0108-346 (BLDG)LICENSED CONTRACTOR
| hereby affirm under penalty o/ perjury't!49i | am licensed
` Ch(commencing with Section 7000> of Division uo/the Business and
Professionals Code, and myLicense ioinfull force and effect.
License # Lic. Class Exp. Date
Date Sig natu re.m
OWNER -BUILDER DECLARATION '
,
hereby affirm under perjury that |omexempt from the
License Law for the �following reason:
( ) | as owner. o�Ve 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 &Prof ei;Sionals Cocl6)
1, as owner of.the property; am,exclusively co,itracting with licensed
contractors to construct thi
project (Sec. 7044, Business--& -Professionals
I 'am exempt under Section for this,remon
Signature., of Owner
WORKER'S COMPENSATION Db:LARATION-
II- declarations:
'),.I have and -will maintain a certiQate of dons'ent to selMnsure fdr 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 mainta I in workers' compensation insu , rance, as re qui�ed b -
Carrie r Poli dy No.
(This sectio'n' n6�6 not be' completed if lhe permit valua tion Is f6 I r $100.00 or less).
I shall not, employ any. person in any m . anner so as to become subjectto the
Workers' Compensation laws . of Galiforrii�:,'��d, agree that if I sh6 61d become
ybj ct t6 the workers' I sions�of Section 3766:0f tli� Labor
'Date: Applicant
,Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject,an ernployerfto criminal penalties and civil fines upAo $100,000, in
addition.to. the cost of compensation, clamagesas-provided for.in Section 3706
of the Labor Code, interest and attorney's foes.
for a permit subject to the conditions.. and restrictions set forth on -his
1.Each person upon whose behalf this application ismade & each person at
whose request and for whose benefit work ioperformed under n, pursuantm
any permit issued a00000v|toLtmuapp|icamnagrees to, &xhan..indemnify
& hold harmless the City of LoCmima. its officers, agents and employees.
u.Anyponnit issued as result orthis application becomes nun and void i/
work is not commenced within 180 days from date of issuance cx such
ponnit, or cessation of work for 180 days will ovUf ecpermit mcancellation.
| certify that 1have read this application and state that the above information io
uonoo. rogrewmcomply with all Qty, and State laws relating to the building
oonmmction, and hereby authorize mpeoantmivox of this City menter upon
the above- menhovod,pmportyfor inspection purposes.
Signature (Owner/Ageni)' Date
PERMIT #
DATE VALUATION LOT
JOB SITE
N
ADDRESS
OWNER
CONTRACTOR DESIGNER ENGINEER
USE OF PERMIT
(04
SEP 1 06 2006;]l
CITY OF LA QUINTA
FINANCE DEPT.
OPERATION 'Ja1Tr INSPEC-TOR E OPERATION DATE
INSPECTOR
BUILDING APPROVAL,
MECHANICAL APPROVALS �
Set Backs { {
j ?}nderground Ducts I
_
Forms & Footings j
- Ducts
Slab Grade I
— R,?tui,. Kir
—-
— I------
Steel {
Combustion Air I
Root Deck i !
exhaust Fans
0. K. to Wrap j i
c F,A,Li.
Framing
i
Insulation E !
— --
Fireplace P.L.
vents
I Griiis — !
_
Fireplace T.O. _ }
u — -- ^—_
...._._ {-Fein,,,Co_nirals
c
---..+.'--j
Parry Wall insulation !—
Party Wall Firewaii
Exterior Lath -i—
— Condens��i Lines
-- - } - -- -
Dryvmll - int. Lath—
— i
Finals.:PA
g� ,f�.ra 1. .t'' r•qq
S
-`�— ,
Set Backs _ .—._i—._______—_ ----1
Footings
Fain :.'rr;in
Bond Beam
orcrai to Cover --
i
Eau:,,)m t Location
-.-i
Undercrcund Electric__ I-
Final - - �i-_---•--
ate. �ia.MS1NG e-"%i',iR9OVALS--'
- I Uroer.:,ounti R?tom. Test
— ! Gas r'iriry~ j i
est
I Waste Linesester
Water Piping _�_ _
Plumbing Top Out — .--.-__-- {
_Shtrxer Pans - --�- i
_!
_
Fina': '
rlumoing -incl
—
_ nt �nclosur_
�E,�uic ne, Enclosure
O.K. ,or Finish Plaster_
Sewer Lateral _ I
ooi Cover
Sewer Connection I i
, nc:.rsulation �
Gas Piping -- -- { --
Gas Test j
Appliances ---- � —V
► i ---1
I ,OMMEt S: —
Q I
'
I !
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
i Rough Wiring
Low Nottage Wiring
' Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F 1.
Smoke Detectors
emp. Use of Power
c
Final
Utility Notice (Perm)
- . — `..,,,,,�;,��:y „n;yR+u.i"+ir+i►iC,r^'`r � +i,�M'fy•a'�/is`.._ . ... _ FviGl'+LsaJ,-. �'Iwa{i.�:�'vrcvi';.,r.,��,4 "+""_'3
Page of
DAVE STEAVENS
Inspection Services
PROJECT Pe, A W F-,5 p$41i `'Sg • t k3 PROJECT
ADDRESS -CLIENT-4-)(.f1 AoA-
dAFl /li4C. PLk0 BLDG 3 ` DATE 0? "1. nn�n.c 9Qo.Z .
BLDG. PERMIT # ARCHITECT 6ous ok R rLCri .
ENGINEER SA Jo t Q =.ac. CONTRACTOR 'DEL w) A ✓j- t?A Cu C--
INSPECTION TYPE
INSPECTION. REPORT,
„L7- TIN. kt-5 Lo. Gk/ 'LYJA' t (0 C.
