Loading...
0104-239 (BLDG)LICENSED CONTRACTOR DECLARATION I herForffaISirm underpenalty of perjury.that I am licensed under provisions of Cha(commencing with Section 7000) of Division 3 of the Business and Profess Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date ' '' F 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 & 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) 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 r 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, indemnity & 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-meritioned property for inspection purposes Signature (Owner/Agent) Ii. .I , -Y , - =9- - Date: =` . - y _/ . BUILDING PERMIT PERMIT# DATE VALUATION LOT (3y- TRACT JOB SITE ADDRESS lj �O APN OWNER CONTRACTOR/ / EN INFER MA F'W.P,'SrT IM4L1MM L4.i ltiMV CJL['1, 0141 F.L M$1I.1. G AC"1 1C VEWRAL C0JGN .W..l S !0L V PO DOX 1060 462 MVERsi.r`3,V& 0302 LA Q-01 'I'A CA 92253 WM.ANA.BEACH CA 92073 (858)7 .1500 C.13U 5823 LOCAL MAC Y. BNYORME,,TION USE OF PERMIT NODO { LMEO- s 75-160 ST. CHARLES PL N4 �, 1"PE ,'5$91PSJibP.32ia3� €2VOt,UNTA,RY S'D RUC`t`Uf AI, h+ OD01'CA'(1L' NS 3 VALUATION Cif3NSTRUC11014Fitt 103n000-4,19,-(➢i1t% $207.00 S`P�I.t�AI•�� ik9Ci`i'TC1hi 1��; - Iii ui.p '1 Ci'.i-C$i)Ll-2�.'i-iECttB �%2.Q0 LJ ISM PMPAID FI $0.00 APR (} 2J� , � 4 ; ?i:K.EW13`.K FUS ME NOW 1 CITY OF LA OUINTA FINANCE DEPT $209bo RECEIPT DATE f BY DATE FINALED INSPECTOR {{ ' i INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Backs rSe Underground Ducts —Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck A, Exhaust Fans O.K. to Wrap *,� F.A.U. Framing- �� _ ij 61 Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls . Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath D�r�ywall - Int. dX ��-�� _ - ¢� I_ _ - Final Final POOLS - SPAS BLOCKWALL _ APPROVE LS 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: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles ^ F.1. oke Detectors emp. Use of Power Final Utility Notice (Perm) Page ;2- of Z DAVE STEAVENS Inspection Services PROJECT:&P, � i-, sl • WKsp: - I A PROJECT # Al ADDRESS s:—, -C� CLIENT 0, Lz v4o BLDG. PERMIT # ENGINEER h, INSPECTION TYPE' DATE , --,')g Av.(-, appi ARCHITECT.4=0,-ZA 'A11CH free-Twze CONTRACTOR�SL K\AyZ -;)Nr-% fri c - INSPECTION REPORT' 41,*3� `s,-rt7-yr4? KWAL .At- L C—i 4 TILOQe Agh �LA A L -S A ,j'o%Z 80 fos!] 4,49, L -S el -5 1-4 '-j') LA t C) C --s- 14 C,fx'q- t,3A I Lt &I t, ©Q L,4 - Cam?(-Z'rZ X13 1 COS (281 ALL 4 A"b NA A I L-1 ki C., QMiLtTE 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 __,;he locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO-0_25Ct INSPECTOR NAME tAV 0 ZTZAVeo ..DATEAUGXTU INSPECTOR SIGN TU " Page I of ,k DAVE STEAVENS Inspection Services PROJEC14 GN uJ E t`f --i t INS P— t A PROJECT # aZ vo ! - 0 3 ADDRESS 4-S c_( STcb CLIENT' G� cc)EST r•loR DATE o74 10 of BLDG. PERMIT # ' ARCHITECT GO"N �rZ+`►+ �i Ec: i K � E ENGINEER��,,JrJ SAJ a,E Sac CONTRACTORZ:1 E&- MA K. INSPECTION TYPE INSPECTION REPORT �w_A%— iQ�vr�i,J(� r ����Wr4'.a2-F`_cgn►r�L�—��1'SwLA i (oij ALC*d Ar, -).t, aA sic -H CJ k- YJ,,- S r La I-/ % G /j ;z 1, A J CERTIFICATION OF COMPLIANCE: To the best of.our knowledge,'all of the reported work, unless otherwise noted, Ssubstantially 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. 