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0007-166 (BLDG)LICENSED CONTRACTOR DECLARATION I her ffirm under penalty'of perjury that I am licensed under provisions of Chaw (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 ,x,'333152 B Ke • '� :* DSignature of Contractor u4 03/31/V 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 & 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&PC for this reason -i t Date 45_9--)t- Signature of Ow er" - '! atC � WORKER'S COMPENSATION DECLARATION I„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 Section 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 CAL INDEMNITY Policy No. N3062174A -,(This section need not be completed if the permit valuation is for $100.00 or less). (V(certify that in the performance of the work for which this permit is issued, ,t 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 r aCde, I shall forthwith comply with trios provisions.. te: tsApplicant Warning: Failure to secure Workers' CdOlilipensation 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 pu, poses. Signature (Owner/Agent• � j Date o > 0 BUILDING PERMIT PERMIT# • W07`3 DATE VALUATION LOT TRACT* d JOB SITE z s pSO . 01 'TCL -1 _OOz/ APN - - WNER CONTRACTOR/DESIGNER/EN (NEER PGA V4FZr DEL MAR PACING GEWMAL COldT"=f PO BOX 1060 462 STEVENS AVF- 4302 LAQU.QJTA CA 92253 SOLANA)BE.ACH CA 92075 (858)192-7500 C13W 5823 USE OF PERMIT NwC R=1 QnUL W/ SMl' REFS PnASEA - STRUCT.A.Ut3l14KNI'ATION & N113C AR,CHITECTURAL REPA1,RS 20 [1`h ITS - 55044, 056, 060;,0 , 092„ 104, 1f6,123;113;1 124,196,708; 232, M4,256,269_; 2113, 30% 317,324 VALUATION 30,Q00.001'as ` EST=A3i`RD COST OF C"OLV9Mll'C'I'lOR7 t 101000.21? PEL21?MO.' SUIbfSv "Y CONSTRUCTION FEE 101.000.418n000 SP9150 STRONG MOTIOiI FSE - RESI D 101w000-241-000 c•.,S SUB -TOTAL CONMU•C110WAND PIAN CI]ECIC LE33 PRE, -PAID 1W-5 :' X0.00 TOTAL TIMM MS W RECEIPT. DATE. BY DATE FINALED INSPECTOR 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 DrIwall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test al Gas Piping PLUMBING APPROVALS laste Gas Test Electric Final 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 COMMENTS:9 4�— Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles 0—lokeDetectors i emp. Use of Power Final Utility Notice (Perm) %S Inspection i n R eport for o PGA West Oak Tree Structural & Architectural Repairs 9/26/2000 Lower Prelim - 55-324,312,300,288 Oak Tree 9/27/2000 Roof Nail & Wrap - 55-234,312,200,288 Oak Tree 10/2/2000 Upper Prelim - 55-288, 324, 312 Oak Tree 10/3/2000 Upper Prelim - 55-300 Oak Tree Partial Lower Prelim - 55-268,256 Oak Tree Frame - 55-288,312 Oak Tree 10/4/2000 Lower Prelim - 55-268, 256 Oak Tree Frame - 55-300,288 Oak Tree 10/6/2000 Wrap/Lower Prelim - 55-256,244 Oak Tree Wrap - 55-268,232 Oak Tree Lower Prelim - (Partial only) 55-208,196,184,172 Oak Tree 10/9/2000 Lower Prelim - 55-172,184,196,208 Oak Tree Frame - 55-268,256,232 Partial 244 Oak Tree Lath - 55-324,312,300,288 Oak Tree 10/11/2000 Wrap - 55-208,196,184,172 Oak Tree Upper Prelim - 55-268,244 Oak Tree 10/13/2000 Upper Prelim - 55-208,196,184,172 Oak Tree Lower Prelim - 55-128,116,108,092 Oak Tree 10/17/2000. Frame - 55-208,296,172,184 Oak Tree (Steve Traxel inspected) 10/18/2000 Wrap - 55-128,116,104,092 Oak Tree **330pm inspection, no personnel on site and no plans provided for inspection. Wrap observed only. Prelims not observed as scheduled on roof. 10/19/2000 Upper Prelim - 55-128,116,104,092 Oak Tree 10/20/2000 Frame - 55-128,116,104,092 Oak Tree Lath - 55-268,256,244,232 Oak Tree Lower Prelim - 55-080,068,056,044 Oak Tree 10/25/2000 Wrap - 55-044,056.068,080 Oak Tree Upper Prelim - 55-044,056 Oak Tree 10/26/2000 Frame - 55-044,056 Oak Tree Upper Prelim - 55-068,080 Oak Tree Lath - 55-172,184,196,208 Oak Tree 10/27/2000 Frame - 55-080,068 Oak Tree, No inspection performed; job not open ready for inspection. 