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0108-335 (BLDG)LICENSED CONTRACTOR DECLARATION U) I hereby affirm under penalty of perjury that I am licensed under provisions of H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and c� W Professionals Code, and my License is in full force and effect. .., License # Lic. Class Exp. Date 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 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 OrofessionalsCode). 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 tiereby affirm under penalty of perjury one of, the following declarations: I have and will maintain a certificate of consent to self -insure for workers' coripensation, -as provided for by Section 3700 of the Labor Code .for'thf performance of -the work for which�this permit Is issued. ( ) _I have`and will -maintain workers' compensation'`insLrance, as required by Section'. 3700 of the Labor. Code, for'the performance of the work for'which this permit 1s'issued: My workers' °compensation insurance carrier & policy no are: Camel Policy No.. C -r ,r , J'�i•ft: ii ll`i� - ai_%��t:-,r.t'i (This'section:need not be completed•if.the permit valuation is for $100.00 or less). (.) 1 -certify that in the performance of the work for which this permit is issued, shall not employ any: person In, any manner so as 46 become subject to the workers' compensation'laws of.Galifornia; and,`agree that if -I should become subject _to the workers' compensation provislons`of; Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicanf Warning: Failure to•secure Workers' Compensation coverage is unlawful and shall subject an employerto criminal' penalties and civil fines up to $100,000, in addition to the cost of compensation, damagesas,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 Duinta, 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 $tate laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. BUILDING PERMIT PERMITN DATE VALUATION LOT C,S 113 IS 135 TRACT JOB SITE APN ADDRESS OWNER CONTRACTOR / DESIGNER / EN 1NEER . 1<�ti./��r._"•�I:.. `•+ 1 t..,:! i •.: it �: r _'t�! '� .` `.h]:'A __:rI. l,L_vri =A_tC S,i 1.r1tii,dlf ;:�:. •.'!', 4'L 25: ,•jl_A.f'.t'A':'}_LAC { CA ��L ILK'! 5 F. USE OF PERMIT P%_ C. .Y , 41. lel. :4`S1 ;,��y.>L i•'rl1.,L•• t.'•lll L 131 !'N Ci I.,•�:.i, }; ♦I:.u/ jI7 t.) r, !•J., Ml.�. !, 11. •./'.•��I�MI - �a l,.1. T) � Os— tol. < c) ;',i;.TT fucr.C)"N' =000,00 .4 10 111, NCf.NQNtAiRY _ •�i �.�,';' ..�,>. ,•ii ,1i i•!!i_,=!z i.:r: dpi!}7. :1� P•_i ,,,,; E,:;t.r"1', _ua I I;r.. 1...E..,;Li 1. 1. ).t(' 241 Cr( u. 4•[.CtG. ?s 1-1E00 1A FEES 0 :'C?`T!,.F, F'!_`s, t =�.I'I' ti`I?;Is;S I)i�1?` NOW$209,00 . RECEIPT DATE BY DATE FINALED INSPECTOR • Page of ' . �- DAVE S•TEAVENS I is,it) Services PROJECT �6, A W ES'f Pd O S C 18 PROJECT # 02 DO 2 - O 3 ADDRESSS -7 9 78/, �lg,3; go CLIENT T&A�j ES?' HOA ©meglLC. 01-mij Z DATE , /.� /-6Q 10o Z_ BLDG: PERMIT # ARCHITECT 60444 ENGINEER1r I �l A I SA �/a�� �% .c' C CONTRACTOR J 6 IWAA Pig G+ G) C INSPECTION TYPE INSPECTION REPORT }I -L L/9i._1. GIJA LL,5 1 5ijP-A R I Lj' ob ) t TA 11-5 44 " 149 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. 'CERT. NO. D 6S93 IVg ` J^y INSPECTOR NAME730A 2e 13 r E clea 1) DATE C3 Zay2 INSPECTORSIGNATU,..� ifl�'�s^„rn.�'i�.T'� i�'"K�-r�' �'Y.•a9, "r f'�` .�' +`L-N+{��•'����•1r7 �' "tea 7f ���'rFifT�xliti�'7�' .. _ Page of DAVE STEAVENS Inspection Services PROJECT -W ISE i� PROJECT # vp ;t - O 3 li, 0� v �ADDRESSSSI- DAaCN � �.�: c.�L#a �+Oj 9 DATE 101 FE l3 , ayy � BLDG. PERMIT# ARCHITECT(,aL:;�,A -A, -%A ►'tEc_'r.�2L. , ENGINEER �� o �J SA Jo t 2ti 1. � CONTRACTOR 1� . L m A(Z r i C ; INSPECTION .TYPE INSPECTI N REPORT LA °\ 3 w c -A N"\t✓ CC) t~ �'T t.. &1A 1 LI Jy kt ti'tT1. L L6<-V4's Z6 v.)1 I. i ►J C, £ PL4 0 A t t, •. -�1 I vre, �-4;- F.