0305-068 (BLDG) LICENSED CONTRACTOR DECLARATION BUILDING PERMIT PERMIT#
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
I— +Cbapter,9 (commencing with Section 7000) of Division-3 of the Business and 0305-068
DATE VALUATION LOT TRACT
W' Professionals Code,and my License is in full force and/effect. st,ACJiD,O�►
O ch License# Lic.Class Exp.Date
LO JOB SITE APN
LLI r` 5-1555 63 B STC: 1 f�lWzc ADDRESS 49„7M AVMfk D.RXVH -
Z ,Date Signature of Contractor. �f OWNER CONTRACTOR/DESIGNER/EN (NEER
CDO �i r
r'- I-- � OWNER-BUILDER DECLARATION CE�3t2`1'DUNNAM I0*B�.3'LDI- 'SC:'0XP01 A1.?T0X
UJ C)
I hereby affirm under penalty of perjury that I am exempt from the Contractor's �9�75a A (L�DRIVE P U BCX 3235
W License Law for the following reason: j"A(,7CANTA CA 42253 PA,;ry D)Wd `I' CA 92261
Z ( ) I, as owner of the property, or my employees with wages as their sole C1650)346,50"16 f 33L# 3333
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, a( exclusively contracting with licensed
pI IIIIIII VIII IIIIIIII IIII 25
contractors to construct the project Sec. 7044, Business & Professionals O. �LI!"h�lil..�;ITY"DW
Code). ADD NEWfat FIRPPLAC K PEP,PL1?t P-OVED PLAN IE
O I am exempt under Section B&P.C.for this reason
LO
N Date Signature of Owner
ON
C7
d Z WORKER'S COMPENSATION DECLARATION
C:) 2 Z I hereby affirm under penalty of perjury one of the following declarations: VALUATION I,Qa�.�O LS
� O ( ) 1 have and will maintain a certificate of consent to self-insure for workers'
X w Y= compensation, as provided for by Section 3700 of the Labor Code, for the
O � Q performance of the work for which this permit is issued.
m Q I have and will maintain workers'compensation insurance,as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
Il Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier cb Z) fiiilCl+l1P I Policy No. ESdMA=COST CSTe CC+NS1'RTJLMON 3.,000,010
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(This section need not be completed if the pei d valuation is for$100.00 or less). PLAN CHECK 11; .101-000-439-318 �I6,a$ .
( ) I certify that in the performance of the ork for which this permit is issued, r
I shall not employ any person in any manner so as to become subject to the CONSTRUCTION ION ME 101-000.418-000
workers' compensation laws of California,land agree that if I should become
3 subject to the workers'compensatio4 provisions of Section 3700 of the Labor
Code, I shdlld�fohwith comply with th���o�����iesprovisions.
ate: /� I�1 lltl) Applicant
Warning: Failure to secure Workers'`Compensation coverage is unlawful and
shall subject an employer to criminal p n Ities and civil fines up to$100,000,in
addition to the cost of compensation,damages as provided for in Section 3706 MAY
of the Labor Code,interest and attorney's fees. 1• O 6 2003
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 CITY OF LA QUINTA
application.
FINANCE DEPT.
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
CCAti'� •(�6L!) 'rl2TCZO1tiI Al+lldA.(�1`S G? SC $41,25any permit issued as a result of this applicaton agrees to, &shall, indemnity LMS 1`R1"3-PA fa FFZ-3 $0,00
& 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 TCY1'AI,xsY-,j,�ly,UYF F IN DT N0W $41.25
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 118'0,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'a111/City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon e /
the above-mentioned prpmrity forf i�4ktion purposes.
^-�
RECEIPT DATE rr- By�' ✓ ' ' DATE FIN LED INSP
VSlgnature (Owner/Agent) 1 Date46 6 C/o
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 Wali Firewall
Exterior Lath
Drywall-Int.Lath
leldr- 22
-3
Final
Final POOLS - SPAS
BLOCKWALL APPROVALS Steel
Set Backs Electric Bond
Footings Main Drain
Bond Beam Approval to Cover
Equipment Location
Underground Electric
Underground Pibg.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)
1.4
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VT T T A T A nT TTNYr A
i HOMEOWNERS ASSOCIATION
78-225 HACIENDA DRIVE
LA QUINTA, CALIFORNIA 92253
APRIL 7,2003
MR. CURT DUNHAM
EASTON BUILDERS CORP.
