0004-0326 (CONR)47750 Adams Street
LICENSED CONTRACTOR DECLARATION
Fliereby aff m 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 # 04 - Lit.. Class ` "r~ r ' Exp. Date
7216640 112(
30r12(
Date c • ` I - ` Signature of ContracD VECLARATION
OWNER-BUILDER` "
I hereby affirm. under penalty of perjury that I m 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.
AA 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 TlaWER INS.13ROE'P Policy No. WC14195959
(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 prop sions of Section 3700 of the Labor
Code, I shall forthwith comply with those,orovisions4L.-
Dater r . - r t APPlicant
t
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall,, indemnity
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representativesrof this City to enter upon
the above-mentioned pr perty for inspeRction purrp'io es
Signature (Owner/Agent) - •--- Dater
BUILDING PERMIT PERMIT#
DATE j J VALUATION LOT s 0004"326 TRACT
JOB SITE ` ' Y'
ADDRESS 47-750 ADAMSYsRT
L 6
APN
649-03D-W6OWNER.
.
CONTRACTOR/DESIGNER/EN (NEER
'11M 9P TWOS CORPC9MION '
DiE SPPNO9 CORPORAT.K)N
5029 LA UMr DRIVE SUx1'E Al
1341 W, ROMNHOOD DR.
RISI'1MSMR CA 92507
SOOUT ILAS VEGAS NV 89109
(909)786-0777 r; BLO 5906
USE OF PERMIT
CO1RC.:AL.
RECREATION BL DO- Pii1,'Ml T DOZS NOT INCLUDE L4L0tI VAIAZ OR POOL
FORCHJI ATIO 10208.00 SF
COMMERCIAL 4128.00 SF
ECS7WATRD CWT OF CeO.NYMU'CWON
263,9.'7$.40
CONSTRi1CT1014 FE7i:_ 101.000.418.000
PLAN CHECK ir- Z 101.000-439-319 $95754
MECHANICAL FEK 101.000.421-000 5118,99
ELECTRICAL FEE 101-000.420-000 $183.56
PLUMBING FEL 161.000-419.000 S178.00
S '`
STRONG MOTION PEO, b COMM 100-000-241-000 $55.37
• ` i j
ORADINa RE 101-000423-000 $20.00
DLYELOPER IMPACT FEE
ART IN PUBLIC PLAC0 - COM? 701.000-255.0011 $1,315,89
SIM-l'OTAL CON'S?"' WICT014 AND PLAN• CrEMM
$8,815.07
If,i M. -PAID FM _
0
" 50100
TOTAL L'kRWr FE_ES D`UJr 1+ii N
:51 ;E►'1
IIIIIIIIIIIIIIIIIIIIIIIII
41
` . t
IE
RECEIPT
DATE
By/
DATE FI ALED nn
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOf
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
14 Set Backs
M
Underground Ducts
Forms & Footings
Ducts
Slab Grade
,
Return Air
Steel
Roof Deck
% - 00 s
Combustion Air
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
�p
Drywall - Int. Lath
-
r
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
gip` (� 1" ' y /�
Heater Final
Water Piping
/
Plumbing Final
Plumbing Top Out
\ Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Ivy
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
C:
CITX0FjLXQUINTA
C�NOFp�` BUILDING'&,SAFETY•DEPARTMENT
•, - 7777012;-,; x
OF Li -t C-UlgAT&TION_REC2UEST. LINE '
777-7153':«
Owner AY E?9ANOS CORPORATION- L
WOS CORPORATION
_N004-326
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
47-750 ADAMS STREET
JOB ADDRESS
RECREATION BUILDING -PERMIT DOES NOT
INCLUDE BLOCKWALLS 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
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
BOND BEAM
O.K. TO WRAP
GROUT O 4' O 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
,SEWER SEPTIC TANK
FINALS
ELECTRICAL
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
0_ CITY OF LA QUINTA
c BUILDING & SAFETY DEPARTMENT
�Oi 777-7012
%'.p;7Y Y Or L - (71";414OCTION REQUEST LINE
NAM
NOS
`
�r MAY NAMNOS CORPORATION
,6 'H iOS CORPORATION
Pwmit Number 0404:326
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
STREET47-750 ADAMS
JOB ADDRESS
RECREATION BUILDINGPERMIT DOES NOT
INCLUDE BLOCKWALLS OR POOL.
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
DOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS d GIRDERS
ELECTRICAL GROUND WORK
00 NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS i GAS TEST
HEATING b VENT- A/C
BOND BEAM -
O.K. TO WRAP
GROUT ❑ 4' O S'
FRAMING _
INSULATION...'c"
c' !c
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH — OG
POOL PRE PLASTER
POOL FENCE & GATE
R SEPTIC TANK
FINALS
FINAL GAS TEST
HEATING - IVC
HOUSE NUMBERS
i JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Certificat6,''.'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: 47-750 ADAMS ST REC BLDG.
Use Classification: MFD Bldg. Permit No.: 004-326
Occupancy Group: R1 Type of Construction: VN Land Use Zone: CR
Owner of Building: THE SPANOS CORPORATION
Building Official
Address: 1341 ROBINHOOD DR .
City: SOUTH LAS VEGAS NV 89109
By: KIRK KIRKLAND
Date: 11-04-01
POST IN A CONSPICUOUS PLACE