IC.tAI ;80,►100,09 l.,.�3 Yf:97:1!c•�s��'T OF �'0?4Sy..M17(T1..70,N 20,cux►:� 11ERMYTYKE SUMMARY. C'021 "I f413C"1 TOAZ FI?L.., l i,11-(ZU(h 4 l S�fiJt1 MOM ' STTI. HO PAUTICIN FEE.r I:E5ID 101-000-244-000 SEP 1.0 2001 CITY OF LA QUINTA FINANCE DEPT. ',gCJB-TffSAt: CnA1SI'It.U'C°11C?N AN1') `I AID C"I}! (`IC $2,09.00 1,ITa3 PRE_PPM N $0100 T OTA14IMMM IfJET S DUENOW � l iw�,t3t) 1 Len RECEIPT DATE K. BY DATE FIN E I PE OR ✓O INSPECTION RECORD OPERATION j 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 Dryvrall - Int. Lath Fina! i' BLOCKWALL APPROVALS Final POOLS -SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric _ Underground Plbg. Test —�— Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enc:osure Shower Pans O.K. for Finish Plaster _ Sewer Lateral Pool Cover Sewer Connection --- Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: .0007 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) .. , .' xr�'�!{ :i.'�i :�'r4; ';-'�C.}; .9 �.: �YgGAv:;: H;;roN.- � �,1,• ��., �1 •'�:3.b T 1��} ;�(:: ""y3:�: .Y:n. - ._mss.,_. :. Page Lof ..-DAVE.NS., 'Inspection Services, :.'PROJECTt7(,.4� t.JCrST - "k�, ocs: PROJECT #' Q oo -o3 ADDRESS S y- f o l 10T. 1 a ; 91 CLIENT -S ' t-4, 04 RA -i ,. DATE :' Ae L! L , Zc n 7 BLDG. PERMIT #ARCHI-TECT . G D Lei. A 12C -t+ _. `ENGINEER t,L,yrJ Spm, E CONTRACTOR IA R -A Ca i t ( m INSPECTION•TYPE INSPECTION 10EPORT Lou l o A Lt -S - Am 10. C. 17f4r2(�: c tJ �1 i2 �. ,rJS�[�*4 r` '16'.) CERTIFICATION OF COMPLIANCE :To the best of'our knowledge, all of the,reported work, unless otherwise noted, substantially complies with approved plans, specifications and' pplicable sections of the;bulldih6:codes. This report covers the 4ocations of the work inspected'only.and does not'constltute engin;' - 'opinion orproject control. CERT. NO. ''INSPECTOR NAME S'�JQ.L%EA%S r t o wry) �1 y 1 DATE / / �- 2ZW-Z.. F INSPECTOR SIGNAT '. Page of Z �-� • � DAVE STEAV�NS Inspection "Services PROJECT A W aT - AA's E' 12, PROJECT # ADDRESS" L�-Lp� a /'.V ;�..i CLIENT:y �..� • T t-4 E) DATE'' .,BLDG. PERMIT # ARCHITECT A :1 P_C. r, -t . ENGINEER,., ,mow 1 SA Jo�:�c. , ;� CONTRACTORWk A Z -..'INSPECTION TYPE -INSP19CTION.REPORY. tyg', dot og t4, (-A (-A Co r - . . t..v e�.L (i,:.� (. � A - 3 5 5 • (_ r�T ,y S L - 70 � " �w. �u­z C. S'-►tS.121 :lr'1 'll.'s` QA"1/ 41 &c.. L14.� � Lyt).G:�/� J. CERTIFICATION OF COMPLIANCE To the best of ourknowle'dge,,alI of the reported work, unless otherwise noted, substantially complies with -a` pproGed plans, specifications andApplicable sections of the'building codes. This- report covers the locations of the work inspected only and does not constitute engineering opinion or.proid4control. CERT. -No. 4./gIC93 JCS INSPECTOR NAME • 1 )•}f �J� s'�c�1CICVS /f DATE Z� . A I? >z l L INSPECTOR SIGNATURE" A ESTEAVENS Page � 1,f Z D V ' Inspection Services PROJECT J(_�) C 51' - 'A4AS a PROJECT # c,7 001 ADDRESS S`I-IOa. 1oS rot t 04 .7 CLIENT P6A W e5T No/} 0&!nW 1 u Ai k, t i fl -6011 DATE e A {Q ( L ;vo2- BLDG. PERMIT # ARCHITECT (o4 -3A A? -C -q ENGINEER�wJ,�l �flJe)kt, �eJL CONTRACTOR,��� /h (4 r2 PA cf i �C- INSPECTION TYPE !,may INSPECTION4 REPORT 1. - oc."c.��f,Jra LyC�A�r'f�rJ5 Eooxy 5,r►�i�5�11 uSN 4 X/J d CSL-e'q'l d r-E i'Li c A-7 �o�.l �r1,J J 3".JS •r -a LtrAT fuhl 5 t��R •Y�e3v 419 44S— !5 -q- IoPr C�AK�A k1_L L fl L4 ,. �ZJ c a - a Lo c5. gj-05 - /.�"t),C-PTN 1' !) (A Ro05 - l7 4 E r;,,4 '�� c�L15 A 0 Fist �\J-�LoLS- No�aS - 1�` �� 14 ��, O -rS' Lc.r,1 (,1 If - Ll -10-t' ©Ai,LN1t.(.. ?LAfi (% u 11 �' � �. • k -0e -s - NoteC s - t�.. 'be y0 y1 ���c�t►-a •� Ig3 � ��a 3/ s- �.EAR Cz�Tti�Z - a LvGS " �-ica�.1�S " 1 � �X�1"'t �'�F�� R. 4��5' I S l..C►`1C�T H /8 �,� 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 •''thip locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. D1 ,!5 793'T ' �U INSPECTOR NAME __ DAJ9-5-t4AJE.w5 ' Q e (Prim Clearly) DATE C9 AAe 0 INSPECTOR SIGNATUR��Ir iZia.a_ CZ.�"TE.�1- a t�cs- �uL�S • 3 " l 2.�� D��'[W �ti t��� ' . i�oDrj- l� �y�Tw ��6�� � �A . "V;reA ►le W 1, Ll- PLA /J "r Q , 11 L OGS - 6-AOLCs � 2,' bCPTN1 1 �► .)I I\A J', 1 '7 �D QS � 1-7 �g / 17 � f! ,prk2 WCSt- L %y - .) LoC5- H0Lt-S ,1 - 1Z 1� Ct�'IH 005- I S L.t?.t)G I H 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 •''thip locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. D1 ,!5 793'T ' �U INSPECTOR NAME __ DAJ9-5-t4AJE.w5 ' Q e (Prim Clearly) DATE C9 AAe 0 INSPECTOR SIGNATUR��Ir