0401-352 (SEISMIC REPORT) (2)79731 Arnold Palmer
LICENSED CONTRACTOR DECLARATION PERMIT#
U I hereby affirm under penalty of perjury that I am licensed under provision of BUILDING PERMIT 0401-3W
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and DATE VALUATION 9f1•cl:l LOT TRACT
CV W Professionals Code,and my License is in full force and effect.
License# Lic.Class Exp.Date 7.
OWLr) 733152 A RIC 1 01U3l3 Ji ADDRES*# 23 ARNOLD PALR'1.KIR APN —
x 1 _.fir OWNER "' CONTRACTOR/DESIGNER/EN (NEER
Z
Date
Signature of Contractor
r O o OWNER-BUILDER DECLARATION % __f PGA ➢ Zr 11F. .0F_W'. ►1k,C.ASS012 `11ON 13m,MAR T 14CTIC'011W. R L E.OITI.i .1,.M'CDi 9,
_J U cn P.7.1...t•OX 1060 25:.33 3C W.H COP0.1 i MCI S—_ 250
W W I hereby affirm under penalty of perjury that I am exempt from the Contractorfl- 's CP. ??3 CAfa7 Ir` b'Y i1yE SLA CA. t1ddU?
~ d License Law.for the following reason: , AQ Mm,P'
co ( ) I, as owner of the property, or my employees with wages as their Sole ( r )t5::5 I ltl C«?1I; 5363
compensation,will do the work, and the structure is not intended or offered for
sale(Sec.7044,Business&Professionals Code). USE OF PERMIT
( ) I, as owner of the property, am exclusively contracting with licensed 01MIGZAi BUB j}RIG
contractors to construct the project (Sec. 7044, Business & Professionals
Code). I V01AINTA.RY SFFSIAIC RETROFIT
cr) () I am exempt under Section , B&P.C.for this reason
L
N Date Signature of Owner
O N
Z WORKER'S COMPENSATION DECLARATION
0 Q 1 hereby affirm under penalty of perjury one of the following declarations: VALUATION tjt1D0.00 LS
r F- O ( ) 1 have and will maintain a certificate of consent to self-insure for workers'
X W u- compensation, as provided for by Section 3700 of the Labor Code, for the
O J JQ performance of the work for which this permit is issued.
C0 Q U ( ) I have and will maintain workers'compensation insurance,as required by
O 0 . Section 3700 of the Labor Code, for the performance of the work for which this
liLO H permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier STATE lt`(11dL> Policy No. 0460RP 11 R 000941! .UYU ° .TWD COST OF Ci'31 T1TTt3:d '.€ N e t,{ F3t'J.Cl Y
°oD Z) ?X.RMH'F FID I`I[1Mt/a_dAR
J (This section need not be completed if the permit valuation is for$100.00 or less). (XI1 STRUCS?'1011 FEE 103•-000-418.000 12L00
( ) I certify that in the performance of the work for which this permit is issued, STR0140 MO7T1014 FEE•RR ID 101-000.•24 1-000
1 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 r __
subject to the workers'compensation,provisions of ySectio J00 of the Labor
Code,I shall forthwith comply with thyse pro is`ions
Date: Applicant i ! ." •-
/ 1
s Warning: Failure to secure Worker s' Compensation boverage is unlawf I Ind e . A;N 2
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 I his
application.
1. Each person upon whose behalf this application is made&each person at SUB-1VrAT COAbi3'IRU•C`TTN-4AND P.I...WCT-WK 81.60
whose request and for whose benefit work is performed under or pursuant to LESS PRE-PAW p F,} qCj 00
any permit issued as a result of this applicaton agrees to,&shall, inden}nify
& 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 d't7'i. .3. 1 ' 'ri3 •
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.
1 certify that I have read this application and state that the above informati n is IIIIIIIIIIIIIIIIIIIII IIII
• correct. I•agree to comply with all City, and State laws relating to the building 76
construction, and hereby authorize representatives of this City to enter upon IE
i
the above-mentioned property for inspection purposes.
RECEIPT DATE BY DATE FINALED INSPECTOR
Ci—fi— /(l... cr/Anent\ --•_. ! t•./! / ...1: flats !/.'a/ -/1 r- :• d
INSPECTION RECORD
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
Drywall-Int.Lath
Final
Final POOLS SPAS
BLOCKWALL APPROVALS Steel
Set Backs Electric Bond
outings _.- 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)
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)
IIIIIIII�I�IIII�IIIIII��I 77 Page of
'E DAVE STEAVENS.