74091 LARREA STREET
PALM DESERT,CALIFORNIA 92260
DEAR CURT:
THIS LETTER WELL CONFIRM TO THE CITY OF LA QUINTA THAT OUR
ASSOCIATION HAS AGREED TO THE CHANGES WHICH YOU WISH TO
MAKE ON YOUR HOME AT 49-754 AVILA DRIVE,LA QUINTA,CA. THE
CHANGES ARE LIMITED TO THE SEVEN ITEMS THAT YOU HAVE LISTED
IN YOUR LETTER OF MARCH 12'x'.
1 DO NOT BELIEVE THAT THE CITY WILL EVEN HAVE TO APPROVE ANY
OF THESE CHANGES EXCEPT FOR THE FIREPLACE. YOU DID MENTION
ADDING A TILE ROOF ON YOUR GARAGE AND AS LONG AS IT IS
SIMILAR TO THE DRAWING THAT YOU GAVE ME,IT WILL BE
ACCEPTIBLE. 'I HAVE SIGNED A COPY OF THE DRAWING YOU GAVE ME
WITH OUR APPROVAL.
NTRICK
TRULY
C. ROSS
PRESIDENT
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Warmth,style, and efficiencyare just a fv,of their attributesefficiency
The LBR and LBC are much larger in size, and a.smatic lead in style
Available in two sizes—38" and 43" sdea opening widths
A.
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�' 3,r peeing with
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recessed scan pockets
C •r°a; • 20" deep ' a standard or
herringbonrptactern liner fire
chaniber w.m,,integrated ash lift
•Tight closir Ncrierny-saving cam
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LBC ,
• Full "masonry look" liner
• Heavy-duty sceei grace included ��^_ "�'•+
• Oprlonal bras.; trine nic{ glass doer, ;•
• Optional outside air kit and fcrce
air blowers
,
R 'Su"PERIOR.
i
There are conventional, mid-range, wood-burning fireplaces. And
then there's Superior's LBR and LDC Series.Tlii;fireplace pro%^des
a large"custom"look and comes with many features as standard.
The LBR and L3C is bigger where it icott_nts the most-in its gener-
ous interior tirebox dimension.Due to the recessed screen pocked
its 38"or 43"screen opening can be Ml easured virtually from"rock
to rock". The LBR and LBC is a generous deep. 2 high.
However, size is just a small part of it. With such featLu-es as an
incredibly realistic standard brick or herringbone pattern liners,an
integrated ash lip, decorative flexibility with either a clean face or 1..BR-4324-H T.BC432=
optional polish brass grilles and optional forced air blower for cir=- tGrate,amurrd io show
Ladng units,the LBR and LBC provides a custom-built look that's the t:errin;tiwva de;air,
class of its class,
With, perio �zero�ieararice design and proved lt)"chimney sys-
tem,installatioquick and easy. Remember,there is a step-up
masonry-loolc fireplace that will help take your homes cc,the next
level ifs called the Super.or LBR and LBC. Front
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Complete,one-piece _ –u: r —� '
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chimney top. �` Storm colla:: jl'u
Fitrsrop spacer- Rcof flashing.
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secures;ititnney ut f:�-„,..•._ z�i s
ceilir► or between
tight -
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combustible materials.
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up to.EreplacC.
Optional outside �+ 1 'j C,}� •- � I '�i ..
air!tit. �' I I•�--�_'1.`^� J! j/ � I j
Top
Fxalisticintct^,er j' I I' `~ - 1 1 j damper.with V1CW -P - -
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screen pod es.
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rirrp!ac-�to tl,?or. frani*imensinn
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szfc strip. _ rci ittrl pt I �icdcl „I Height I Drpth—j
Qpdor%ai glass dc-)- �\ _ Ilt.f1R,1324
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BUILDING &SAFETY DEPT
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DATE a---BY
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