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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 11 Lic. Class Exp. Date Date 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 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. (,!.A 1, fi-dfi(+: 4141T`i' t.!?•i. (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: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety - for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced, within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building " construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes Signature (Owner/Agent) Date BUILDING PERMIT DATE VALUATION LOT 010141 •'<< 11139 TRACT y0,00i i,L` f 3 JOB SITE APN ADDRESS OWNER CONTRACTOR/DESIGNER/EN 1NEER i1 .'i /l�t�;ii?:.. ili:i`rt'••?'"rv!'Cf.>�F.. ''�'?r�t.•''t''(a.P�sir:'f. . _ .. �',; • ai : , .. •+; `.t 'r•4' i•' ;,. ���t �. _ t, .+t [ b � :� f''t ... ! �i....S:iti.r.. f. C. C..r3'I"k 8`d'."i'Ci.N .t?� i.•4. ':�'.. (!'1: I,,i •t.4:i •J.l ./:. r1r:;,1`tiT fi.V'��. %.f'�r �.!L ,.�` a ;'i'Eh{'('.!: .`!�. .:f:G4t;, �!,.`5?:iE� �•:.i::i`,�::'i'? .a'':. `,Il.i)'1 USE OF PERMIT I.,I'i4'� I✓°°_+{iY�. r),j ,rl Mj.!I'); i„ •>�...)l: �' :'�. ��S i.'a!: i.:.;.�i !'%. (1 .,. , i;U•r`.'..�, 5f:•�'�11 r.If.$i't•.r,_ i.i�1.};� ';'_>.,.`;•' i4'Ltit..!!'+i'����'!' kt'lr. rail:f.i.m,.O't'li'i{..'.fa'}'I%:ia:'' 't.(:dr?9'i 4'E'.a114i('f' J� S'„�' +vS 111°i7a'l ii.11f''4 ...:•i`;'<'lil•,:t'•?'I,i;':}; iei'< �;)':i;f;t^,},i?,.;i'r)r.; i;ii)'.ill�! ..0 5'9; . �!:{ ; ;.a i,:'j,.et'i P'�1�i', .; i'...:{,, 1 !i { • r :C!(? ��l i • .!t:{. „.,c.G(1 i' ...' � -----___------t---_._._.—i f��, },i':�;; c', t' �f'.•�'Jii c 6:��'a i-i:�• 'f; 4J 1.17 �1':'!�_t .�.fi 21 j''6� it ye�'f!.'`�• itf ji. :� 4 ' I aEie.?•d_t�j _J CITY OF LA 006A i FINANCE DEPT i RECEIPT DATE BY DATE FINALED INSPECTOR r .: �Ir • yl. � t ...1s � ., i^!�`��-• �- F•Q�..• `,j.I t c .. ... • r � - F. u :^v .� : F;5%� a•; _ _ _ -�.•-i • � �e�:.i��r. ;: ''wF�i <.-i�^r.,�torL. , o.•.'�.>ji.:atrr'.;. :r•*;ry- Page ;.. of Z DAVE STEAVENS Inspection Services PROJECTp L.,� z in• d�1�5F - I A PROJECT # 2 Qc, t -c> 3 ADDRESS }k S `. s'�� CLIENT(�A BLDG.. PERMIT # ENGINEER, o r 1 Sp�\)o,j� -17.%e INSPECTION TYPE DATE ,z:,)8 Au�.V dao I ARCHITECT Cao�A 'A11CN t i Eg-TuRr. CONTRACTORJ�\L ty Ak 7�4Ac, Fi c_ INSPECTION REPORT Z r_•A 1 Q TAtt_S l . 3 t 44 IS L oCk AOh Pt_-� �lA�l.t►.1 C,- �rn� C.E i G Ab•cR�,� LA "i t o ALL '4 oz-y-Tt c.•s - `$�,..SN�A(L tJ� ►L.t.J ©�L�-1 - Com�t_�.Tt PSA roZ ���5 - t.:2, 3.1� 'I5-� � .�LaLfC A.J ii }���I �At� �►1t,, - �r�n�J�.E'rE . AzT� �S ��_TA ► -S Co BLOC-kC /t or') f:,, H G f41z- t�A I es t I C„ -(2-0 L t I- F 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. ��1 T'j�`J V INSPECTOR NAME �-� ^ ►.