0004-0103 (MFD)47750 Adams Street
LICENSED CONTRACTOR DECLARATION
I hereby 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.
721664 D r '1, /i(
Date ` ' `' C, Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I amme..xempt 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:
CarrierPolicyNo.
TAAER IIIn+; .$ROKF WC14196950
(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,11 should become
subject to the workers' compensation provisiO-ns of Sec lon'3700 of the Labor
Code, I shall forthwith comply wihthos ovisionns
Date: —w , ! -m ; Applicants °•,.- . " . — ".
Warning: Failure to secure WorkeX' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application. -
1. Each person upon whose behalf this application is made & each person at ;
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representat fes of,this City to enter upon
the above-mentioned property for inspect ion_ purposes.
Signature (Owner/Agent) ^""'" " Date
F
BUILDING PERMIT PERMIT#
DATE! ' VALUATION LOT OW4-103 TRACT -
, S457,078AO
JOB SITE
ADDRESS 47450 AD.AM3 SMM 649-0
APN
-t;3.3f
OWNER
CONTRACTOR / DESIGNER /ENGINEER
TDF.VlM019 CViVR3ON
ME, O$OS 4✓LPVRfMN
}.341 W, R.OBIM100D I3 .'.
134) W. ROi3'CN -QOD DIL
SOLTM LAS VEGAS NV $91.09
SOUM LAS 't ELAS NV _950109
(909) 786.0777 C.1;kvil 5906
USE OF PERMIT
IviLIZ,'IZ-FAMMY DST+)MUOG
MM-71AUNITS-BUILDINGS1TYPE 3 PEItIl IT DOES NO'f 114C.L.0 D1:
OLOCKWAU, OR. POOL
BREEZEWAY 336.00 3F .
APARTMENT UNIT 7,6 0.00 F
PORCFIIP.ATIO 1,033.00 SP
t- °9
vqsyaQ gqrr ee yyy qq tt qq s p pypgS +yy ., }+ pq
D C+Off 01 C'4Pd\4Z .dd.LCJbr.L O
01109.40
yyyy } . 7p' , I g' pg, ' ES11LYLtS.i:1
PR'.iC.trdJ..N. fi7 KE SE,1Y1+1Y.FAR J.
PLAN CHECK FT'il? 101-000-439,-318 $1,2" 1:31
a
COiNST12UCTIO14 PER 101-000-.418-000 $1,992.50
a. -
ME, CHA.NICALFEE 101=000.421.000 $354.0.0
EIAC 'RICAL IEE 101.000-420.000
PI«UMB No PEE 101.000.419.000 $084.40
SxFlA WO MOT1014 FF°.1; • RIr.SID 101-000-241-000 $45.71
C1R1,iiWO ME 101.000.4.23.000 $20;00
r.
ART IN pl BUIC PL&CES - PM1r 701-000-245-000 $642.70
DEVELOPER I;MPACT FM39,6f)° t40 .
SUB TOT. L ruONSTRUMC5R AND PLAT CBECK
IMS IME -PAID F
x'0.00
TOTAL PF—RM-H MS DUE NOW
IIIIIIIIIIIDI
IVIIIIIII 44
IE
RECEIPT
DATE
BYr'1
DAT FI ALED
INSPECTOR
c.
i
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
TINSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel 16 —e j �
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test 2731- 07 049LY
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
LIE'Ry Notice (Perm)
I C4
& s CITY OF LA QUINTA
' BUI�DING & SAFETY DEPARTMENT
OF
7
INSPECTION REQUEST LINE
MAY 31 2000 M-710
D
AN
T$F4 S S CORPORATION
Owr - t.,__
THE�P CORPORATION
Contnlctor
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MU§T SIGN ALL APPLICABLE SPACES
T KF,E T
19n�i
INCLUDE BLOCKWALL OR POOL
j TYPE OF INSPECTION DATE INBP.
FOUNDATION 3 SETBACK
FOOTING STEEL
i MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO MOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH GAS d GAS TEST
HEATING d VENT - NC
BOND BEAM
O.K. TO WRAP co
GROUT ❑ 4' ❑ 8,
FRAMING
INSULATION
PRE -ROOF
CO ER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE d GATE
FIKIAI S
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4
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CITY OF.LA'QUINTA
BUILDING &TSAFETY DEPARTMENT _
Of �- c_.: F U(iii4TAn-7ot2 ' . _
INSPECTION REQUEST LINE `
�1AY 31 2000 774153
Owg;F A • THE SPANOS CORPORATION
ContractorCORPORATION
Permit Number
POST ON JOB IN CONSPICUOUS_ PLACE
INSPECTFO�SR MUST SIGN ALL APPLICABLE SPACES
Fll
M -!i U ILD
INCLUDE BLOCKWALL OR POOL
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE -GUN ITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB �-
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP _ �1
GROUT ❑ 4' ❑ S'
FRAMING
INSULATION -_
PRE -ROOF
U / / -' 1 Ozz . GCI
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL — -d
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON MR ITIFS AR ry rl icv ai m rutin
Certificate of Occupancy
% • ■ I �/ SSI ! 1 ,-wo V i + I
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 STREET BLDG # 3
Bldg. Permit No.: 0004-103
Type of Construction: VN Land Use Zone: CR
Owner of Building: THE SPANOS CORP
Building Official
Address: 1341 W ROBINHOOD DR
City: SOUTH LAS VEGAS NV 89109
By: KIRK KIRKLAND
Date: 2-08-01
POST IN A CONSPICUOUS PLACE