9809-028 (SOTB)LICENSED CONTRACTOR DECLARATION
I 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
19186
4 �
,Date 6 C1 )Signature of Contractor__ . -�� a,
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).
( ) 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:
Carrier Policy No.
civ, C ONIP wwt 13 t 9 -,(go )
(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 of the Labor
Code, I shall forthwith comply with those provisions.
Date: v { s � Applican
1 xt�_44;__
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, 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° "t - Date sA
.cr y
BUILDINGPERMIT
PERMIT #
CONTROL#
DATE tt tr VALUATION
53,I.M to LOT TRACT_
812 4
S �%a�-.`►1�-5 MY 57.
APN -
-
ADDRE ,
OWNER
CONTRACTOR/ DESIGNER/ ENGINEER
"
4?pp'01(,0N CUMASKIMp. TS, LLC
1.111. 'CIA `HJLNC.
78 -%5 AVENUE Z
4196 BOARDWALK P,204
LA, Cr INTA
CA 92253
PALIM Dl-Sfsl T CA 92211
(7600)340-01150
CBL# 3024
USE OF PERMIT
COMFORT STAT.10N
GARnGEYCARIsORX
1W.W s1r,
P1";ItAW FER SUIMN1ARV
FLAN CHECK FEF
1014M-4-19-318
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101 -ON -421-1100 S 3.on
Ei i C1'RfCAL FEE
101.4)01)-4170-000 521.00
Pf.UtI481NO Ff;r
1014Y 01419-W $.416 00
TWR A.3TRIK. TflRf1: t . ;
?2S-fW-44:;-2W2 $120 c)n
ST10*;b07ION FM - {. (A1 1100-000-211-000 1.b5
St.JB-TC'YrAi, PLAN C'fIE.C:k,
i..I:SS PRE -PAID FEES
$0 00
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VIII III VIII IIII 79
t
IE
REC'EIPT
�) —, f"
DATE /,';I
(—/,
BY /
/ /
DATE FINALED
INSPECTOR
/ I
/ .
/
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 DeckG :
Exhaust Fans
O.K to Wrap
F.A.U.
Framing y
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath �9
Drywall - Int. Lath /
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam d
Approval to Cover
/7,r—,,7y 11471 L&
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
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)
COMMENTS:
12/31/98 CITY OF LA QUINTA 1
INSPECTION SUMMARY REPORT
Permit Number 9809-028
Site Address 78-505 AVE 52
Rereference Number
Site City
Location of Project
Date Applied for 9/4/98
Date Approved
Owner Name TRADITION CLUB ASSOCIATES, LLC
Date Issued • 9/10/98
78-505 AVENUE 52
Date Finaled 12/31/98
LA QUINTA CA 92253
Date Expired
Contractor Name J.T. HAYHOE, INC.
Valuation $3,136
41865 BOARDWALK #204
Fees 309.61
PALM DESERT CA 92211
Description of Permit COMFORT STATION
- INSPECTIONS SCHEDULED OR COMPLETED
Scheduled Completed
Date Date Time
Inspection Type Inspctr Inspection Result Inspectors Comments
9/22/98 9/22/98
Al -FTG ST PASS
9/22/98 9/22/98
A2-P-GND ST PASS
10/1/98 10/1/98
B6 -BB DPC PASS 1 ST LIFT COMFORT STATION
16/9/98 10/9/98
B6 -BB DPC PASS TOP OUT
10/23/98 10/23/98
B5 -ROOF DPC PASS
10/29/98 10/29/98
B7 -WRAP DPC PASS WRAPPED WITHOUT INSPECTION.
10/29/98 10/29/98
12/31/98 12/31/98
C1 -LATH DPC PASS
D2 -COMP** DPC PASS
8 Inspections completed.
Gt
SHINNERS PUSHED AND RE -NAILED FOR
WRAP OBSERVANCE
MISC CORRECTIONS LEFT WITH RICK TO
CORRECT.RELABLESUBPANEL,-
WATERSERVICE REGULATOR, PAINT ABS
VENT AND SECURE WATERSERVICE
BOND. FINAL RELEASED BECAUSE OF
AREA TURNOVER 1/1/99 DPC. -
8 -Joh Ave., 5Z
GUY KVAMSv INC.
31-L 5 DI -am Way
—hcuskm* ?;Li7m Ca. 9=76
10, 1998
J.T. Hayhoe, inc.
A=: Rick Trwdem
RE: Traditions C.C.- Ca-zdar, Station
Dear Kck,
We -e pleased to aur the following work related to Trish car-penty
r urrash ars instaUl:
Frames
301" x 6;* -tical grain Dcuain Er with aploded stcps
Doors
ea. i 3i4'1".',ousdw Er pnc-
ei style door to rrmk Clubhouse
Hardware
Reading # I
(2 Doors)
3 StanicyFBI51-1,01 4.5 x4-5oUSlOB hinge
I ez.- PL, sh ilaze 4" -% 16'
I ea.- Custom pull to Maxch F -I&% -ay House
I ea.- Custora B-1.60 deacUbolt
I ea.- LON 404C 1131= closer
I e&- Pemko 17113 36" brmL-- threshold
I ea- Pemko 216:x` 3 6' bronze door sweep
Q UY rLVA:VS, INC.
'�. Toilet Accessories:
a.- seac.;Zame �icw :0:0 -,6" grab �zY
�.- Seac::=me CW 5042 4.." g? --p '7ar
'•�. • .Satai wee:cL'eI aaer �o;. is slack :CII
=ans, iwse zei w- w ca;I.
• Sit:��y,
C=ner-aii a ?:—,. �317t4�S2C'a.
Certificate of Occupancy C,�
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the UniformBuilding various ordinances
cern
finyg that, at the time of issuance, this structure was in compliance with the
of the City regulating building construction or use. For the foliowing:
78=505 AVE 52
BUILDING ADDRESS:
Bldg. Permit No.:. 9809-028
Use Classification: COMMERCIAL COMFORT STATION Land Use Zone: GC
Occupancy Group:. B Type of Construction: VN
Owner of Building: TRADITION CLUB ASSOCIATES;
LLC
Building Official
Address: 78-505 AVENUE 52
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 12/31/98