0108-345 (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
C%4 W Professionals* Code, and my Licenseis in full force and effect.
License #
Lic. Class Exp. Date
r_ Cy U)
LLI
r, W 7.73 1 2 B,
ate Signature of d6ntt�i�a/
Z r— D Ci6f
OWNER -BUILDER DECLARATION
W LU .1 hereby affirm under pe nalty of perjury that I am exempt from the Contractor's
0-
U) Lic6nse Law for,the. following reason:
Z: 1, as owner of the property, or my employees with wages as their sole
compensati will do the work, and the Structure is not Intended oroffered.lor
sale (Sec.,7044,'., Business& Prof essionals Code).
I, - as owner of the property, am exclu§ively 6ontracti ng', with licensed
.contractors, to •construct 'the project (Sec: 7044, Business Professionals
Codb)..��.
(a)-JIannexe , m pt,undersectio'n - �',,'MRC: for this reasori
,
'DateSignature .,of -Owner
ENSAT ON'
I(OVIF) DECLARATION
1. hereby .affirm ,..:,L,j.hder-.,Oenaltyry,p!,pprjuone� of,the f6flowing-'declarations:
I have arIdmilfrina,iniairi a certificate ofconsent to self -insure for workers'
Compensation,, as Provided for, by. Section: 3700: of the Labor. Code, for the
performance of.thei work for which thi's peirrit'is'issu6d.
I have and will maintain workers' compensation insurance, as required by
"Sebtion 3700 of Labor C6de; for the performance of the work for which this
permit is iss.6ed.-My- Workers' compensatibn!insurarice carrier & Policy no. are:
Cartier' ..Policy No.:,
CAL I1dDEW"111':
, his section need Completed iithe permit Val . uation is for ! $100.00 -or less).
I Certify ihAfih' 'the, pe'rformance of'tKwWork for Which "this -p6imit is-Assued
I Shall not employ. any :�,personin a . hy.manne . r so as to become subject to the
Califoinia,and agree that if Fshouid.66664e
.,..Sbbjbdt to'tfi4.woikiirs'- comperisaticri,provisions of Section 3700 of the Labor
sppll.f irth .0
C I t
,Code,,I wiih'! mpl `1A1'hiiiops.
.1 pl 7 Y1111 1S?FrO"
b,M
.;Fshall'sUbjbbt"6n,-ern-plpy-erto I criminal :lbehilti6s 6nd,clvil -fines Up to $1 b0j600, in
adclltlon-to'the 66si oi'compIdn'saitio'n; damages as provided for in Section 3706
hof the Labor Co'd6,',jinterest and aitcrri6y'i fees.
i
'IMPORTANT :Application, is hereby mia'db_-�116 the Director of Bu '. I I ; dinb'ind Safety
peirmitsUbjiict° -to'. the- 6 'nditions—drid., restrictions set -forth' -06 -'his
.'.7'application.",
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, indemnity
& hold harmle'ss,the City of La Quinta, Its officers, agents and employees;
I 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 certity 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 pr party for Insrction purposes.
i..%J Date
BUILDING PERMIT
DATE VALUATION LOT 0108-345 TRACT
JOB SITE
APN
ADDRESS -
OAK JAUZ
-
OWNER
CONTRACTOR/DESIGNER/EN (NEER
PGA ASSOCIAMON
1-W1, MAR. tAC191C Gkf'3QFYAL CONTRACrMly.
1>011OX 3 060
4162 "TfEV11111 AVE, #302
1-k QUINTA (.!A 9225.'3
f7i
' SO U.) 4 A. T!, * EA _ I CA 92075
C.B1.0 5923
USE OF PERMIT
[A)CAL, OFHC . VNPORMA i1014
SdAW,,, M, - M. M-365 M - 15 3 ().AK H I 1., 1, B 1-I'l I J "'t 01 TY P Z
0 v
C OUINTARY OTRUCTURAL WX CA.V(W,4
VALUATION 2figac(l) ]..s
TD C091, (W
.2o'c"no-
C*r UTHMCTJOWYXIE, 101 "W0.4 J 000 00
STRON 40 M rff 10N FX.V - REM 0 101-000-241-000
- -------------------
;SEP 10.21001
I NT
CITY F QU fA
FINANCE DE T.
