0009-183 (DEMO) LICENSED CONTRACTOR DECLARATION BUILDING PERMIT PERMIT#
U) I hereby affirm under penalty of perjury that I,am licensed under provisions of
F- "1 -.Chl*ter 9(commencing with Section 7000) of Division 3 of the Business and(1) DATE VALUATION LOT !1€0_183 TRACT
N ProTessionals Code,and my License is in full force and effect. ��- }( ,plgj
O 5 M License# Lic.Class Exp.Date
JOB SITE APN
ILLJ6326,30 C21 � 12/3Il2c ADDRESS M 700 AITNTM&I
Z r— vDate ' s-c P Signature of Contractor _ �'�•��� OWNER CONTRACTOR/DESIGNER/EN (NEER
(O 0_'
~ C:) OWNER-BUILDER DECLARATION ION C000P.ARId1JRMUES ARMM.E ll"CLIN&S L"D C FARWG
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's 81.880 ARM A'tEbM, 82.910.6WKWAN D12.
~ co License Law for the following reason: KID10 CA 92201 r1WRNL iL CA 922'4_
Z ( ) I, as owner of the property, or my employees with wages as their sole C1 IX 2809
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
contractors to construct the project (Sec. 7044, Business & Professionals DIM.0LMON
Code). DEMOLITION OF&XISTINC1 t�,t0USE AS P&R REQUIW OF OWNER
LO
() I am exempt under Section B&P.C.for this reason
O N Date Signature of Owner
ZWORKER'S COMPENSATION DECLARATIONCL .
:oI hereby affirm under penalty of perjury one of the following declarations: xCr '
T �. O O 1 have and will maintain a certificate of consent to self-insure for workers' ALU�1T3t�11 3,f}00,0!)t.3
_u1LL compensation, as provided for by Section 3700 of the Labor Code, for the ,
.
-J Q peformance of the work for which this permit is issued.
Q U (�).I have and will maintain workers'compensation insurance,as required by
OU Q Section 3700 of the Labor Code, for the performance of the work for which this
Il' rn F- `R permit is issued. My workers' compensation insurance carrier & policy no. are:
Z
Carrier STATE FUND No. 3 43819-�9 I r 'II A $y CC3 ,WJE`Cf3IVl3°i 7�` 014 3,f300.43iD
db
J (This section need not be completed if the permit valuation is for$100.00 or less). DEMOLITION FI;E ;,, •� 3011-000-423-000 3.QI1
( ) I certify that in the performance of the work for which this permit is issued, e
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
3 subject to the workers'compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those pr•visions.
Date: Q. >c_ Applicant_,-
Gia
Warning: Failure to secure Workers'Compensationco 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 9 `
application.
1.Each person upon whose behalf this application is made&each person at ON
whose request and for whose benefit work is performed under or pursuant to SU�i-'Cd`S,AIUNyA �'Ax3 fv`f31ri--1C $45 00
any permit issued as a result of this applicaton agrees to,&shall, indemnify „I Is� P 1+ $0.0
& 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 CD jD ice`��MS DIRE NOW ;
work is not commenced within 180 days from date of issuance of such A-L
100
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 62
construction,
• 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 I IE
the above-mentioned property for inspection purposes.
! RECEIPT DATE BY 1 DATE FINALED INSPECTOR
Signature (Owner/Agent) -Date`9- iw.E�, .a'- ''�•%` ��^�
14
INSPECTION RECORD
i 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.Q. 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
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp.Use of Power
Final
Utility Notice(Perm)
! t
09/22/2000 10:03 909-784-0844 STEVEN WALKER HOMES PAGE 04
STEVEN WALKER. HOMES .
June 30, 2000
Charlie W.Smith
Cocvpah Nurseries of Arizona
81-880 Arus Avenue
Indio, CA 92201
Dear Charlie,
RE:ASreenwM Torr SeMoes
This letter is to confirm our agreement conoeming the terms and conditions under which this company
will perform the agreement pursuant to our telephone conversations.
Whereas,Steven Walker Homes(SWH)are owners of Tract 28603-1 within the PGA West community.
Whereas, Cocopah Nurseries of Arizona(Cocopah)are owners of parcel number APN#761-090-012,
in the City of La Quinta,CA.which Is contiguous to SWH property.
Whereas,the Cocopah property has an older home in poor condition and is affecting the sales of SWH
production homes,and SWH contacted Perry to discuss the removal of said home.
Therefore we have agreed to the following terms and conditions. . .
1. Upon acquiring a demolition permit from the City of La Quinta and furnishing the required
Certificates of Insurance,Steven Walker Homes shall perform the following tasks with the sole
intent of improving the visual appearance of'said lot.
2. Perry agrees to allow SWH access to Perryproperty to perform described work only,
3. SWH will contract with and schedule a California lic ensed Demolition Sub-Contractor.
4. Supervise all work while Sub-Corrtractor is on your property.
5. Wont included:
• Raise structure and foundation, including foundation footings to the depth of 24"
• Load and haul off property all demolition debris, including any hazardous materials
found within said building.
• Rough grade building site to approximate grade of surrounding surface.
■ Perform all safety procedures required by,..ode and law.
• Protection from damage by this operation of existing walls,landscape,fences and drive
approaches.
• Dust Control during work progress and cleanup of site after work completion.
6. Work excluded:
Excavation of any below ground level structures, pipes,valves etc. outside of existing
building"footprint'or any items below 24"within the existing building footprint.
• Search, Certification and/or removal of any hazardous material on said lot outside of
building structure,except asbestos were found within building.
• Watering, dust control and cleanup other than that needed while SWH performs
demolition work on jobsite.
SWH agrees that the above scope of work will be performed at no cost to Perry.
WWW.STEVEt4WALKERHOMES.COM
7161 Indiana Avenue, Riverside, CA 92504 909.784.0840 }ax 9.09.784,0844
09/22/2ee0 10:03 909-784-0844 STEVEN WALKER HOMES PAGE 05
C000pha Nurserles of Artzone Page 2 June 30,2000
If this describes your understanding of our telephone conversation, please sign as"accepted by and
return to me in the enclosed envelop.
Thank you for your cooperation.in this matter. If you have any questions please give me a call. Next
time I am in the area I'll call you I would like very much to meet you in person.
Sincerely, Accepted By,
Daniel R.Beal 72-6
Director of Land Development Charlie W.Smith Date
Steven Walker Homes For owners of APN#761-090-012
Enclosure Return FedF-x shipper
Sep 22 00 01 : 52p Brickley Environmental 909 381 3433 p. 2
ouNcs LAND c1.BnaING -
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