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0104-239 (BLDG)I herr' affirm under penalty of perjury that I am licensed under provisions of ChaF (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 7 331 u2 1t (; 13 'If? Date b 4 0 4 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. (.1 ) 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: Cartier 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, 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: 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 purposes Signature (Owner/Agent) Date BUILDING PERMIT DATE VALUATION LOT f?J.'C��o•'ti��!t TRACT "r 0 1 i:00 JOB SITE APN ADDRESS V OWNER CONTRACTOR / DESIGNER / EN INEER E`;..fl!:�/.!?if'?{a;�iil5ii:.i�'.1'f,'�•E,a3:iU��€P,'['!riP� 4'?%?l-,.h.9.(•'.IAF:r.(:'';'h't[:.:CSP:'-.:�5��:;2.�X,C.'�'I^1:1:1i�1)'.'.'i�:J.N e, 'I62 a.ta�l+t-{�'i'•E:1`j,V.f':. 1}•.:+I:iL USE OF PERMIT !',�i,,+f:!.tJ,•).,.r�?41':;_>�E,.i 1S..�L,.c,' S A �,i.:.':L+ i`l. iii.9.6i r. Sll•u?�{, �;-',',.�,�jl r.&a'% •'S,i^; i;.rt.};' '{'i•.`•`i'�l': iil.tii:ia+A�i�'t's't'IS r. r [e pa nn ((+ ♦♦ + ' {. �. +J..f 7.!: I'i l•1....i) t.: +;_rf!, I. .•� t } <,-r,R +•' , \.:'�. ,(?t. -+Y. 1.[)•. �'I%+.%:f ))4V )l} r Y I ,..Ff./. illy 3'.61.`3 11+'x.[' 3' 3� s?; N:.;::>'i:Y�•'; i:�Y �^e F.1' `i .sS �':.. ;Ai tr",.;) )c.il:i ri'.i.4, .'. i:.::F tc.' � t/ t •!`;Ctl,+ ..•) I •t!lt!; u� (lij ..l_—, 1 1•, : (,'C? l: Lfl�i•'.!'41i'{� I v ¢ ' ? . f..?. �:fvi.t,h').1: f.yA+,+!,Y':,iv 2:+C.1.1.+: 1q(:DW CITY OF to OUlUTA J FINANCE OSPI j _.l RECEIPT DATE BY DATE FINALED INSPECTOR Page ;2- of Z - DAVE ST.EAVENS Inspection. Services PROJECTP, c,.] cin W4,.Scr- - I A PROJECT # 2 3 ADDRESS S CLIENT v4oj?, BLDG. PERMIT # ENGINEERJ -:r7 INSPECTION TYPE DATE,o0Q ARCHITECT 4'no'-ZA AIZC'q 1rMT-LA.JZiC CONTRACTORJ)L ly\Alz ;)Ac-% F, c - INSPECTION REPORT' Gt c. LQ KWAL o - - C- kku I?- LIL,,7\ A)s 3 At J b. -S'H E4> iz CERTIFICATION IFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, —,substaintially 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. INSPECTOR NAME V IL DATE q9 AU 61 ;z 00 INSPECTOR SIGNATU; IL-Z� LAV'j 14 ©QLD Cam?( -CT -,E 0 -71 a-1 3 to' 91 ©aye-rect' 2L c" 3 -T P,-Ao I L L( I I 14.63,1*1 1p--ra i E -.s � 'BLOC-),( V3 C (2-0 or, Lc'TE P -L -l -f -7 CERTIFICATION IFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, —,substaintially 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. INSPECTOR NAME V IL DATE q9 AU 61 ;z 00 INSPECTOR SIGNATU; ��Q: -. , �. .i•. �� �N.«=: J.. 1.•`1.. .��'Y4K�•/: . .-r� �.w... .. [e�a.'��i-S^,� - ,�y. � 1�'•-w:�..:.,wA...a.\..- ....x .. .. ... - Page I of DAVE STEAVENS Inspection Services PROJECT A t,Jr 5`i —� NAS e. A PROJECT # o2 u o ! - 0 3 ADDRESS CLIENT'�1 G P, <.J EST rE o R DATE o74 V 10 o I BLDG. PERMIT # ARCHITECT ENGINEERJ a E Y a c CONTRACTOR Ec. MA 2 INSPECTION TYPE INSPECTION REPORT 90 -1'.