10/30/2000 Frame - 55-080,068 Oak Tree ll/l/2000 Lath - 55-128,116,104,092 Oak Tree 11/2/2000 Upper & Lower Prelim - 54-588,576,564,552 Oak Tree 11/3/2000 Frame.- 54-588,576,564,552 Oak Tree Wrap - 54-588, Partial 576,564,552 Oak Tree 11/6/2000 Wrap - 54-588,576,564,552 Oak Tree 11/9/2000 Wrap - 55-080,068,056,044 Oak Tree 11/16/2000 Lath - 54-588,576,564,552 Oak Tree 12/22/2000 Final all above permit's 0010-284 & 0007-166. Project complete. 0 0 Page of DAVE STEAVENS Inspection Services PROJECT C MP, oJt�NA5E ( PROJECT # c2aoo —0 3 ADDRESS c�> A K Tec t-1 CLIENT 1"G/Q (,,J f.5r 14o pr DATE :2c.r BLDG. PERMIT # ARCHITECT 6oc.3 A A (ZCH i Te - c -fu r2C ENGINEER � u o� SAJOI E I i.1 L CONTRACTOR l) E`LyhA-►2 f HCl t=IC INSPECTION TYPE INSPECTION REPORT 4 �Ly -�-� 3w c.� (►..l C� .�) A (c�e X71., C'v,►�o L o L3 Lk) k L L_ 5 - S NES r2 0J A'(L i >Jv-t- 15m CA P P (&V, - 'caw• 'Jc�-r� Ac%—r% c.. �� �.��. 5 �� " rA_V_ �,F> 2T�t WALL lJ.►.� �►2�n,��c., ' A�Z1 H�ZOvJd�2E " �'.cav�n:��..,�T� ' l24>n-, �L-CTC r.tooT f�fifi(C ber-A(c.4, 45-9 AAU- u01T--i 056,4-0900 00 - F(?A�+�►�JG, . 15644 WA,600 '5Pr-_AZ 1JAti_k 0C, -Cow, ►7L CTr RCA ('L : A-t--tl G bero(`5 � '9�S-� Ai' i "ARTH '(,JAc.L UIJrTS c??`5'�r:� USO'/ ��r4ry►�w!(� A,tD 11,x,2 D LvA 2t Cd ,\,2 L t rt✓ A-rTic �1 7,A(t.. q/ -S-'9 Ar- P1gvr l WoiL-c_ lxri TS o69 3 R -3,!�s MISS (�� '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 he locations of the work inspected only and does not constitute engineering opinion or project control. . CERT. NO. OL7�.. �7 l�• INSPECTOR NAME « k A J E -� (Prindaearly) DATE C2.��1 ©G-� INSPECTORSIGNATUR_EE •., -_ Page of DAVE STEAVENS `. Inspection Services PROJECT`WA r' A 10 J NAS A- PROJECT # oV voo ADDRESS 6 4K TR Ee BLDG. PERMIT # ENGINEER,utilfj 5Af01,r. r, -JG. INSPECTION TYPE CLIENT PGA IhIGS T H A DATE 16 i, 2 o c. ARCHITECT Goe- M i9 2 C w ►Tf c%ta✓L t CONTRACTOR C -L MA (Z ?Aic., r- i G INSPECTION REPORT EPox-I sirv,Psc)vJ ig-r-CxP.4-da. k4aLC-S ���-�t CNEc�:c�3 32y�sNE� �1►J� cLtw.>�►.� n r A•J:� a'J—ecy .o'\ CJS ��2.c �F9�fS C-15 „ N�o DS - (-I L E tJ G I �-k -1 , �, ►t „ . r + \4� ,-r-•- 1 LOC_`-FiC]LGS - �2 ���r�� 1 iYIN .. O165 1`1 ��►J�t-►-1 /� 1,A. (2"r:P' i4 J"t), /.; IqO 0 - 31' c.t:.OG-r-b1 j" D. A , 5�'-�os�-,3�� �-��..��5-�t��s- ice' � 1"�,�• �o� r�"� �, T� � `' Cts%:. 3l"LC' J(;rH tit= -AR C- E 0� Z R W 0, LL- .2 t c cs - a �C S� 1 �'1&Tt;-t 3/,4" -0vP, , i�p - l S L .,X rq S/ ' ` y) i A, �J)m �i,A2 LTJ Sam-�►•t „�l'A�- �.�' 1 �tPTH � DSA ' Zy1�- 3� (.t�1� � h 55;-080 gt0 21 3-.2Ux-5-140t-c$-la JepT%4 l 0tk. „ ��-r---a LOCI JcPr i l''J,A„. v,7s- (1 LC#.1GTM �ls� Dia I k LWkOCG N�)gR--Fl W4Q-- txt-11Dc,�r�1 i"��r,, tZdt►�c,�K a a�lA, CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, ;;jam substantially complies with approved plans, specifications and applicable sections of the building codes. This report covers �he locations of the work inspected only and does not constitute engineering opinion or project control. CERT.NO. (0859 348- Sy INSPECTOR NAME I)A J Z &C"t 1A k/S '� (Pr' t Clearly) - DATE, /g QC-7--VQQ(� INSPECTOR SIGNATURE--' )01-1-- 7Re. - •