C-0 C.�t_c-r
y � T( c s — 5t�t �.CZ k At t-1 k-) � A ►J � l_OG.4� fJ A i iW
Cv>.,,
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. O INSPECTOR NAME A'JE J/ �►�f� �5
c( ri rclea,
DATE C>7117 ARC IP00.47, INSPECTOR SIGNATURE �nat� '—�
_ ;""�,: �—�r�•---".'r..'•-.•w'�.�yq;l�idM'+u'�''rs°"`''rM'gr" �wr'npdder'i� . ` K��rii+r`�I.;rFf�"""r'."`w�'.';'^^a
-, y Page d1 of oZ.
DAVE STEAVENS
Insp'ection'Se�r`vices k
a PROJECT
PROJECT�C�A w 5 t' - ?rw�SF_
--
ADDRESS;IV=�Lf`1' aAck, At L 2oi - . CLIENT'
0A �f I �L �0 t� rP�AO 9 DATE cOG ,�AP4C$4 a`ov2-
BLDG.' PERMIT # • ARCHITECTC-.,o4jA A QCH
ENGINEER J(jq IJ S•A Jyr E =01 L CONTRACTOR .D L r4 2 A.4 a r L
INSPECTION TYPE -.--.
r•{.
INSPECTION: REPORT:
iZ*5 LA.LA-T tai. `i-� AZbt-J 2.Z -mow. nom -
1-Z AWL\ YJ n 'PJ f�.LdC-1,IU..� �•' V ,'S /7 ...)'^ti `O ^i\ DLr—T�v. ' �y
�CoTA I c.. _Z 3 •► �i ='g Loc:li�_/ I;jc, -A,,.) z) 14 3S'IS :,- Co✓•.�t-;cT+�` .
- F
• i
CERTIFICATION OF. COMPLIANCE: To the best of our-kriowledge-, 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.
'4 CERT. NO. ��J / -3 /� ' �d INSPECTOR NAME I lA J E Si EA ✓£,nJ'S
(Print Clearly) ,
DATE �o /4 2 C rW �V0 INSPECTOR SIGNATURE_ A ✓ C Sti7A' u E, J S
PROJECT
Page + of.
DAVE STEAVENS
Inspection, Services
F -':K --tW59: k
ADDRESS S 14,--:.14 t, . 1-2-9. ;.,,-1, z o TO
OAKKIN —LL.!
BLDG. PERMIT4
ENGINEER�)uQLJ
INSPECTION TYPE
19 79LZe
PROJECT # 0 0 2
CLIENT cJ E.S N0pt
i3
ARCHITECT 6=0LAA A(2c-4
CONTRACTOR b &-C ^AIZ
A
INSPECTION REPORT
r
Z-0e-.47-/-QA)5 RAwc, Y' Sim PSoA/' -7 14c, e- f,!)
7) RP-tAe - tCO Aor) C-LiQN,6 e
45—
LA "i
U li Lor- 90Lr*- A 1CP-rPq L C. U G T,4 b ► 11�
'M :t LOCJ93 I40t-Cl, 1) 6 ?T -v1 Cb%(k - ZOOS- 1-7"LF-JC--r(-4
4
7
zr-AIi sozr�A�-% i - t 1-o c, HOL I)VTH 'b %0, RO't - k -I Lzuj /6 L
-T
RP -Aa Cr- �-r L UC- 5% bZ?Tv-A kA k b 11 " L e 0 t, A A -
Lo C's - S -E-P--1H %IA. -Pob 5 - (7 L F -Q G; —tt-4
IL ;4 8 S/1
LoOLC S — D C prq 3/14"b %A LF -
k's 0L --T"
c.-SbiA.
0
4*,2 --�3 ?)1 11
"iz-Ta L i - I Lo(- 14OL17- J�C-PTq I - b I A k -1 LF- Qr-71 %-k ZIA
Zo S OA),e W I L I -
z -4 (L S, -r,4 LA - ( L 90 L C I) cprq IN RO 6 L C. ",-T H c7 Z
LOU) - i\Ot-C-1, - Lcy (.1 \4
Bc.oC. ONILtOG Lo tje(z- 4) we
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 0
the locations of the work inspected only and does not constitute engineering opinion or project control.
ICERT. NO. DO -5`92 49- 5-0, INSPECTORNAME_ N
V,
(Piint plarly)
J \
DATE Alfileck4 1�900 Z) INSPECTOR SIGNATURE
DAVE STEAVENS
Inspection Services.
t`
PROJECT FST
ADDRESS
kt.D G # 3 J 4;
BLDG.. PERMIT #
ENGINEER) ,, a) S} JOI
INSPECTION TYPE
:i
Page _ of
PROJECT# avo •2 - D 3
CLIENT �-, iA,
DATE
ARCHITECT 9o,.:C,d o4 4►eg_u
CONTRACTOR C l.- h'► f1 !L- CSA c.� (.L
INSPECTION REPORT
A 0 IL 5 -r- 7-A �'Mp r ..... .
77-777-
L el-(;-,
�.
r
3 Loc L I `ij C, iA = 3 5 5 ' L -70!5 0M12 �TZ-
A-rnc P3Locl,tr,J� A- 3`S�" G -.log
LD J t42D:WA 'E S-u�ATI y o• C.z°'
S1S Scr2�1S /1 A.Jci�a ll�uis ll�N7'r.D
CERTIFICATION OF COMPLIANCE.To the best of our knowledge, aIC'of,the reported work;"unless otherwise noted;
substantially complies with approved: plans, specifica#ions and=`appbcable sections ofthe building codes. This report covers
'the locations of the work inspected'only and does not,constitute engineering oprnion:orproject control
�..
CERTNO.S / ��k ` . d �: INSPECTOR NAME
DATE /�.� e C`' ZZOo L ? INSPECTOR SIGNATURE w