( 7, Le 7 3 9, 6 E S 3 S /,a PC -01 r1 S • ��PAr►,,,,��,, wgebwA a6 C�.h.�L r-�,�/Sc.LAi(atJ AL-sd Sys, c 4: Aaj-o Arjc-H X)— % S - 'Y, ci N 7 C iQ il 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. fy0. 0.3 �� -so INSPECTOR NAME (Frim clearly) DATE o? f4 u V a-061 INSPECTOR SIGNATU .,� ... - :�.. � .... �."t .. .. ,... zn,'.ui.�,•„.3. 1%v".� ' .. �;'it'n Y S V�� l�4i%�f� � � •.ttt�.,.. - r..�t ,... ;..-�. .. ... , •., .. .. ...iT:. •'4%`ChJ�.�� � �: .._?YF'iiS.b eb.;;:p.�%3�.'%'�J+:�%:'':'.. Page ( of 2 DAVE STEAVENS Inspection Services PROJECT k- A \z ST - I H A5 E 1 N PROJECT # a v>o - o 3 ADDRESS So -(-6l �.-7 3 L-79 4)4 f,/TZE C • g i p rG. 3.5 t.2 lkf\J - BLDG. PERMIT # ENGINEER'ju,Q Q S A j o l c Iy c INSPECTION TYPE jS::o V'4 CLIENT L1£S7-. l4oA DATE ;-)'3 -A%k(- ac.)aI ARCHITECT GoL3A CONTRACTOR I £ L INSPECTION REPORT CDT) V1 -r a-Et�LA Q `f tD "` 1 Ly c- oLEs lz' fir, t4 t"3%A ClVS I -1L -1 A ��gIt �. A VEA9- U�T-5T LI J d f:Ocg- E I +1tiP'1r1 (�� IJ�A (Z0DS ' ►- "Li G -T -7g go -(,73 OA�T.YEE LFIrJ oZ a r 3tfl� a - .2 CS - f-1 o`t P i H I D1A.tcUDS - (' 1 r�LE►aC-,`rr-i ,fig 1 A . Re -A& �1JT�12'ZLocS-rio��S- �1' bef..T.h1t �iW t�ol7g-1-I' L.c�JGT-1 �•�1sk g0 - �1.q OAr:TIZc ti c�L:;k►J a. L1IA.PO-h$ 1-i LCQC-Z,-+ 8 ntA ���4/Z C>��ze12 • rsZ LyCS - `'�OLC S ' (�-. •, r. F�"1-) (,' r tl. r .� ii L.A o' �D Z•+IhAS'oZWc,.S.-�o�•'g'�a �DEi'T� '� ��A l�v�S• �1 L£UC.•T►•� ($ b�� 1L�r�2 EA��' t,�U- � LCIS- �Of_F�-t� (� liL>'Ir"fi ./��Rf)DS'/7• �.CA1G'rN�IB iA t3o►�E 1-yCATio,j-.5 £Poa`( SImPnoo ETF- EYE 4-03 HO LF- `�i r�T N Irl tc �I.�F J . Ru S+�Eli o b C- L- f 1 'L' 1z 5. C'!J —1/ ons A J_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 ,the locations of the work inspected only and does not constitute. engineering opinion or project control. CERT. NO. 68..0 43 INSPECTOR NAME- A J6. S -t -r -A 4)e:05 (P. t V—ry) DATE --2:S A u (p . x o O l INSPECTOR SIGNATU�c���.� _= 9 ,., -DAVE STEAVENS Inspection Services PROJECT4)(,# u)ESJ - N A SF-' I A ADDRESS 90 Z (�-7 G S5 ttpA W ore ct Q L 04. 3 S' /2P -L J BLDG. PERMIT # ENGINEER1,,.,.,j INSPECTION TYPE -Page 2- of PROJECT# c2vol-o3 CLIENT PGA L,,-) 5T HV DATE A3 AL&I, ARCHITECT C, oLaA dl* &H t -e E- c-71--st <- CONTRACTOR4 �je4 ci Fl �r. INSPECTION REPORT' i?o - -r . G`7-3 /0,1. e. e:5- e3t_" �L.L, IT/ c-'-7!) 0 W106, A - �1 'i' I- 1)7-- V Is 4- 70 5 CERTIFICATION OF'COMPLIANCE: To the best of our knowledge, all of the reported work, uniess otherwise noted —'substantially complies with approved plans, spe6ifications an&applicable sections of the building codes. This -report "covers —)he locations of the work inspectedonlyand does not constitute engineering opinion or project control. CERT. NO. e) ig 5:N3 q A - t QINSP , EM-RNAME,-'_16jjC '4e"- Cleary) ,DATE e�7S INSPECTOR MGNATu