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9810-111 (PC)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 D�te /U"d el' 51 Signature of Contractor y r -/7 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. (This section need not be completed if the permit valuation is dor $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 th se provisions. Date: ;rep- a—,, rr lr. r• Applicant E�—� i 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) �-!�E Date f��'`�`� BUILDING PERMIT PERMIT9814-111 CONTROL# r,r DATE "�{]��. /�}� VALUATION +'y{;j,y(j LOT TRACT 8 A 6 4 i V � JOB SITEADDRESS �-5:7 t��: {I�+, :4 APN - OWNER CONTRACTOR/DESIGNER/ENGINEER 'IR,' 1)H9ON' CE..iR. ASki::C'rA'.'E:S, l...0 SC'JTE'S CONST ::t.(" IT°?i`< si?I:VTCi':i 78-305 A'ti E NUF 32 K092 TAHQIS177. AVE 1-A QlAh PA (2A 42253 INDIO CA 1)2201 0160)347-3407 (191,111 USE OF PERMIT PATIO 17,x:12LATT WE, PAT W# C-0VIR,R '014x• i"'t.UB I10USl. Cl WONU-.,Ns 1,0i1f^a u1) P-ORCIMIAT110 211111.0+1 SF LSTIAIA7'11,D i:"OST 01' i",t?MVTRUC--ION 2,713.2-0 i 11:RK1 T HE i.1UllCNIARV VUAN(111`(_'KFPY i�)i-IJlK1-�#?V 3ilc ?5.1u +^'f)N�l'1"S2,T,If,�'iC1Ni.t:l; fill-41('±f).:ij}i-d1iN1 �5.i,t1(1 IONG . 410TION FI- COINTN' 100-000-2.41-00 S >.S,iF1��•i4.t-'t�T�1STIR'fiX7I(.ljd ANN PLAN C'XtI:t�Ts 0.R�r,7 p UOTAI, I'1SKhilT FEF -S 0M, NOW .�.�/ Of J` �R9,h7 I I�IIIII�I�I�II�IIIIII��I ': 10 i 3 IE RECEIPT DATE BY DAT INALED INSPECTOR 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 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 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 Law Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power f Final Utility Notice (Perm) u �1►i1r''�l� ����.�� 1#i�tiRgiii� mpo;mztwl low �.■■■ ■omm irOrr.Y /Yi 6. © . Q � � Ifwrrww .11M IYl ■■moi I It.■■ /.ww........1 IrF1,2 >: .■t 1■tt■: 19:1l Ilowlia-Ji l:ia_/.�-*A' © tw■ 1■1 ;• t■w■■■■■■■■■■■\■■■■■■■■■■■■■■t■■t■1:. .... t■■■■■■■■■■■■■■.e■■■■■.z.._■■■t■■■■ t■1t■1; III`I �] - vuuuu■■■■■►■■■uru . '■I>u t •. i�iii ■■ ■■■■■■►.Irrw/■■ t■■ t■1 ■■ ■■■►���■\■■■■■■t■■1■1 •: :: © ■■■■■©t■■■■■■■■■. 11111'' V V iGiGi■I^n: sy■m■■■■ouommcw_=== •c%:•� I ii■uu■u■wp mu■■\`3■t - iiwiiGi Iw■■■w■1111■■■I■■■■■■■■■II■■■f■ p. 1■■■■■■■■■■p. Ito■■U■■■ t I I �■.�■■ ■._.. Ir. �� 1■U■■■■■■■■U �■■■■t0■■■I Ir• -_\1111■■■■■ ►CSC ioloou. v.�r��no■uu■ Ij •- �' Immillm 111oii1■■ s: �- 1/2" dia. x 12" lag bolts -�=-----------------------.-------------------.--,--.-------T-._ i exist. bui ding ' 1 x 6 posts w simpso EPC84 caps-- r.;� �1..�•_�` - - - ----- ------ - - �� I . J 1---Y- � �i' _ _ __-- - - - - - - - - - - - - --_ --- --- l i I i t I I I I I I I _ I I I ! l i _ I I I_ --- - - -�^ it I II II6Ix11 lam i I-. 71---1 l -i exist. doors to remain =PI'•G'' I . exist. brick patio to remain II II i II '! 11 II II II I! II li !i i I'I•II II ^'<.` �'L.` = it OI: II I I; li II II it II II II Il I! i Iplll II __ ! I 11 ill I; II II II II II II II II 11 I` I� III Ii ��" o, 11 II _ 1i I !! I II IINiI II II �b�fs�, Xi;4treIli memIk.ii ;i D�1E _ - _ _--.-..,-=: _I.-_ II°�•i !I I �' II it it II li .I I! 1CP•II I! 6 x 6 posts w/ Simpson CB66 bases 8" 1 2" new trellis ►� '-6'6ix' exist. to remain 12'-6- 6'x'10! eom 77. - APPROVED COMMUNIT QEVELOPMET D N ^ 1.1 11 ll i I I; 1.1I I; '� gy etc DATE I. NOTE see 1/2� details for more InfoY -BUILDING SECTION A scale: 1/4"=1'-0" _ -' CNEXHIBIT CASE NO. . co 1'-9" 2 x 4 stud column surround to match exist. V-2" 7-5" 7-5" 14'-10" LA 20'-3 1/2" FIR f NEW TRELLIS - FOUNDATION, FLOOR, FRAMING, & ELECT. PLANS scale: l/4"=1'-0" trellis members - match exist. connections"- F -- - --- 2 x flat furringw/ plaster over to match exist. ------ — j _- -- —-__-_-� — — --.n - j i exist. 2 x 6 stud wall 3/8" exterior grade ply wd. -Simpson HL55 heavy angles w/ 4- 5/8" dia. x 5" lag screws ea. to I 1 _ I bottom of beam & 4- 5/8" dia. thru bolts @ 6 x 6 post 2 x blk'g. as-req'd. to match exist. col. detail �I li li ;,r 7/8" exterior plaster over paper backed mtl. lath- match exist. finish & color typ. --I 2 x 4 stud column surround , 2 x 12 solid blk'g. & 1/2" ply wd. spacer between exist. studs @ 32" o 6 x 6 post 4 x 6ost w/ simpson EPC84 cap , BEAM TO COLUMN DETAIL & BEAM TO EXIST. 2 X 6 STUD WALT, scale: 1/2"=I' -O" EXTERIOR ELEVATION scale: l/4"=1'-0" O� Z o Zo H W Q �QU �a 0Oz L C Cy= W H a000Q sheet # I of one