9811-019 (GRES)LICENSED, CONTRACTOR DECLARATION
"I'hereby affirm under penalty of,perjury that I am licensed under provisions of
Chppter 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
084857 13 1 131100
Date Signature of Contractor xi)
:•
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:
Carrier Policy No.
S"TA CIi 17 UNt).'''A'l- 9$-0009t5'b"
(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., C
Date: 1 (�1 v. �,.� Applicant—/- G< , jr 1' b- t..t
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:inspectioWpurposes.
Signature (Owner/Agent) ( =� `' =� ,.(t , to 1-7— P3
PERMIT CONTROL#
BUILDING PERMIT '
98114)19
DATE VALUATION $4,3 70.Nll� LOT TRACT 8580
r'S -
ADDRESS ' 56- RMERA RERA JOB SITE
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ROBERT K & KIl44T3ER IX SCCj'1`C
1108 EI)Et'ARDS CONS111I. U 1' 0IN
12 BU N1NG TREE RD
19-9210 FIESTA GR1VE
NEWPORT REACH CA 42,060
LA QLUF A. CA 1Y,2253
(760)775-7933 (131.1# 3212
USE OF PERMIT
R Sltakly 1'LAL fU')D MON
GOi.% CAR1' GAILkOE 4
D8
OV 17 1998
GA12ACAF-CA1.IIt)Rr 22-1.00 S.r'
"1TYQF
LNC Ulf T
LST1Nt%XED COST OF, CONSTRUCTION
4,370.80
PFRNIIT i< KC yUMaisAARV
PLAN l;f°1EC''iC YE:8 101-(1041-430-318 S46AP)
r(')N,TTVrt(-110ivY'is ffil-(ino-Aifi(N1fi 5,7±(Iil
E1,[iCTRlt'.'AL I:16 1U1-f10U < .0 iiv0 $19:56
')'1 Ot�ii:1 tv11(�T!(N F-07 - ft ISH) .101-04)0/-241-000 $.40
Sl Y3-` M. Al. i`t`)NI,'.i'i OC -7110N AND PLAN CIIE'CK.
$1'39 76
LESS PRE -PAR) POS,
50.00
'1" Y AL fi<ER11 IT FKMmS WJE NM
3f3S.7to
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
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
/ Q
L ��
Exhaust Fans
F.A.U.
Framing
Compressor
Insulation
7,01
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
2 _ 4X
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
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
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
i
I
Final
ts/ti{ity Notice (Pirm)
COMMENTS:
PCS WEST
November 13, 1998
Mr. Robert Scott
56-545 Riviera
La Quinta, CA 92253
RE: Request for Architectural Change
Dear Mr. Scott:
PGA WEST If RFSIDE.NTIAL ASSOCIATION. INC.
P.O. BOX 1282, LA QUINI'A, CA 92253
(760) 776-5100 FAX (760) 776-5111
The Condominium Architectural Committee has reviewed the letter from your contractor
in reference to plans submitted for a golf cart garage addition at your PGA WEST home.
The Committee is pleased to inform you that it has approved your addition based on
that letter and the following stipulation: -
1. As previously discussed the maximum width of the golf cart garage
door not tD exceed more than 8 feet.
Please contact me at (760) 776-5100 should you have any questions or concerns.
Sincerely,
For the Condominium Architectural Committee
John J. Monahan
Association Manager
CC: Board of Directors
Unit File