0004-0119 (MFD)
47750 Adams Street
LICENSED CONTRACTOR DECLARATION
l 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. B
Date ` I ' ; + Signature of Contractor- =t ••-
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).
( ) 1, 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.
( )1 1 have and will maintain workers' compensation insurance, as required by
SNtion 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 T,"NgR Ii4S. BROKb Policy No. Wei.1196939
(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'fof the Labor
Code, I shall forthwith comply with those provisions.
Date:^ L, Applicant -\\ • '` _
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 compensailoR-?damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is tieireby 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.
(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) /JN9jr 45? -1: . r Date
BUILDING PERMIT PERMIT#
J }
DATE /_ / VALUATION LOT TRACT
Ir I ' $WS,324M
N.D99.054
;lr
JOB SITE
ADDRESS 47- i il AI?1 •
APN
649-MO-O.V
OWNER
CONTRACTOR / DESIGNER / EN (NEER
7 ' SPMOS CORPOI(A.TY014
TM, SPA13'os COAPOW10M
1341 W. R,OBDMOOD AP,
1343 W. ROM HOOD
11111,
SOMU LAS VWAS NV 89109
801YrR LAS SAS
NV
89109
(909)786.0777
C'
R, $906
USE OF PERMIT
ADULT -FA1v. LY DWRZ12 G
MI 04,t UNITS-BUXUDINO i0TYPE 50, PF..RMIT DOM NOT INCLUDE
BLOCT.WALL OR POOL
(14RAOFJCARIPORI 1,A-00.00 €its
BREEZZWAY 536.00 SY
APARTMENT U14IT BAUD 3F
POPC',Ni'PATIO I,032,DD SF
ESDAAA17? COS' ' OTi' OONYMU(.."1 0N.
555,324-80
PERWi1'FEE 911JAVIAAM'
PLAN CHECK FEE 101.000.439.318 VX6,04
.+y
CONSTRUCTION FEE 18-000
'MECHANICAL PEE 101.000.421-000
ELEC;TRIC..&L FU 101-000-420-000 $684.52
PLUMUNO WE 101-000.419-00A 1624,00
ilTl
9T CO140 MOTION FEE AE,SID 101-000-2141-000 $55.53
e3RA IMO FEE 101.000-4:23.000 $20. ►
0
.ART IN IRLMUC P ACSS - Rmir 761-000 235-000 5388.31
DWFLOPER IMPACT PEE
StM TO FAL CCl14MUC'110114 AND PLAM CHECK
$15,868.70
IMS P1i.U-PAID FERS
$0100.
.r01AL PIM716. U1 MN DUENOW
4i ,13684?ti
IIIIIII
VIII III
VIII IIII 22
`
IE
RECEIPT
DATE
BY'
OF E NAL
p
IN
INSPECTION RECORD
OPERATION
DATE
I 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
OX 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
LOuk
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
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)
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)
y O
CiTVOF LA QUINTA
cFboFo BUILDING & SAFETY DEPARTMENT
777-7012
MAY 31 2 aPECTION REQUEST LINE
_ P►. EPT� 777-7153
Owner THE 'SPANOS CORPORATION
ContractorTHE SPANOS CORPORATION
0004-119
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
�p
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
Rf ADQU D'ERMIT 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 SIGNEC
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 lo -76 _ GO
BOND BEA
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING _ Q
INSULATION
PRE -ROOF
J
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
ELECTRICAL ^ 6. Q
PLUMBING
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 Bui/ding 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. # 10
Bldg. Permit No.: 0004-119
Type of Construction: VN Land Use Zone: MRC
Owner of Building: THE SPANOS CORPORATION
Jd*4"'l
Building Official
Address: 1341 W. ROBINHOOD DR
City: SOUTH LAS VEGAS NV 89109
Bv: KIRK KIRKLAND
Date: 6-21-01
POST IN A CONSPICUOUS PLACE