0004-0102 (MFD)47750 Adams Street
-1 LICENSED CONTRACTOR DECLARATION
I iliiiero'1y 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
{
721€64 B j r`r v'NaE %ZZ
Date ' + 1 -0U Signature of Contractor l
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
A
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:
Carver 'A ER 1NS. DROK0 Policy No. W01-1146959
(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 provisio
ns Secti 700 of the Labor
Code, II shall forthwith comply Ith those provisid'ns.
Date s -"'k 1- 00 Applicant( s^ ` - i _ . .•_ r i L___'
Warning: Failure to secure Wor pker ' Compensation verage is unlawful and
shall subject an employer to crimirid 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 representativ a of this City to enter upon
the above-mentioned pro erty for ins6ection purposes.
* ?
Signature (Owner/Agent)l 'z"'" Date >
BUILDING PERMIT PERMIT ##
DATE--/ [j j VALUATION LOT TRACT
Q 60 S 9 -654
JOB SITE
ADDRESS 4.7_750 ADAMS RF31',T
APN
64"30-W
OWNER
CONTRACTOR/DESIGNER/ENGINEER
113E SPANOS C0R1a017,1An0N
TkZ SPANOS CORPOILALZON
1341 W, ROD=- O0n 13R.
1.341 W, RORM-100n DR.
SOi: rH LAB VEGAS NV 89109
SOTS' H LAS VEGAS NV 89109
4?)7g6f7 t;7 Clvi 5906
USE OF PERMIT
T. 141-PA1v ILY mmi-wo
Ill d a UNITS.BUIL D1N0 11' TYPE 20 -PERMIT Dt9ESS NOT INCLUDE
BLOC1'WAL.L. OR P001,
POR.CIMPKPIO Z06U0 OF
CARPORT 1,280.00 SF
BREEZEWAY 1,012.00 OF
APARTMENT UNIT 14106.00 SP
ESIUdM' J COSH' OF CO.NS1=(7=4
g8tlROli 7.50
PERMETM MYMARft
PLW CHECK FEE 101-000,439-318 1`2,2i9x
.
CONS RUCTION FEE 101-000.419-000 A146.30
MECHANICALFEE 101-000-4-21-000 $716.00
W.1zf„:TRICAL1t'1Z 101.000.420-000 $1,066.12
Pi,UMS11 O PER 101-000-419.000 $1,224.00
{ '
STRONG MOTION FEE - RE SID 101-000-241-0004;,;
1 , f
ORA{a1N0 IEE 101-000-42'3-000
ART IN PUBLIC PLACES . RESIE e701-000-255-004 5),02.00
DEVELOPER IMPACT nit 519,216,00
0
St)B TOTAL CO1;I rJCMON AbM PS.Ag i 'CIC
2 ,42'I.2t1
1=SS P .PAW bio
$0.00
IIIIIII VIII III VIII IIII 23
RECEIPT
DATE
BY r
(\
D E NALE ^^
INSPECTOR
`. f
!11 V
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
Exhaust Fans
O.K. 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:
J X ee, ✓ 12.
-r
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) f
s QTY OF LA QUINTA '
cF'b
OF.TFBUIL ING & SAFETY DEPARTMENT .i
777-7012
M�1 ZQZZINSPECTIO N REQUEST LINE
%THESoS CORPORATION
Omer �
THE SPANOS CORPORATION
Contractor
0004-102
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
��ppINSPECTOR MUST SIGN ALL APPLICABLE SPACES
MPll-B U
En
NOT INCLUDE BLOCKWALL OR POOL
TYPE OF INSPECTION I DATE I INSP.
FOUNDATION & SETBACK I % -=7L 1 ,&
MAIN GROUND SYSTEM
`
GROUND PLUMBING
�G
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
A-Zou S/
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
6 G7
HEATING & VENT- A/C
FIREPLACE
ROOF/
BOND BEAM
O.K. TO WRAP
/
GROUT ❑ 4' ❑ 8'
FRAMING
Q
INSULATION
Z _�
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
7 —1 ? - Gu
FINALS
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
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 ADDRESS:
Use Classification: MFD
Occupancy Group: R1
47-750 ADAMS ST BLDG. # 11
Bldg. Permit No.: 0004-102
Type of Construction: VN Land Use Zone: MRC
Owner of Building: THE SPANOS CORPORATION
Building Official
Address: 1341 W. ROBINHOOD DR
City: SOUTH LAS VEGAS NV 89109
By: KIRK KIRKLAND
Date: 6-21-01
POST IN A CONSPICUOUS PLACE