0004-0113 (MFD)47750 Adams Street
LICENSED CONTRACTOR DECLARATION
I hereby affiri; i 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
121664 :ki .414 130l2C
Dater • t "L L' 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.
( ,f 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 INS,BROKI4 Policy No. WC1.119699
(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"l'should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, Ir ha, forthwith comply with those provisions. j
Date: J " i1 f Applicant3 ,,_ _ I,,-."
Warning: Failure to secure Workers Compensation coverage is unlawful and
shall subject an employer to crimigal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application.is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within. 180 days from date of issuance of such
permit, or cessation of work for. 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
It
Signature (Owner/Agent) _ ° Date' -
BUILDING PERMIT PERMIT"
' " 113
DATE ! r % VALUATION LOT
:.,I C '
TRACT
-654
JOB SITE y
ADDRESS 47-750 ADAM
APN
t b -tf rt?-€JAS
OWNER
CONTRACTOR / DESIGNER / EN (NEER
I'm Iv"OS WRlaCSR=014
T.TIE SIPMOS co"ORKMX
1341 W. ROW. 00DDIL
1341 -WI ROBIIJ:C OW DR,
SO= kI LAS VFW AS NV 89109
SOUTHLA'S 'S VEGAS
.NV
89109
(909)7€I6.T177
Ci
TAI 5906
USE OF PERMIT
WX.0 T?ANMY IDWM'CI` G
Kra.'. LIMITS-BUILDIN i t TYPE 4a, PERMIT DOM NOT INCLUDE
BLOCKWALL OR POOL
IAriRC:iii AT'IO Z064.00 3F
C#APA,GMARPORT 1,200,0000 SI?
,
B RISd'.nGIGI ►. 1.I I. Jli.00 alb'
APARTMENT UNIT 14%304.00 Sig
y +A 4. +i +y (s t • t T v, rpy Y/ ply p
&J1VR.is:d.e D COST OF lvi✓6PA71.$i- I CTIOJ.
o_ w
s✓e 6.1WAAPfs
•v q, y 1j 6yT
&"drY 3C .J62..v d.+6M i76J 1:GE
MUM
PLAN CHECK YET 101.00Q-43 =318 t2,43A A2
144
CONSTRUCTION IME 101-000-19-000 $3,3xso
MECHANICAL IEEE 101.000.421.000 X1.0.00
a
ELIX fRIC:AL tYZE 101.000-420-000 01,112.24
Pi,UMBfNio PTIM 101.000.419-000 S1,2200
' -
STPIONG1 MOTION ISE - RESID 101-000-241-000 $93.66
f f"DING PER 101.000.421.000 520.00
ART 114 PUBLIC PLAM9 - R RIE 701-000.153-000 $1,840.16
w. .:.-.-
!l ],OPER IMPACT Fri Ir19,316.tMijl
"•`LWAL COMTR1IG".I MI A1,TD PLM CPX
$301002:3
LM PRE -PAID FM
$0,00
i MAL M&M FEM DUE BOW
III IIIIIIIIIIIIIIIIIIIII
30
.r..
IE --
RECEIPT
DATE
DATE PIAL
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Underground Electric
Ducts
Slab Grade
Final I I
Return Air
Steel
Gas Test
Combustion Air
Roof Deck
Heater Final
Exhaust Fans
O.K. to Wrap
—. /0— C)(
F.A.U.
Framing
O.K. for Finish Plaster
Compressor
Insulation
Sewer Connection
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
I k7_ S'4
75— / Z
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 I I
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
I Encapsulation
Final
COMMENTS:
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp, Power Pole
Underground Conduit
Low Voltage Wid
Fixtures
Main Service
Sub Panels
Exterior Recepta<
G.F.I.
Smoke Detectors
Temp. Use of Pa
Notice
-ITY OF LA QUINTA
UILDING & SAFETY DEPARTMENT
7TT-7012
IA
_WSPECTION REQUEST LINE
Fi
777-7163-
POOL FENCE & GATE
SMR SEPTIC TANK
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
T11PH ON UTILITIES OR OCCUPY BUILDING
FOUNDATION & SETBAC K
THE SPANOS CORPORATION
FOOTING STEEL :z 46� siz
owner
GROUND PLUMBING
PRE-GUNITE
UUU4- I IL .1
pwmft Number
POST ON JOB IN CONSPICUOUS PLACE
JOISTS & GIRDERS
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
ELECTRICAL GROUND WORK
it.
4 1 - I av Auj%lVjta a I I&EIL I
IAQM
MBUIL INU 13 FYTE 41(i-YEFLMIT D ES
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
NOT INCLUDE BLOCKWALL OR POOL
ROUGH ELECTRIC
T%mc Of 1108parmw DATE
POOL FENCE & GATE
SMR SEPTIC TANK
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
T11PH ON UTILITIES OR OCCUPY BUILDING
FOUNDATION & SETBAC K
FOOTING STEEL :z 46� siz
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
POOL FENCE & GATE
SMR SEPTIC TANK
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
T11PH ON UTILITIES OR OCCUPY BUILDING
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB ci
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS GAS TEST e 7
HEATING & VENT - AIC
FIREPLACE
OND
BEAM
O.K. TO WRAP
GROUT 0 4' 0
FRAMING
t7
INSULATION 4/ Z5 f
PRE -ROOF
UNTIL ABOVE HAS BEEN SIGNED
COVER NO WORK
DRYWALL INTERIOR
tp
EXTERIOR LATH d/A4
—1111 --Ai..
rl,
POOL PRE PLASTER
POOL FENCE & GATE
SMR SEPTIC TANK
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
T11PH 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: 131
47-750 ADAMS ST
Type of Construction: VN
Owner of Building: THE SPANOS CORPORATION
Building Official
Bldg. Permit No.: 0004-113
Land Use Zone: CR
Address: 1341 W ROBINHOOD DR
City: SOUTH LAS VEGAS NV 89109
By: KIRK KIRKLAND
Date: 7-18-01
POST IN A CONSPICUOUS PLACE