_ Inspection Services
PROJECT (, t)r.51 CLASSIC-S PROJECT # CPO
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ADDRESS -I(R - US I 7 -zQo L:!' ) 1 CLIENT P6A t-JC:5 i qo6
?AcWAG2 DATE A-f MA Y dO� �-
BLDG. PERMIT # O `f A I - 3 S ol., ARCHITECT tLBA {�,2c k1
ENGINEER w)c., Otd SA ,bl c- CONTRACTOR ;fie�F�
INSPECTION TYPE
INSPECTION REPORT
rA I a A f, S-A 15- 3 A -r' vii -Pr, c coo s i,
WAF-rF•4 At,-- 7�ce-rL
s
CERTIFICATION OF COMPLIANCE:To the best of.our knowledge, all of the reported work, unless otherwise noted,
•substantially complies with approved plans,specifications and applicable sections of the building codes.This report covers
the locations of the work inspected only and does not constitute engineering opinion or project control.
CERT.NO. VB S 7 �Q '�y INSPECTOR NAME �C:11 Ch _S
Pr' -6learty,)
DATE L/ C/ 'INSPECTORSIGNATUR
Page of
IIII DAVE STEAVENS
78
IE
E:!IIIIIIIIIIIII Inspection Services '.
P .
PROJECT�(-,i� u)Z 51 - CLW315-5 PROJECT # [P Oy¢ -
ADDRESS �1� = 1 t 7`�1 �,aca c.:�!, CLIENT A
_?1k cWn N:;-Z DATE '�.� /h A `( 0s c5 0\4
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~ BLDG. PERMIT # O 44 o t - ARCHITECTh,�e4A A-e—eA -1 f
1 ZJc- CONTRACTOR,
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ENGINEER
INSPECTION TYPE t nr'
�
INSPECTION REPORT
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CERTIFICATION OF COMPLIANCE:To-the best of our knowledge, all.-of the reported work,unless otherwise noted,
substantially complies with approved/plans, specifications and applicable sections of the building codes.This report covers
the locations of the work inspected only and does not constitute engineering opinion or project control.
CERT.NO. INSPECTOR NAME �� � � •�
�� u0 � (P,rint Clearly) "
DATE ` INSPECTOR SIGNATURE'�--)4&-_R._..
Page of
DAVE STEAVENS-
Insp 'lion Services
PROJECT !�C.,aR i; )E--37- PROJECT #
ADDRESS `7q - 7 23 "�l—wlf1-1 CLIENT"�GA w ezj
DATE 3 . AN tA.`•I.
BLDG. PERMIT# ; ARCHITECT Vic..BA Q 14
ENGINEER SA Ju c. CONTRACTOR� c
INSPECTION TYPE.
.. INSPECTION REPORT
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Page of
DAVE STEAVENS
•Inspection Services
PROJECT; C6 A. W iZ !0I C LAS'S +.c,5 PROJECT
ADDRESS 7 a "� w�'"t 3� 7 CLIENT 'i"• --�c�r'�
Af-A A L to p ft C-0 <.2 DATE t . AM i c_ av6 y-•
"BLDG: PERMIT # . ARCHITECT CoL A
ENGINEER iA9,�,� spwo to %0, CONTRACTOR�t- M�t 2 �ACr�= C
INSPECTION TYPE
-INSPECTION.REPORT
arc.��°�--5 �°4 +4. � 5'3 ` �. •`�� +' . �d �;� �,.r�-- .
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h T" fA 5 Z-rr tZ i3 w- E'.La. �" 1.1 d7
CERTIFICATION OF COMPLIANCE:To the best of our knowledge, all of the reported work, unless otherwise noted,
substantially complies with approved plans,:specifications,and applicable sections of the building codes.This report covers
the locations of the work.inspected,only and.does not constitute engineering opinion or project control..
CERT.NO: ` 6�! � q�! 5 U INSPECTOR`NAME .� : V
tom
; ; ,.. Print Cleary)
DATE �� �` '"�?�U INSPECTOR SIGNATURE�,Qlx- t.�..�.+..J