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0010-284 (BLDG)LICENSED CONTRACTOR DECLARATION ,.Ihereffirm under penalty of perjury that I. am licensed under provisions of Cha(commencing with Section 7000) of Division 3 of the Business and Profe8mMals Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date Signature of Contractor Xti ]AIN r A 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&P.C. for this reason Date Signature of Owner 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: Carter Policy No. :A1,TNAMNITY 1006217 , (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, 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 Sectio 3700 of the Labor Code, I shall forthwith comply withthose provision Date: m "'0,� Applicant—: ' j`;t,:�`i' _1 a . i �3.: ` vWarning: Failure to secure Workers' CoXensation 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 asa 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'ois City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) ^ r i f►'/ L Date 1A ' �► PERMIT# VL`�,BUILDING PERMIT DATE. . VALUATION LOT 0g0 2 TRACT. filmsVic JOB SITE APN ADDR W 6- -516- (/� 0AX MftJM OWNER CONTRACTOR/DESIGNER/EN (NEER F-10 BOX X 060 462 9rdnN3 AVE, 036' LA QUUTrA Q& 9221.SI sS•OLa%NADEACH CA. 92075 ttS�s�9^T0:5 5823 USE OF PERMIT VOLUN1 't.MZ'Yt3Nfv RADiitBGIgN, 0142 Bt.tIs,.D➢NO - izsL&N TYPY,12.341144 54--"14 64464 &A-.412 RUM COST ill,+` CONSWIRUC:'X on 201M)AX) PERWrFAMNUUMARY CONS^i RU1' '1014 FEE 101-4000.418.000 STRO14LI MOTION FIX, M RMID 10 1 -•000-241 r €81iR-` OTAF., CONVERUMON AND D P'f..A°►'4 C;'MCK LESS :;PRE-11AZID FRO 76'4Y AL FMMr FKKS DUX NOW 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 Drywall - 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 *eal ,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 COMMENTS: 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. oke Detectors emp. Use of Power Final Utility Notice (Perm) i� Inspection Report for 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 - 55472,184,196,208 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 11/1/2000 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 11/912000 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. s2 y� • • y,Mr.-+ - .- . .-. .. . r ..-. r.• , ... .. rem.. ,n . .r. . . :... .. v r , , .. .. ,.. ,. ... r.+ -.v x^ v ...nw+ .e..; +,r'.^„th-^r'.rt,M _. . . .,. Page 1 of DAVE STEAVEoTS ;.r Inspection Services PROJECT N+Ady\P o� I�MIAS 'PROJECT # 03 ADDRESS QAK/ t Ze-6 CLIENT. CSA cx)EST He) -H DATEj. J , Zvv ca BLDG. PERMIT # 0 O 10 - a �9 A ARCHITECT (:S- L 6A 2<fV I i Cc -'a at ENGINEER�u��1..SAi��- CONTRACTOR , J� �-- /►'�lAcl FAL INSPECTION TYPE INSPECTION REPORT 5_y - :5,.5 9 TZ, 4. 5,111 5'9 i 68Ql` k CC A4 -L- -U._)AL 6- A,3 b SMZ�qp_l t:1C. <zw-Jc.4TE' T -7ee * .58 Pie d 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 ,`,,.,­.substantially locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. S Sv�3 "1 L7 s U INSPECTOR NAA c� / o �' �yU'r.> PrntClearl DATE �INSPECTOR SIGNATURE 4i t • , DAVE STEAVENS Inspection Services PROJECT C 1 -*(A o) & A Sc I ADDRESS OA < 1 1Z E t BLDG. PERMIT #-8_ ENGINEER� C_ INSPECTION TYPE Page I of J y- PROJECT CLIENT PCWP �,_l c,; i i -t A DATE . t,�O j ARCHITECT C-- Qi ZA CONTRACTOR C L MA(z -An C.t t: -I C INSPECTION REPORT 01;1, (4. -S- -7 l� . rl o AKT-►2r t t 140 Sc RZQs A,Lj- AO C A4(21 1 Os : I -t' t ,Jti 1 L.dv..�yJALLS � �FA�e'.1 Folz 1F R P. K \ 0 G '`e 00\R -\1-h � ON && `' © r\,7 LIlLTt: . y?.rtatL 5�1� � .�- 51(� - `�� ti:. -1i2. f.� 1 � ►,.� (-. C'�:o �.� c...� Z � -�-7' � � S -� fi ,2m 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 •he locations of the work inspected only and does not constitute engineering opinion or project control. • ` CERT. NO. d 6 5-� 3 7� ' �y INSPECTOR NAME Pr'n Clearly) 1 DATE C � INSPECTOR SIGNATURE-��'�-�. • 4a+ q Page ( of .^_. DAVE STEAVENS aInspection Services lie, PROJECT e -1 Am o1J /-P-f4ASC 1 PROJECT # a cru -U - O 3 ADDRESS O A►.T,'Zre r CLIENT �6=, A BLDG. PERMIT # c)r-> 10 - -;QLi ENGINEER INSPECTION TYPE DATE i QO J! Av u O ARCHITECT 604.3A-A2Ct•- ,-rEcru:(.2.I CONTRACTOR ()C.- rnAOZ ;�A�t,=te-. INSPECTION REPORT ro"OLA- .�� L00- _T_,otJ`Z EPox�i Srn�Ason1 ATF-�x►�. �r� 'C'►��c�lrLl �t �Zusr��r) ,Aad C.L_r::�t.l ©F �t✓.d2tS. �t��c.,rCcr�Tic�1.1 ��Jj A e, C L (Z =G? -,CD 40-14,!;7, k, -r - a LoL5- -\ourIZoD - Irl Lt+�C:TrA 8 eta. t7 - 2. LOC -S- 140LE1, -'1I 3NZ i-iT'r-1 1 At 0.. Oh, - 43 rAJ\S,P3,6-.1LoGS-I-IoLf- t:1 stCr'TV-i I da. cFA+�, L\J [ .W� A��C y ,, L3/ir, �/ r+ 41A . 511-56,14-Pizea -. cLo(-s- AD .teOT14 1 D,A. OS 2cra �� %A., iii . LC,-JQ7-/Qj �1r r P EA IZ v+A A e, . omit, 0-" b.Z.P't ra 1.4 2,zA�2 ti. N o Ra t-1 \...t A t. -L- - M ULA 5,4 ` k?( —r �ucs- HoL.�S- (a, a�PT� � r t 1A . i�nj�S - 11rc.e.J�H �/g J+A ALS.: 2LOU'> - Vk VLts - L A� t'r>J /`� D t I�.. i� *JS' IS LL►J(aTyA btA . ,t -� I 1' 1� �'2LUC-t, 01-C-Za DLr�TM Z+A. �,tDiJS" (, Le�:1C.Tti-V Z�tft,. ihtAs. X17- aLocS- �n�ES- 12��O�t�1r( 1� 1)\A. lZoOS - 3�r1Lt.n�G'rH ,lea �ItQ . CERTIFICATION OF COMPLIANCE: To the best of our knowledge; all of the reported work, unless otherwise noted, AAsubstantially 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. CERT. NO. �Y Sr�(3 TS ' j 0 INSPECTOR NAME ^ J •Zne°9 J co5 � II c(_Pt t -C early) DATE / /y V lJ ;?W -C-"0 INSPECTOR SIGNATUR�a, @-.- /'J