0004-0110 (MFD)47750 Adams Street
LICENSED CONTRACTOR DECLARATION
I'hereby,affirm under penalty of perjury that I am licensed under provisions of
Chap%r 4 (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
722664 Vi,Od2t
Date T -- 3 ) Signature of Contractor -
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 UMNER INS. BROKE Policy No. Wei -1196999
(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.
Date: i 1- 1... (. Applicant ' b r
Warning: Failure to secure W rkers' Compensation coverage is unlawful and
shall subject an employer to crimiRaal 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 inspectionpurer
Signature (Owner/Agent) t' f -,-4— - Date
r 'BUILDING PERMIT PERMIT#
DATE,4%'// fir VALUATION LOT 000`4-110 TRACT
*482,166A0 ffl)99-654
JOB SITE - IPN
ADDRESS 47,1750
ADAMS SvtXWr _:64",310-036
OWNER CONTRACTOR/DESIGNER/ENGINEER
T.M SPAN09 CORPORATION TH1+:, SPAN'OS CORPORAXION
1341 W,1ROBMOOD DR 1341 W. ROBIM 00D DRP,
801.TrA LASVZOAS NV 59109 SOUTE LPSASS I-IV 89109
(909)786,0777 CBL 5906
USE OF PERMIT
M13 I -N -R .'Y i V Fi C3
M'1e[),°d UNITS-BUIfv,l IN0,9 TYLE 7 311 PERMIT DOES NOT INCLUDE
BLOCE:WA,,1LL OR POOL
OARAW, CARPORT 12$0,00 OF
.A,PARTMENT M.11T 7,080.00 Ste
PORC.WPATIO 110325.00 SF
BREEZEWAY 536.00 3F
,STHAA D COn OF CC)NSM1757, 014
P1 i1P i ':,x StZ16+Y,iVJAikF.1
PLAN C1° WK FU
101.000.439.318
S1,130,59
CONSTRUCTION FRE
101-000-41€1-000
SI,$80.60
WHANIM PRE
101.000-421.000
13P4:00
ELECTRICAL PUE
101-000-420-000
$639.40
PL13MB1110 FEE
101.000-119»090
$684.000
STRONCI MOTION FM - MID
101-000-241-000
$43.22
GRADI O FEE
101-000-423400
S201W
.SRT I`i3 PUBLIC. PIACES . RESIL 701-000-255-000
$709.42
DEVELOPER IMPACT IEE
$0,608.00
0TD-TOa.AL CON5'T.R.1)CrION AND'PZ,A9 ClECK
LE33 r1R.F,-PfijD 8
IOTAI, PMO&Tr S DIXIE NOW
RECEIPT I DATE I BY
r I -
IIIIIIIIIIIIIIIIIIIIIIIII 21
IE
INSPECTOR
4 ,3fxQY •"!tD
15,39 r.E3
E0.At1
IIIIIIIIIIIIIIIIIIIIIIIII 21
IE
INSPECTOR
INSPECTION RECORD
{
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 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
4
Drywall - Int. Lath
17 _;53- GU AAX
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
FinalN
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)
COMMENTS:
04 ��
_ s PITY OF LA QUINTA
CE.'bOFT1� B6�61NG & SAFETY DEPARTMENT
777-7012
SAY 312000 INSPECTION REQUEST LINE
777-7153
Owner THE��A.NOS CORPORATION
ContractorTHE SPANOS CORPORATION
0004-110
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS
MFD-BUILDING 9 TYPE 3G -PERMIT DOES
NOT INCLUDE BLOCKWALL 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 _ a
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBIN
ROUGH GAS & AS TEST
HEATING & VE
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP -/
GROUT ❑ 4' ❑ 8'
FRAMING _
INSULATION
PRE -ROOF
M i /�✓r <--
/ 'L-tJ oZ-�
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
_ (�
POOL PRE PLASTER
POOL FENCE &GATE
SEWER EPTIC TANK
_ d ._ '
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
4
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. # 9
Type of Construction:
Owner of Building: THE SPANOS CORPORATION
Building Official
Bldg. Permit No.: 0004-110
Land Use Zone: MRC
Address: 1341 W. ROBINHOOD DR
City: SOUTH LAS VEGAS NV 89109
By: KIRK KIRKLAND
Date: 6-21-01
POST IN A CONSPICUOUS PLACE