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0004-0118 (MFD) 47750 Adams Street LICENSED CONTRACTOR DECLARATION I FI 6,7y affirm-alhder 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 r Date Signature of Contract OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that h'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: Carver TAN3+igR$, I3R0r% Policy No. WI -1196959 (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 Sectio 3700 of the Labor Code, I shall forthwith comply with those pro visions` Date:? I - Applican,rt`s-, Warning: Failure to secure Wtorkers' 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 representatives -of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) W Dates i BUILDING PERMIT PERMIT# DATE - _. , _ VALUATION LOT TRACT SM,424M MP -9-654 JOB SITE ADDRESS 47-750 ADAMS S=W1: APN 64g i13WG OWNER . CONTRACTOR / DESIGNER ENGINEER NEM WANOSCIORPORA i1/1 L[M SPDp08 CORPOipWN 1341 W, ROBRIWOOD DR. 1341 W. ROBWHt7i2D DF, SOUZ14 I-kS VEGAS 1V 59109 - SOUTR LAS V1: G 9V 89109 (909)786.0777 CKH sw USE OF PERMIT .MPD -16 U-MITS,ZUIL D114CY TYPLP SO. PLM:IT DOTS Nar INCLUDE BLOC. ALL OR 0& is1ARAc31alCARPORT I,BBCs.GO 8F APARTMENT UNIT 8,9t too Sr POit.CWATIO 1,032,00 9r ORd?IM?R1%dAY 536.00 43F 1RSITAW1ND COST OF CO.N.' UCTIOW SSS,324.80 PEJUM 1W r9'i1KWAY PIAN CHECK FEE 101-1000.43.9-J 1 S S1,3304 CONSTRUCTION FEE 101-000-418.000 $2,207.30 MECHANICAL FEE 101.000.42111000 0800 ELMTRICAL FEE 101.000-420-000 $694.52 ' PLUMBING nE 101-0110-419430 $684.04 t , 4 1-- STRONO MO11ON FEE - RESID 101-000-241-000 $33.33 011-ADINGPRE 101.000.423.000 120.010 • C ,3 ' ART IW PUBLIC PLACSS.. RESI'i 7131-000-235-00 $888,31 r DEVELOPER IMPACT 99 S9,6t18,00 C "3 r i3'!.M-IWAL C09MX ,nl`LC'X ,AND PLAN CHECK $11,868,10 ` LESS PRE -PAW iWO $0.00 MES DUE NOW IIIIIIIIIIIIIIIIIIIII1 20 . IE RECEIPT DATE BY DATE A n INSPECTOR \ / !J Z r INSPECTION RECORD OPERATION I DATE I INSPECTOR OPERATION I DATE I 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: Final Utility Notice (Gas)424­/ 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) 5 os _ CITY OF LA QUINTA BUIIIDIN•q &-APIFETY DEPARTMENT ► vF. 777-7012 MAY 3111�066CTIO N REQUEST LINE , Owned-• rTHE SPAN©ptf'ORPORATION ContractorTHE SPANOS CORPORATION 0004-118 Permit Number POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES 1111.:1.. i wa9Wits 9DI9611dlisp NOT INCLUDE BLOCKWALL OR POOL TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK _ L FOOTING STEEL 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 NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS !PkS TES HEATING & VE ROOF BOND EAM O.K. TO WRAP GROUT ❑ 4' ❑ 8' FRAMING Q INSULATION 2„_(217 PRE -ROOF it c COVER NO WORK UNTIL ABOVE AS BEEN SIG ED DRYWALL INTERIOR EXTERIOR LATH / POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK - ' FINALS ELECTRICAL PLUMBING _ r - FINAL GAS TEST HEATING - A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER 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 47-750 ADAMS ST BLDG. # 8 Occupancy Group: R1 Type of Construction: Owner of Building: THE SPANOS CORP Building Offici VN Bldg. Permit No.: 0004-118 Land Use Zone: CR Address: 1341 W. ROBINHOOD DR City: LA VEGAS NV 89109 By: KIRK KIRKLAND Date: 5-15-01 POST IN A CONSPICUOUS PLACE