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0004-0097 (MFD)47750 Adams Street LICENSED CONTRACTOR DECLARATION I here, 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 7216 ,.. n C Date S 4 Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 TANNER I148BROKE Policy No. WC1-1196954 (This section need not be completed if the permit valuation is for $100.00 or less). () 1 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' compensationprovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions -1.1, -__1 Date:: - iP. C t 3 Applicant, If` Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to cnnainAl 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 pines Signature (Owner/Agent f" I . ,. Date i BUILDING PERMIT PERMIT# DATE , (( ry VALUATION qq r. aye .yam LOT a7 TRACT 4+ _ry r F+.38 0, I a7 9M W -S .9 -654 JOB SITE ADDRESS 41-M IMAMS SIMM APN 649„030„06 OWNER CONTRACTOR / DESIGNER / EN (NEER THE SPtU'CS CORPORATION THEe SPA140S CORPORATION $029 1AMAP.TDRIVE :5U A2 1341 W RQBMH(>OD D.P., RMRSME CA 92507 SOUTH LAS VEGAS XV 89109 (9,09)786-0-177 C'1 of $906 L&NCR PEPPER ARMITIXTO USE OF PERMIT lvl l{ Ti-1? Y DV4M!_JNG 4625 W .fLWNIFF.R, SUITE 101 def. rlJ 3'NI fS-BU1 L DI1gC t2jT 'P81. PERMIT 1=5 NOT iNC'LUD& 6Lr AILS OR POOL PORM)IFATIO 11032.00 8F BREEZEWAY 536.00 SF APARTMEWT UNIT 0336,00 :3F XbTIMATM COST OF CONITMUC2TON 38%M.20 PEP".TIM S1 bomy i ) Al Clik',CiC I 101-000-439-318 '$110$2.0 CONS1'AUCTION ?FIE 101-000-r+i$-000 51,633.00 MCr.CN.AN16.t1.LFEE 101.000.421.000 $332,00 R14CTRICAL PEE 101-000-420-000 54102 PWMBIWO FRE 101.000-419.000 $540.00 STROT40 MOTION FRE , R.ESiD 101-000-241-.000 $39.07 hs _ GRAA,t5J1dc3 PRE 101 i-000- 423.000 $20.00 r • -_ ALIT IN PUBLIC PLACES R&SIE 70'1-000-25:5-000 $451:02 » DE'VELOPFA IMp,A.CT ,FE.E $%608.00 w ... gti13-TOTAL t9bNS .UCYLON.t PLAN C CK 67.48 IYSS PRE -PAW FEM 4D $OM TOTAL PUMVITw 6 DVEE If OW 514,167,0 1111111 VIII III VIII IIII 24 .IE RECEIPT DATE I BY — Dqj ND / !/ AL INSPECTOR .. ;,. A � _• 4 OPERATION DATE INSPECTOR BUILDING APPROVALS t: Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air INSPECTION RECORD ; ` OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS t: ` 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 DeckzqU Exhaust Fans OX to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T:O�'.: Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS 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) 7 47750 Adams Street Aug 15 01 01:17p Aventine Rpts 4 } 3 qJT- Y OF LA QUINTA BUILDING & SAFETY DEPARTMENT ` SOF 777-7012 ZtlIJO INSPECTION REQUEST LINE 777-7153 owner THE gPANOS CORPORATION Contractor THE SPANOS CORPORATION Permit Number 0004-097 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 47-750 ADAMS STREET MFD-BUILDING 12 TYPE 1 -PERMIT DOES NOT INCLUDE BLOCK WALL OR POOL. TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING: PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB JOISTS 8 GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING 6 VENT -A/C FIREPLACE ROOF _ C BOND BEAM O.K. TO WRAP -27 GROUT ❑ 4' ❑ 8' FRAMING .. INSULATION - . a( - PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR //.. /( A EXTERIOR LATH ( C t POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK `] • % ? 1 FINALS ELECTRICAL O PLUMBING FINAL GAS TEST 2. O HEATING • A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO V. 115- nu i Vru irtce nn Mnl lov 01 In nikjr- i W'T OF LAQUINTA BUIS SAFETY DEPARTMENT • �° - 777-7012 INSPECTION REQUEST LINE MAY 3 3 2t1� 777-7153 TNOS CORPORATION Cadractor THE SPANOS CORPORATION Pwmit Numtw 0004097 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES ,108 ADDRESS 47-750 ADAMS STREET MFD-BUELDING 12 TYPE I -PERMIT DOES NOT INCLUDE BLOCK WALL OR POOL. rfPE OF INSPECTON DATE INSP. CONCRETE ®O NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED O.K. TO WRAP GROUT ❑ B ❑ w FRAMING INSULATION —mr ftA/1G ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING w Certificate of Occupancy City'of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following.- BUILDING ollowing. BUILDING ADDRESS: Use Classification: MFD Occupancy Group: R1 47-750 ADAMS ST Type of Construction: VN Owner of Building: THE SPANOS CORPORATION Building Official Bldg. Permit No.: 0004-097 Land Use Zone: CR Address: 1241 W. ROBINHOOD City: LA QUINTA CA 92256 By: KIRK KIRKLAND Date: 7-12-01 POST IN A CONSPICUOUS PLACE