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PAT (9801-137)44095 Mariposa Ct 9801-137 LICENSED CONTRACTOR DECLARATION U) I hereby affirm under penalty of perjury that I am licensed under provisions of F— `iinaptei` (commencing with Section 7000) of Division 3 of the Business and 04 W Professionals Code, and my License is in full force and effect. O :5 ch Licensy)# Lic. Class Exp. Date LU s i 4i V31it'9 LU oZ /Date Signature of Contractor r- O U OWNER -BUILDER DECLARATION W w r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ d License Law for the following reason: Z( ) 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 LO N Date Signature of Owner ON a- Q WORKER'S COMPENSATION DECLARATION C:) 2 Z I hereby affirm under penalty of perjury one of the following declarations: LO O () 1 have and will maintain a certificate of consent to self -insure for workers' X w compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. m Q C) (k) I have and will maintain workers' compensation insurance, as required by O U QSection 3700 of the Labor Code, for the performance of the work for which this L rn F— permit is issued. My workers' compensation insurance carrier & policy no. are: "t Z_ Carrier Policy No. Cao : a`"F1'f 14.i't,JIND 141129Y,R <Q (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 3 Subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /Date: Applicant 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) Date PERMIT # CONTROL #. BUILDING PERMIT 111NOI-137 DATE VALUATION,v 4e . LOT TRACT 6769 JOB SITE ADDRESS Al2 ( s !< APN't OWNER} CONTRACTOR / 'DESIGNER ** rj {{ / [ it ++ (!qq j PAN! CA fill N ♦, I AN!EIA G', SAR30 /;ENGINEER d14'` t TUR, it PM i E. 44095 iltMUI:.10.5i L i ., tri v I bL 1 411 4114`" LA (,#Atv'i'A CA 427,51 LA. C, fANNTA CSA 9' .t'l t USE OF PERMIT PA.` 40 3W `: '. afX1101.O Ui AND i)6. k (NU) ) 4'_`'Sa`i f ii:Vk a u 1kRA61:1 t 0 . - tl l It a.4td2 J itIrii i.ti ►i'4.af. .'1i ai.slA 1, 1 b.ai. lx'•6 1a .`i PLAN C t*'(*K 1 Sit: i 1 4i.,i `i;3•,41T'ro 5r'Id1.V5 . K•r t f :'i I7.fg " d VN #-Pry i(11._000 ailr(10th , tROJINC bVIOTI(I)IN14T leu.11>f.4) to •3l -t31}() $ ` OD n ® CQ. LL <r0 . CJ ('.(i ;: i `( i1f3i9 /1Ni,l f'f.-1N 'ii,T?t`'(a a $1o:t .icy _l 'iTf'S` A), FICRI IT F IRMS !)E)NOW S10,S.4w RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD ' OPERATION DATE Set Backs INSPECTOR BUILDING APPROVALS Bond Beam Set Backs Equipment Location Forms & Footings Underground Electric _ Slab Grade Final Gas Piping Steel Gas Test Electric Final Waste Lines Roof Deck s, j Plumbing Final O.K. to Wrap Equipment Enclosure Shower Pans Framing Sewer Lateral Pool Cover Insulation Encapsulation Gas Piping Fireplace P.L. Gas Test Fireplace T.O. Party Wall Insulation Party Wall Firewall Exterior Lath Drywall - Int. Lath —/ 7 — 95l OPERATION DATE INSPECTOR MECHANICAL APPROVALS Underground Ducts Ducts Return Air Combustion Air Exhaust Fans F.A.U. Compressor Vents Grills Fans & Controls Condensate Lines Final ,3 le BLOCKWALL A PROVALS Final POOLS - SPAS 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 