SUB-T(YrAL. CY)MMUC11014 AND PLAN C11KC Y.,
If 01M, PERMY FUN DUE, ROW
V W. 0 0
RECEIPT
DATE
DATE FINALED
INSPr
1BY
INSPECTION 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
Drywall - Int. Lath
Final
Final 7r7
BLOCKWALL APPROVALS
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 Enclosure
Shower Pans
_
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
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)
COMME TS:
4 /Ll�C I
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Page % of
=DAVE
STEAVENS
Inspection Services
y,
may`
i
PROJECT (. iA c,�
_S" 7�1Q�S�'c t . -
PROJECT, # 07.6a L4
ADDRESS S5�-ZS?�'�.?�t� , 25.515 3
CLIENT^ PC��4E.STb�A
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DATE. e2vZ i►+^iAJZC.a.� a.Oc��.,
BLDG PERMIT.#
'
.ARCHITECT Got -e A A 2 Cv-1. i
ENGINEER V.
W tE - ::z AJC:_
CONTRACTOR I.EL 'M A2 PAC' -► if�_
41
INSPECTION TYPE
INSPECTION REPORT
0Avc►4 L L.� �o # ,a.. ;)L#4&, J /o
L AV.:...� L: AZD.w Nye - C, =rJS �,,�A r to#A - (T4 '
SDs : 5 c.2 e Lzi 5 �.:> > : A.� ca,-� 2 ►J u s` - � Ca w-(, += +J i�
c.tTL
4: A—%C_5 ��Lp..LloGi.0 t iJ a .3S s Lt'.TT `F 3 L -7y's -:C'a�•T
CERTIFICATION OF COMPLIANCE To the best u�.
of oknowledge, all of'the.�reported work, unless otherwise noted,
substantially complies with approved pians,• 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 -0959 3 7,9 INSPECTOR NAME
DATE ._� Mf�a2CW INSPECTOR•SIGNATU Qa_
.., .r-•, .:•'*Y:�.' 4(;..�.'s �e•r=M-'n�.i! y,Jrra.a x,.'3.'Jk %.ta.s 'fe.G4...ru`:.°4` ...p�,.ca,,a:�7O"i-..e.`,L:�' (K: �-..f_ a'• xT..,•,-:;TTu=•.. ,.�'.c
Page. of �
DAVE STEAVENS
s� Inspection Services '
:x
PROJECT iC�' A t.J"5T -� 1=1d�S,� f ►3 - PROJECTS# o?y0 Z -y
ADDRESS 5=y -.2 8 ; �-1 '1 , Via? S3 CLIENT. 5 -i 0
0AIIH I L L -A k 0 6 # i ?c At)' I d DATE' .�-. f: rh !AQ cel 7'wa. 2--
,'.. •.;BLDG. PERMIT #ARCHITECT C>OLB A 4 e Cil
ENGINEER.1 ..S A.1ca E Z 4t CONTRACTOR Jl '6G MA i? }
INSPECTION TYPE CAVY Y
e 1
INSPECTION -.REPORT
vLe4nc--� t"Aic Loco -r 5 20��dx Y 51 m+ P-5 o•J C7
4? 4),' s; - ;: rbc'eA
J
i -74 J_S 'P (..L�4 '7 ion✓ A _5 .Z�C iOo yi CIE
a.
jj
�D 3 - , LOG- 1 u S - k-.)-��:� .:� 1K LC —rr-F'
Ri Ait. �� J LA,t1-4
l - LDC." $ 12. �>r 't' D � a . U 1D S -`CUA ? r1 '�8 J
$4- .177 0APGNILL_
L)
-j S - l ' ..! P,I GTN: a
c�eAR L;J 2>�?�w r�u sok DS °I -7 it a3GT,r-(;.
S µdL�S. �l'L�EP'C 1`:!`�►A ,• t�oOS. S �/�JLcltl(��N '/d ":,/@ I DIN
x 77.
/
l� ADZ �Z�.1Te�2 •1 taGg - : 6'OLi..S - I.-,- 1�C PTH' (: d i`A : KDI S = ,S S uCEA1G7N
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D a 2� ISl-iocds /'1�VDtP1H L��, D t -A. � SIDS- I �%�ILEi�lGTi=1 9r .il �A
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r�>:AQ Lv.,�kZ -rLuL-Hod.-E I1I�t ?tH /,.�►�iiA�' �10l j /S L.F./JG71.1 s�8�'Di-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 thebuilding codes. This report covers
the locations of•the work inspected"only and does no constitute engineering. opinion or-prbibct control.
CERT. NO.f� Sin 3�l� - J�O INSPECTOR NAM AJEFit
SAJtS:
DATE I An lee N" :a00.�
INSPECTOR SIGNATURE