0109-160 (RR)W
I—
N U)
W
perch
C) V7
' W
o Z
CO 0
HCID
LLJ J
F-Wa
U)
Z
C1
LO
N
O�
U CL Q
Z
�Q0
X W 4:
mCj VU
11�FQ—
Z
obp
Q
J
LICENSED CONTRACTOR DECLARATION
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
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
770940 019 HIC
Date Signature of Contractor
OWNER -BUILDER DECLARATION
b i /3012f.
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).
(1,1) 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 A
Date 1.I ' f 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:
Carrier Policy No.
STATE YDND V11-0Y-00)9.►Yl
(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 Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date:; f/ : ' Applicant`; 'y� •?
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purpose]$,,
Signature (Owner/Agent) _ t,�';1 �°� r� 2 Date—/
BUILDING PERMIT PERMITq
x
DATE VALUATION LOT (.1109,-160 TRACT r'
('F'.=/"7 V111( f.
JOB SITE
APN
"
ADDR
OAK IVRMEP
v _
OWNER
CONTRACTOR / DESIGNER / EN (NEER
+y
I'C.A �►lii,'p1' f ;l l ?c t�'1' . 1, I10Mfft;t' WMI-W .P
US FUERAM ROOFti G, WC. •'
.�,C�..13C?': S� 1. &10
83-597 1%W11 ST
4.
:I , i Ij�2.r.A
1 1DW
C A 92261 '
('160)347.9869
CUR: 978
I
USE OF PERMIT
L
�•tadt:d�l-R14;i4-��G,s4.;c3it
e
D
L J
LC1V'.1! t.C)A !1022I
OF IA DUINTA
INANCE DEPT•
:.ft;
i •
ES"i'OYi3.11M C.OF.0 011' C'C)NYM("I'ION
U".00
a' IY.RIVY111 FIT 9UM MANN
t; k c,Z1 J�i� 7 a1 �!1CK�� 3 a-C10<Y MOD
')
SUB-,':I.tYIAL 00..M IK"1:' 014 AND PL AX CTIE- f:;"LC
)Ki
$30.00
LAS FRIG"FA1D M..3
$0,00
TOTAL F',Z1c2M:Y. f IrVXN DITE BOW
$30.00
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
/
1
INSPECTION RECORD
OPERATION I DATE INSPECTOR OPERATION DATE INSPECTOR
Set Backs
BUILDING APPROVALS MECHANICAL APPROVALS
I j Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans I
--�— - F.A U. j
i Corepressor
_ Vents I
Grills
I Fars & Co � of
U", W
Condensate Lines —
I
'r-
�a�V P=JOL S m SPAS
I pprow2l to Cover
-
Main Dr;:ir,
:�� � -
Equipm::nt
Jnderground Elcoria I ��
Jnderaround F'Ibg. Test
- t Ga,
Gas
141aste Lrnes
- - —
Water a;s:, .r
rlumbino Tot) Om
Shower Pans
Sewer Lateral
Sewer Connection
Gas Piping
�-
Gas Test
Appliances
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. 1.
Smoke Detectors
Temp. Use of Power f
Final
Utility Notice (Perm)
COMMEN I zk:
OAIG rRA-6 Page 1 of o2.
DAVE STEAVENS
Inspection Services c �Y
PROJECTC'�1 �S�- �Nfl SE 1 A . PROJECT # a - O 3
ADDRESS A5 CLIENT ?6 A tJJ EST 14y14
BLDG. PERMIT #
ENGINEER Qu_ 3v3 SAub t E :rJC-
INSPECTION TYPE E&Y- Y
DATE .2 y O I
ARCHITECT e4xX2A NGN ►rce-ru OZc
CONTRACTOROaL MA PA Cr rr L
INSPECTION. REPORT
R tL SOc�TM. 1�.7A�.� I L0DF_?l't'd �l�' �A �o� - I�J'LF. i, %W� + 1
,' zA2 tz b�FrW o Ro - 3.20
Q (A--bF_Ptr-I 3��l� 0 iAAbtA
.
oRra(
i
_� t_
Rr.-0LCEk1)T-E•',-L u.1R LL o1Loc5 - SoK'ttd ROS - br-;T". I It n ;�)D - t'1 L_C0G_tH 'S3 .b iA.
Q2T..► , �{ O L �. - l �. a e? T H 3K4 6%;\,. SPO - 1 'S L E til C.TH 0 t A
�} orr,� U►I�, - t .w c. - (�z7-t a 3/� t, ��v� - t 5." �t ►Jc.�-�-( ��8 D &
-7/
t -i Lf;UCoTr{ 8 JrR
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/..
06-571
44o LES Zcyi -
�Nfc.�Cc-D�3i�SrEt:ai �,4�rJD
e.t�.,J or'
�G�iZt S �1 r�e�t_l �T�o►J
A►.��
2aJ STALL -AT ,off A n
). r2 Z'ct3 0
ckS ,
INSPECTOR SIGNA
3 8 0AV TZgcE
wC- -Nrot-C r(17- -P`T;,J
6Ak -reLC
)L A" al. Q
R tL SOc�TM. 1�.7A�.� I L0DF_?l't'd �l�' �A �o� - I�J'LF. i, %W� + 1
,' zA2 tz b�FrW o Ro - 3.20
Q (A--bF_Ptr-I 3��l� 0 iAAbtA
.
oRra(
i
_� t_
Rr.-0LCEk1)T-E•',-L u.1R LL o1Loc5 - SoK'ttd ROS - br-;T". I It n ;�)D - t'1 L_C0G_tH 'S3 .b iA.