� r DATE AUG QQ/ INSPECTOR SIGNATU Page 1 of DAVE STEAVENS Inspection Services tANS E ko, PROJECT # c;2 G-o 1 0 -PROJECT+ QE s,"T ADDRESS b CLIENT _1 GP, ,)eZS_1 HDFk BLDG., PERMIT # INSPECTION TYPE DATE o2 4 o o i ARCHITECT Gc>La N � izatk i -r F_ C..i',&A C CONTRACTOR E:L. ^A P_ 4)Kc-( )_) C_* INSPECTION REPORT' go - f.f_ :Z L 7 3,40-7 9, ( .85- 2e_,,p4 3 � 1-2 ;pe -'id SID <-I kc 2 IC fz, A,,j zN Aicxf ic s —r, ;z il CERTIFICATION OF COMPLIANCE:To the best of'.our'knowledgp,'all of the reported work, unless otherwise noted, ,-,,substantially complies with approved plans, specifications and applicable sections of the building codes. This report covers ,,-.,ilhe locations of the work inspected only And does not constitute engineering opinion or project control. CERT NO. 0 INSPECTOR NAME t -(prim Clearly). DATE 02 Y P4 u e2_06/INSPECTOR SIGNA DAVE STEAVENS Page Of Inspection Services PROJECT - &P' PROJECT # :2 a ADDRESS � -4-0 t.'7.3 L-17910 8 13,.nc- 1 -5- t.2 toc^o - BLDG. PERMIT ENGINEER`jLxQ0 SAjole Izc-* INSPECTION TYPE r=:f o V CLIENT t 1,4oA DATE 2 B -A ARCHITECT GOLCA. A C -A 1-r C CTIA. R C CONTRACTOR INSPECTION REPORT L let a LA N4 VrEAVE U�r--,5-T Lk j d LOL-, C Robs - j-7"LZQG-rH 0 A iir-rr-C E. Rk-Ai'C I)EPTH SO 0444 -Me C -Re Cp a-LGC_S Ho Z)C- P-rq 1 6, A 4g z A -Nip) PD&S-1 7• -7y (A 90 - � 8i5 0A -r it C cl- ts lFez--O. 140.5-2 go 0 LA. Rop- LI L-egu-r-i b A\ it. Ito., 40 Le -s- w OC? 1 / 7 " 4. e-)'j6T;tv'?1A .71 "A &0 or- LOCA-rloj" Po K %f as f 61 P'-2 csk'D 477 P- 2iY P 4-03 HO LF- PYT 1-4 049C-L14FD- 1?RaS#4F-0 A#JL) CLLCArJ o k A 'P�P —1 1 0,J AQ -6 Am, latz - iaan CERTIFICATION OF COMPLIANCE: To the best of odr knowledge, all of the reported work, unless otherwis'e noted, - ,-- jsubstantially complies with approved plans, specifications and applicable sections of the building codes. This report covers he locations of the work inspected only and does notconstitute engineering opinion or project: control. CERT N9. INSPECTOR NAME. (P t C") DATE � 3 Q L4 t. 1 op I INSPECTOR SIGNAZZ-�-� n., Page of '2— ..DAVE STEAVENS Inspection Services. PROJECT4)()1 u-) z s;-1 - ;>N ASC. I A (- ADDRESS 90 - t. e, 7 • (,-7 3, , 7q, S5 RLbe_ 3 -r t2pj_Aj BLDG. PERMIT ENGINEER) 1A A, I Q -, INSPECTION TYPE 0 PROJECT # 3 CLIENT P&A L,) e !>-T t4o k DATE R3 ARCHITECT GoLaAAe e.H r c rwrc-,A C' CONTRACTORZ EL A je ?D,+ C/,Or-, r INSPECTION REPORT' s?Q - &L 7, `73, x.79 e. e :5- idt-o-, A 9W& P 4. A A`L_L_ '4 1 re c_S k/ / 0 G A- 3! L T- v 1s, L- 7o 5 A(c, t J 0Drm P1 e7c A912 3C 7A I L --a Ari IS. A - 3 s S n , CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, 'unles's otherwise noted, 3 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. 40. 0 0A ]r_QS - INSPECTOR NAME —1 AJ iC f7t,;!: DATE 3 Pkkk L. INSPECTOR SIGNATU;Z