0004-0109 (WALL)47750 Adams Street
LICENSED CONTRACTOR DECLARATION
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
I— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
O =) C) License # Lic. Class Exp. Date,
d
r; W i 721664 B /30/2(
.
oZ r— Date - `'`J Signature of Contractor ` --z--
o0rl / .
r C:) OWNER -BUILDER DECLARATION
J
W W r- I hereby affirm under penalty of perjury thatl am exempt from the Contractor's
~ N License Law for the following reason:
Z_ ( ) 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).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
cY)() I am exempt under Section B&P.C. for this reason
N Date Signature of Owner
O
CL
z
WORKER'S COMPENSATION DECLARATION
o 2 Z I hereby affirm under penalty of perjury one of the following declarations:
Lo 0 () 1 have and will maintain a certificate of consent to self -insure for workers'
X W li compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q () (\)/I have and will maintain workers' compensation insurance, as required by
OU Q Section 3700 of the Labor Code, for the performance of the work for which this
li rn F< permit is issued. My workers' compensation insurance carrier & policy no. are:
qt Z Carrier Policy No.
cw :5TANA,9R,MS.BROU WC1-1106939
a
J (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
3 subject to the workers' compensation provisions of Section '37'-0-0- o_ ythe Labor
Code, I shall forthwith comply with those provisions.
Date: 'I ' aApplicant
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 caricellation.
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 PERMIT#
jjjj % S
DATE4// /P VALUATION LOT (M4-109 TRACT
(/ ( S61,Gt10
JOB SITE
APN
ADDRESS 47-750 ADAMS STREKr
OWNER
CONTRACTOR/DESIGNER/ENGINEER
Tfis SfPANOS CORPORATION
THS: 4PANCS CORPORATOR
1341 W, ROBUMOOD DR.
1341 W, ROB1NF HOD DR.
SOUM LAS VWAS NV 69109
SOUTH LIS WEGAS NV 89109-
(909)786.0777 CBLdF 13906
4t
USE OF PERMIT
GM11?"RAL B'FSRMINCCG
t
2440 LF'. 6'(H) PERIMETER GARDEN WALL W119"PILASTERS-CITY
°TAWDARD
6 FT. WAIIII 2.440.00 LF
K
Mit U17D COYr 01, CO-iSMCM0 4
6] SOt)O:CDEI
PRS' 11ER BURY
CONSTRUCTION FEE 101-000,418-000 $464,00
suB-TOTAL C0wS"YRiIOnt)x Am :PLAN' cREcy,
$464.00
LUSS M -PAS FW' S
$0.00
TOTAL PE !J +IIT MS DUE NOW
.f1iD
IIIIIIIIILIIIIIVIIIIIII
40
.
IE
REC{ IPT
DATE
BY
D
INSPECTOR
^INHALED
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
I Compressor
Vents
Insulation
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
14.
Underground Pibg. Test
Final _ G
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:
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Final
Utility Notice (Gds)
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)
""Gr .I �
THE SPANOS CORPORATION
5029 LAMART DR., A-2 • RIVERSIDE, CA 92507
TELEPHONE: (909) 786-0777
Transmittal Letter FAX: (909) 788-2035
Date: 08-21-01
To: Mr. Greg Trousdell 760.777.7000
Community Development Department
City of La Quinta ;—y (�q�(�
78-495 Calle Tampico �IJ V
La Quinta, Ca 92253 A 2
1
Subject: Substantial Letter of Completion CI
F LAGIUINTA
PLANNING DEPARTMENT .
Job: Aventine Apartments
How Sent: Delivery= jwl
We are transmitting the.following-items:
If items are not attached as indicated, please notify us immediately.
No. of conies: Description:
1 Tetter of Substantial Completion (signed copy)
Transmitted for: Review.
Remarks: Please contact me if you have any questions or additional comments.
Approved Res
0 Planning Commission --
0 City COANCil
-semm Dev. Dept. 2Z -a
e S nos Corporation Initials ----
Jack Lucas/Project Manager Case No.
Exhibit
O With Conditions
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