Q2T..► , �{ O L �. - l �. a e? T H 3K4 6%;\,. SPO - 1 'S L E til C.TH 0 t A
�} orr,� U►I�, - t .w c. - (�z7-t a 3/� t, ��v� - t 5." �t ►Jc.�-�-( ��8 D &
-7/
t -i Lf;UCoTr{ 8 JrR
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/..
06-571
�B
SCS
INSPECTOR NAME
DATE /V
/h11
7
ryC�(��
INSPECTOR SIGNA
. .., :�.C.a-,•.:c (S a,.,w.yrt*... ^l3. �;,:� f ..Cy_^.;,�C,Z•,L:.'ti:;'�e�yc.�>7Y';.: xj �aiWn,;Yo.::�;.'�i��•��ifsa ^"y�g�..l"a�J!)��yv �:�� -:fix � .. �� .V'JC7 �.A..V+.�:w J7�'}.`_y r --.in "y :..ti+�.y,. �'iT.. i"r
i
_ gage Of ' Z"
,. DAVE STEAVENS
Inspection Services
PROJECT GA WCsT- I Pt sc I A- PROJECT # a vU f -03
ADDRESS X15. Lr s-rtL- J CLIENT PGR vJ C S c 4oA
I
DATE 3 Mi1y o�vo I i
BLDG. PERMIT # ARCHITECT 600 zft . A2CM' t"rC% tv..tz-e
ENGINEER uoj SAJoIE =riC CONTRACTOR -
C.. MSL flu r c C—
INSPECTION TYPE
INSPECTION .REPORT
��y-g0�; �3ty ��to 838 Of1KT�EE !O Q .,
ALL PN 0. 5C Za✓,,)S Ab3LtAo%Z- `I..)u. � S 'TI <-�A re►J—N �'Z
l ouc ► 0 C> _ � S �.� ��T" OV3 - Co rnD LiT C-
ALL !4'T%(C- SgCAit- NAILIJ LAL: —Ir-
IL
1010 3-����5
-
�t'`TArt;S (tet rS- F►za.T-� IZa�� �1-T��cg•1�lucac�+a(v� fl•35s,L- 7o -%Z LG'�t
�ETt�\L 5-q ��G� cr-��-3tDCKto1 A-3S�5 L•-7c101T-4'S i
Sy-''tlg vA+KT;z� ���a l-��ii1�S-I �•Z S-9 - Cvro.?���t
C)C \ 4P, \L. Ll l s p t A -rr c. - a t vc.c 10 G j\ 3 s �.5L 7y'S L P71- q-,
S4 -7q0 oAK-TACT t?LA%3 3
A -3S
CERTIFICATION OF COMPLIANCE: To the best of ourknowledge, all of the reported work, unless otherwise noted,
ubstantially 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. 0g�5 21+G-1:5,0
INSPECTOR NAME
.. riM Clearyy '..°
DATE M fl y Op ( INSPECTOR SIGNATLI
DAVE STEAVENS
Inspection Services
PROJECTC�
ADDRESS
BLDG. PERMIT #
ENGINEER u ►J S Eq l%0 i E I& L
INSPECTION TYPE
Page
2 of 2
PROJECT # gyo 1 '0 3
CLIENT
DATE c9 UO I
ARCHITECT >OC -SA ARcf--��)re-cru.,etf
CONTRACTOR •�� L � � PRCI FI L
INSPECTION REPORT
_A-C_L 454Efl2 (\1RlL-ii,- (., STi?APi01a1 G oNJ �ZCJN+%Z A►.1t7
:"(z01'J ( Ams — .L' or. -.alt T
IVR O OAS eeiz
A-7-1-11(— Q IZ,EA S NG A2
NA\LIoJa (-JS RE: L.TCL . AATTic—
t��.t�AFZS
Z A rh ►J c_. I� 4 D S c_ Z c uj, . A til v,4 o2 N u i 5 �� �H TED Z" J s u c.� 7 7o,�J
.4J 0 A2J waaiE -Com�Le- 711-
CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted,
ubstantially 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. OSS 9 3. � - � V INSPECTOR NAME _ :�t0lJr
DATE o9 S %7%A o?oO f' INSPECTOR SIGNATU�et ►-Q_ ( �
.-PROJECT ?&A. mit .6-1
ADDRESS .A s cr (%i c Z�
DAVE STEAVENS
Inspection Services..*
BLDG. PERMIT #
ENGINEERD "Q tJ 5f�yy 1 E I rJ L
INSPECTION'TYPE
r
Page / ''of l
PROJECT # o? v -o / o
CLIENT -P&A we S T 1-/or4
DATE 3/ MAY cz;) o -o I
ARCHITECT <SaL Ajqr2. CH I-# ccj wtzr ,
CONTRACTORJCI MAot �4cr Fit.
INSPECTION REPORT
Sy- -765;,uit, C.B4 . ,'1 :L OAK 7-/2e_r &L -0G ¢/(
CAC WALL 5 FZA4?L0GK/0, . 2 7 A SU Lr /6Nj c7n�
.r 1
t2 Eli 6 Tkr.S y eI?A
Rc_ b v� �o `illA �LI J CSM QL tt. � �. aA1 RZA CoLLt K4,J j
s
CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted,
ubstantially complies with approved plans, specifications and applicable sections of the building codes: This report covers
.:Jhe locations of the work inspected only and does not constitute engineering opinion or project control.
CERT. NO. Q Q!�9 3 419, S INSPECTOR NAME S
im clearly) .
DATE _� ��'f 4 -A �4 2 CSO I INSPECTOR SIGNA .