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0104-231 (BLDG)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 Date r Signature of Contractor r ' 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&RC. 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: Carrier Policy No. (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: - Applicant— Warning: pplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civ;: 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 purposes. Signature (Owner/Agent) { : '• a+ f Date BUILDING PERMIT PERMIT# DATE VALUATION LOT 0104-231 TRACT MAXIM JOB SITE ADDRESS - 0A�.'M t0 APN - - OWNER CONTRACTOR / DESIGNER / EN (NEER PGA'ii &Tf�'ai� LDMALWYA17,Gs14 DEL int A ,I`IA IC 010 ' .t! L CONTRACTCiR PO BOA, 1060 462 UMMS AVR 4302 I &Quftp" A :"A _02253 801ANAMACH. CA 92075 (858)792-:1500 >vI,3IN $823 FAXAL OFFICE INFO12A+1AS IO1d USE OF PERMIT NOCISULAMOUS 75,169 ST.'CHARlAM PL 90.1.3',_ 10.44.1, 2OA47 & 30.4132 OAK TREA 813iT�DI`I rj?.r; 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 O.K. to Wrap Framing Insulation _ _ _ 3 _ _ _� �� _ Exhaust Fans F.A.U. Compressor Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Party Wall Firewall Condensate Lines Exterior LathDrywall - Int. Lo Final/N Final POOLS - SPAS BLOCKWALL APPROV iS 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 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. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) w -'r ................ Page L of 1 DAVE STEAVENS inspection Services I A PROJECT # V00 1= O 3 ADDRESS X45 t 5 % E zi ;{� CLIENT ;e -"A f") Es T i4o A DATE 3 A U(n a 00 f BLDG. PERMIT #- ARCHITECT 6QL3A- AAIfkr /rIEC7u9!t" . ENGINEER. 1 Q. iJ SA J e l t Vic-, CONTRACTOR E4- A A/P f 1 0 A/G. INSPECTION TYPE 1 INSPECTION REPORT 4:14 1. 44-1 L46 S TrzzCj: PJ� � �1 -PI-Aa tl W ua Su c4a 2 , _J Leo -147 t j 14'1'1, ''t B 3 4 $�i t�A�C-t2r: C. "� ��y� �g �)LArJ to A-J``t�l. 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 onlyroand does not constitute engineering opinion or project control: CERT. NO. ©�?S`f 3 �'" y INSPECTOR NAME :\)V%,oG Punt Clearly) DATE 3 Ay co O D INSPECTOR SIGNATURES u s 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 onlyroand does not constitute engineering opinion or project control: CERT. NO. ©�?S`f 3 �'" y INSPECTOR NAME :\)V%,oG Punt Clearly) DATE 3 Ay co O D INSPECTOR SIGNATURES u DAVE STEAVENS Page ,I- of 2, 'Inspection Services PROJECT- '. c,.IFS �' - 14�9e. t 4� PROJECT # c;L (- p31 ADDRESS CLIENT.�A s vkc7 BLDG. PERMIT # ENGINEER)�uutJ SAJo,e �Jt_ INSPECTION TYPE DATE ARCHITECTC-�oL�.A�Cx� �T,cTw2t CONTRACTO R v► y,q�g {.i t= c, INSPECTION REPORT e...0 t,.i t.�.J t �i! to �J Ca. �'t ►� t� D �J P2E � IJS I.�L4R—r ► o r.1 � �.o a, J c_�-` SSS 5 e.�2 e'�5 A ti O 1A Oe.jlr)%_o t,T s `T ► �'c ,� C5-k4CTa-c-C La L's , �f3 CO �Lfl� LwLo w A k -L rs "' \ fLQ Vh 5� 5 s��2-Cv�s �►..Lfl ArJc�k�� t�,-� 'T�l ��FT'�rJ�� RUQ &> • y Ct M o � . y � � . 