061E;9.? "Y D - SO INSPECTOR NAME 1,1rW C W S (Prim Clearly) DATE O?.7—Vd! INSPECTOR SIGNATURE-.:'/� r _ A J CERTIFICATION OF COMPLIANCE: To the best of.our knowledge,'all of the reported work, unless otherwise noted, Ssubstantially 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. 061E;9.? "Y D - SO INSPECTOR NAME 1,1rW C W S (Prim Clearly) DATE O?.7—Vd! INSPECTOR SIGNATURE-.:'/� `.f'.w.`w`"`^°'..h+�'1.�F,,...-�:7:Q�.:..�:q,i.l'�'°.. ,'Slyf,"r•�+.�1�i^�'Z'r+�`�'rrt-�ihs�9...V.-+..vw.:n.�:.....Ct"+r•�..,,il.-^..'�i....r-.y,%�»`u-n.-'Gi....s+---'^�•y'�^-�.w.�....-�-...v.......-. r?. J DAVE STEAVENS Page r of �. Inspection- Services PROJECT- GA uZCST- 9 RASE ( N PROJECT # a vo I- 0 3 ADDRESS 00 -60 6,13 L-79 1. S J G4�CTi�'EC BcA7G, 3'5- 12 (kry BLDG. PERMIT # ENGINEER71k.x,3)J SAdoiC IQr- INSPECTION TYPE j ":20 V `I CLIENT "ori DATE -)- 3 -Av,c- ;Lo eI ARCHITECT GoL3A �40-c�tTg cry. �eC- CONTRACTOR l E L M ►� ►Z Y�Ac, (- i e INSPECTION REPORT grb a• 1LuC- o`Es• �� IrLPT-k ( J%A. 015 I�l LE,c�,� V3 „ 3/4 tlsa" - *RERltt r,-5-- AC L k J .� Lo( -'5- C 12- �,_i*tP1 . f rr DSA (20DS - 1'f'LZQ4;7641 g0-(0'73 OAK-r?-tE. LttrJ .2t,vG'S• i4oc-ES` (1 7)C i H I+,l�fA, R(�b5- (IrrLe-tie--n-1 �8 ,A.. 1„ -r/ `. Z -A ejZ0-rC - Z WcS1)CfTH I ".Alllk . RD O — 11. LcJG7.a �, altA . g0 -(.11R cxa►.-r LE 1;—; 1 pl-�a 4. ` Pe ,� - 3L0C.5 - HoL-,;F,5- (1. be-prq 61A • F2obs - 1-i Levc, � � �i� Z,A "�:_a2 �.� ���2- ,� Lvcs- 4-ioc.Gs • t �- � r..��'►-1 (A�� �oc�S - t '��r:v�-r-�! '7/g••,���1 Go -(8S OAK-rX-C C �i L-Ao � �E6'Z.-4 IhA5-.2 LOC.S.- 40L-e:DE,rt4f t>��. lRob,5- �-1 L-f-g(.�-v&4 `e3 b tZ:At? L-11)- f2 c_d c S - 4o L F t0 (;L LX r 1 "i I ” f?J DS ' 17 " L ��IG'rN �/� A/'4 LOCA-rloo-.5 E Po>< -t 'SIM P500 E F- EYE 4-03. HOLF-5 ,k\0 -,PT 1-4 0411FCle Z 1?Russ4tcl) AoD of A-PP&eA i 1on1 Aar) 7"0--�STALL--AT-ioJ A -PC #z- =Z80- 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 Ishe locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO.i7 S 5� •3 4/9 - 157;0 INSPECTOR NAME A d 6 J�� tJEJS (P:i t Clearly) DATE A u (, . X o 0 f INSPECTOR SIGNATURE`__. v rw , . r V Page Z o f — DAVE STEAVENS : r: ±;. 'Inspection Services PROJECT4 WEs i - 'PN A 6C' I A ADDRESS 90_ 6 e, 71, (,? 3 P 4�794 G85 06k,.rp Ct, QLD` 3 S- 12p��1 J BLDG. PERMIT # ENGINEEk_0,A ",J SA%J n (C SAi L INSPECTION TYPE PROJECT # oa i0o ! - 0 3 CLIENT f GA c,)e: trV H.v 0. DATE oZ3 ALA,I� �Jv� ARCHITECT (SoL41A 4,ee4g ► � Ec�acQ` CONTRACTOR) EL /h k je ei o I r - INSPECTION REPORT , 479, ��s' ,acv , Rs Pe-A,J LO IBJ ( - a I3 T • �DM LCT£ ��SZ .UCTAIL,-S , / /s 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 V`Ohe locations of the work -inspected only and does not constitute engineering opinion or project control.- . CERT. NO. 4) -A INSPECTOR NAME �116 11£ f2 iP 14 QC_ (Print Clearly) DATE it f INSPECTORSIGNATURE- c�. _ 4_ �, . 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 V`Ohe locations of the work -inspected only and does not constitute engineering opinion or project control.- . CERT. NO. 4) -A INSPECTOR NAME �116 11£ f2 iP 14 QC_ (Print Clearly) DATE it f INSPECTORSIGNATURE- c�. _ 4_ �,