-, CE? -r /� AIS K P\ a7-, "A a- C) t,7\- ",4 . T A TTI c- in P*t-, V.,:3 l . 01 A CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, { Othe substanfially.complies with approved plans, specifications and applicable sections of the building codes. This report covers locations of the work inspected only and does not constitute engineering opinion or project control. (CyERT. NO. e9 SJ l .3 7L 5 C� INSPECTOR NAME - . 1 �JY_ I GA llE-�S .. ,• _ 0 (Priv Iearly) DATE M' 2 Ft R Q V 0 Z INSPECTOR SIGNATURE ,�d .�.i r , A CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, { Othe substanfially.complies with approved plans, specifications and applicable sections of the building codes. This report covers locations of the work inspected only and does not constitute engineering opinion or project control. (CyERT. NO. e9 SJ l .3 7L 5 C� INSPECTOR NAME - . 1 �JY_ I GA llE-�S .. ,• _ 0 (Priv Iearly) DATE M' 2 Ft R Q V 0 Z INSPECTOR SIGNATURE ,�d .�.i iC�F _"_' !i �tq"'Y."'w"�'""*?�Aq'�"�t'�'�^�"iYb�'� ����y/y{'i�tp',�fy""�"yM�S'IRr"#�'��C' �+r'�""..•' Page of DAVE S•TEAVENS Inspection Services" .r PROJECTQ �L ST - ? Nib SE PROJECT # I vca 3 - e:) 3 ADDREs' § '74 ?(og1,j 81 '1 �'a 43 5 CLIENT �4a c�Es't' t-toPc DATE 1 t F' E a ..1 o o Z BLDG..PERMIT # . ARCHITECT4-,o c, &A, A ON* 4111C T- uLrc� ENGINEER`.`4JP,v)n t i7- -Zo .L CONT RACTORN&E L m,2- INSPECTION TYPE INSPECTION• REPOR' T CP MO L, C r- C: l—L S S Sr'_ ►2 F_ t,J'S A i.j /i O C—H n (L QLkT S. CERTIFICATION OFA 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 1— -the locations of the work -inspected only and does not constitute engineering opinion or project control.. CERT. NO. CO S S 9 3 y1� D INSPECTOR NAME ' PP�rint--Clear �)�„�• DATE 06i INSPECTORSIGNATUR.. U-.-- .11. - DAVE STEAVENS Inspection Services PROJECT V(01�-�?JAAS . F_ (,.,A ADDRESS BLDG. PERMIT # ENGINEER J SA J61 E- _rJ INSPECTION TYPE Page of PROJECT # n.1 v"0 2. - 0 1 CLIENT P6A k/zsi X44 DATE FEVS Zloo-t- ARCHITECT GJL?A -rc C:rLt e- E—, CONTRACTOR De -4. MAR P4Cte-1c_ INSPECTION REPORT' 4, -OS* P A 1P_ C_k,L E, t?, Zu -S H e 0) A 0Z, 00:5r <)11t4 1A - (I I ')LeQ(;t."A 'i /S. I I b I 'A L 1 CrH Dia. 3 0-Ai-k t LTJ 5. _k IRKAL QZJTC�Z � Lot .5 - L. c..ac- 1 b(A a E4m_E DF_ -P T\4 k 1-1"L* Lo - C, -7 C77 3.5- - 1"A'. Ltd JE 13 fS I-OL6 4A OLeen E: P T14 k J (Ot -1 CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all'of the reported work, unless otherwis'e noted,- �substantially c6mplies'with approved plans, speciiications�and'appliqable sections of the building codes'. This report covers' ,W. the locations of the mork inspected only and does not constitute engineering opinion or project control. INSPE&OR NAME .4�tr_ A-J ro CERT No. es �1 P, � c - C` — di-_ .4 (Print 41 e -aur q) DATE 7 2, INSPECTOR SIGNATURE NATUCRQO­_••s--- Page of DAVE STEAVENS9) Inspection Services PROJECT �6 A WEST - ? W A 5 E (A PROJECT # 07 0o.;? - O 3 ADDRESS AS :L I STE D CLIENTC P, "ZE.ZT N O A DATE t-9,6 OOOZ BLDG. PERMIT # ARCHITECT Got -se A znq r ie c ru QC ENGINEER,' ,u.,3" S-A&tE k,3C- CONTRACTOR bEL mAr2 1'Aerr�C. INSPECTION TYPE INSPECTION REPORT r�4.6 rJ 9 ge- a I.5 - 9 �- C A 3 S 5 (fom & c-. r E,7A ILS 4 FIfAm, J�.� . sLOc.AC/,k16. S� - S �.. °t , S y.1� � .S3.8(o 5�. D A ►� 1-1 � c.c_ �� A � I �,.--� � c.-.�� .� (, co M p C_ E T' k-- SWC-:AiZ OA 1U �J G ArJD 5-f'2A .� ►il_ - z: I `( 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 11__x- the locations of the work inspected only and does not constitute engineering opinion or project control. '9,ERT. NO. 06?S`•9 3 q?, ' S �! INSPECTOR NAME r O o (Pri •Clearly DATE j INSPECTOR SIGNATURE %-V- Q.@Ag