4 � 3 t�4 al T �t rr c, "it ?I r ZR 9 — I -!s)ctir 5-n - tSLDC-14toG-1C+ t\-310 S ��'T)c.S 1u11 CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work; unless otherwise noted, 7•substantially complies with approved plans, specifications and applicable sections of the building codes. This report covers re locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. 09s93 INSPECTOR NAME-' j DATE c7 A tA- CA p� (�riot Clearly) INSPECTOR SIGNAT RE .`.1.Y...�r...n..-...�if`�i✓•YN•�s-.��..+.Ns.�J.....•-..til+-.%r"'t'n-.a`�-�....-..-'^r-.-v. »�. ....�rry •1�.. .v."�.�.. ._--.•.+-�.-...1•.+...-r�.-. r -...-.•.M1'1 �....�YT\^-r"✓. r �.. --�. �Y1 DAVE STEAVENS Inspection Services .P . ROJECT7(�A W ES —I PROJECT # ADDRESS c:%)G# 01 `1 ?L-04 1 BLDG. PERMIT # .ENGINEER -10,0 1 5kow E Page / of .- p7c7a/-a3 CLIENT *%A W cs� 4D4 DATE .3/ -Y'U L I a 0o ARCHITECT`zoLaA 4ZCJ4r-�-CC-TLk(tLs CONTRACTOR.k)C-L HA2 Act r L INSPECTION TYPE r INSPECTION REPORT C.L,Efl.J OF bC6(2L!:, .CKT tOrJ R�,1:� -s ►.>>—r � t,��--c � otJ A s ? � tZ =Cao "-1 q 4 S, 60-42S-5 o-Awt -1-Z e C- r ^AD .1�4A-ZLoe-5- Nolen - 11W I r �r � t ftp.. 12oDS • (��•c.EtJC�-tr� ��8 ��P P94N W ES"f (tJ `a �ucn • (-�OLES - I DErrt•-� �4 3�I+k, b���S • Il.. LE►.�y-rtt �$ .c1�� 4 %A RtiAR Ct.-u-rC%2• o?Locg - 1 -loges It Di N,t2DD15 (lo LF-NI�TM /b DIR OAK 1 iZ e - C �t Lf".J I t, P- t , ia t j a ---►?Sarz Ctvrc-e • -LWCs- not -'Es • u l�� r�� rg biA, Ro6SW )� L c�T�{ �i8 INtA. . '. R.a�� - �����-l-4oui:s-�a a��H I'D►P. -kobt- 111LEN(a�c�� d©-4*53 oAv4R.eE Lire a. - :1 LOC -5- No( -C-,- 12 �E�-,-1 1"�tF. ?03)s- 1�•r.��c.�•K t18i atA t► � e efs� LILY- a LCX -5- N�� s-�� ��F-rt� D,�, 0�5 • L..�ac,-TH she �� CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, 0substantially 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. �/Y3- INSPECTOR NAME �) P\0E � �Z� P ni`e cJ 2 �/ —(Print Clearly) t 9,ATE .31 �uZ- 1 c� t�Yi i INSPECTOR SIGNATURE I . Inspection Services PROJECT tS-'C r�ti�RS� 1 ii ADDRESS -A.'5 L 1 sTE 1 BLDG. PERMIT # ENGINEERlu oQ SKJotE -'yc- INSPECTION TYPE PROJECT # a o -o f - O 3 CLIENTky'P -N o 04, DATE ARCHITECT G DLt3 A, +Kq.A � Eci ue_E. CONTRACTO1QEL MN6_ t�Ac--,'F i c.. INSPECTION REPORT - 4o'Sc�rl�`I r 7,�i13 oA►CT•2CE 3L4)G. a� t�ui�rJ tow WA u`S N fL iJ P, �.�at ST a A v�'�1 Co — err L�Tc 40 V-+- 'A%,, ST J+cALL !4't'Z 1 CS - 54C AR +JAV1_ 144L, SLO CSC 01\ (L' Jam- Co W1 �LC.Tc ��i�1LS �,3�1� �S-g -�LUC1� A'cJ1� l71`i Page CoM•�LETC of DAVE STEAVENS - . Inspection Services PROJECT tS-'C r�ti�RS� 1 ii ADDRESS -A.'5 L 1 sTE 1 BLDG. PERMIT # ENGINEERlu oQ SKJotE -'yc- INSPECTION TYPE PROJECT # a o -o f - O 3 CLIENTky'P -N o 04, DATE ARCHITECT G DLt3 A, +Kq.A � Eci ue_E. CONTRACTO1QEL MN6_ t�Ac--,'F i c.. INSPECTION REPORT - 4o'Sc�rl�`I r 7,�i13 oA►CT•2CE 3L4)G. a� t�ui�rJ tow WA u`S N fL iJ P, �.�at ST a A v�'�1 Co — err L�Tc 40 V-+- 'A%,, ST J+cALL !4't'Z 1 CS - 54C AR +JAV1_ 144L, SLO CSC 01\ (L' Jam- Co W1 �LC.Tc ��i�1LS �,3�1� �S-g -�LUC1� A'cJ1� l71`i 1JA1LI/J� CoM•�LETC �2) CA LZ�� z J�t, A3t-ocK1ac, r A -3-S s , LPT, y ��L• �D s "Con �LETc .DcTA(L,S i3Loc I JR- a<z - QvQ'MOLG.Tt 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. N0.09-5 7 3+a - z,0 INSPECTOR_NAME _1 A, %3 a Srtzr-, J C Q .5 DAZE 31 due �.-`{ 07. V O 1 (P INSPECTOR SIGNATURE