r�na� COMMENTS: 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) 'a J • fJG '(I I ' ( o, 1'1 ?G • I lixl tiT C \ '✓fir .. G . I .r UI" 1" 3 \ MA164 fyler i _ aT Axl sra - f __a•_+ vv r r I.Yo NIS rATI o 5Fro br-r-swc> I.ar> yi%G1"I AT 2 4-9 Axl STG TuI MIrJ. j . slr'lf : CC c r h l 7 1'6 t7rIv - Pxl9T6 4_0 P_ 100 ED AR yi jaLaT r 'r LA N CONSTRUCTION HOURS . F Geto'oer lst - April 30 SeA LP, x1 ST'G 9Xr. AL L J Ionday - Friday: 7:CO a.m. to 5:30 p.m. .. / i + y . AN ADEQUATELY SIZED DERMS COINTAINER C 5297 8:00 a.m. to 5:00 P.M. U jql Saturday: : None I; REQUIRED ON THE JOR SITE DURING All I..Il, sr1G 51 a1. _ JI• TI Le Sunday* .nt Code Holidays: None PHASES DF CONSTRUCTION AND MUST RE F OFCA1. EMPTIED AS NECESSARY. FAILURE TO DO 0 - G M let - Se tember 3014'► SO MAY CAUSE THE CITY TO HA11E `- Inc r: PPv I ur Ur CLrMoyndjay _ Friiday: 6:00 a.m. to 7:00 p•m• COINTANER DUMPED AT THE EXPENSE OF THEiNiVE Saturday: r8j:00 a.m. to 5:00 p.m. OR/CONTRACTOIR." 111; Sundaone •'-,-_.. •Government Code Holidays: None ALL WORK SHILL CONFORM TO THE FOLLOWING CODES 1994 UBC, 1994 UMC, UPC ' -- Pyle 1993 NEC Contractors 2x pr_ t 1 CIT OF L CU6NT A 2x j Art ol y DUILDiI S F ii` (D P I T I fi hur B. Pyle A w ! _ GG DITKD -AL1.. ' Owner '/A' [ // I ,{ I/ {y/ // 11 //} . (jam, G _yp' ` [/ + ' (/1,\, I' j ph "(^' j _...y+ . V /- I f V V 1 G ''° ^ 1 -• •' ! i •' . :Y kyS .'r. f n '• M A . !. tl r i= ' / CCE 14D F( i a.Rf'ii9 4Y! 1 {-' t'sw• I cq ---- 1. l .. c pp x x ■ p / q j " {a 78-365 Hwy 111, 0147 . r , . `4i + 4: r 5 11 Q d i fi E L./ fl + r SUBJE i TO f TQ.Ti' LLATI0k1'A,s i` _LG' ' yi1 L 9 • r ' i SITE V 1'1 619-398-1 56 92253 t I• , a . t.s`,1, OTS T SCH Ur ., 1 - AND AF'F'Ql AIOLE CX}OE:S %1 NO'EXCEPTIONS! DATE 7 BY UL ylt Op ,f, 2 x AT i (e . 71, -- I ISrnrf"F.P. O 2 x A- ' 1 . ?- • t _ — l 2. ' / IJI J I ( CSI Q ,( I IN.• 3 I`" rztjfL- Ix4'_ - O PLYor l — } .Ii►Jd-.Nig . I.3& N p, 1,0 GpG N v e P o C! co cope,p/.V 1'T v - OC p W CL < cc D - — < C 1 P 5 I?, I•# • T f' a T _. 2x/IAT ILO ' li / Ziu I_n , i.B,I . w -- iTll ro 1"d NQrCµ c Tvxi sTGi ILSGI a ( , I II CQ + c) W D Lir f©U Ne Q V U • - • '` U cn E,, W.„ . . w o (D- ., i NSo ,,, o Ly > . Pt. o. !/) ;4- Q • d •c • :. U •cin ED AR yi jaLaT r 'r LA N CONSTRUCTION HOURS . F Geto'oer lst - April 30 SeA LP, x1 ST'G 9Xr. AL L J Ionday - Friday: 7:CO a.m. to 5:30 p.m. .. / i + y . AN ADEQUATELY SIZED DERMS COINTAINER C 5297 8:00 a.m. to 5:00 P.M. U jql Saturday: : None I; REQUIRED ON THE JOR SITE DURING All I..Il, sr1G 51 a1. _ JI• TI Le Sunday* .nt Code Holidays: None PHASES DF CONSTRUCTION AND MUST RE F OFCA1. EMPTIED AS NECESSARY. FAILURE TO DO 0 - G M let - Se tember 3014'► SO MAY CAUSE THE CITY TO HA11E `- Inc r: PPv I ur Ur CLrMoyndjay _ Friiday: 6:00 a.m. to 7:00 p•m• COINTANER DUMPED AT THE EXPENSE OF THEiNiVE Saturday: r8j:00 a.m. to 5:00 p.m. OR/CONTRACTOIR." 111; Sundaone •'-,-_.. •Government Code Holidays: None ALL WORK SHILL CONFORM TO THE FOLLOWING CODES 1994 UBC, 1994 UMC, UPC ' -- Pyle 1993 NEC Contractors 2x pr_ t 1 CIT OF L CU6NT A 2x j Art ol y DUILDiI S F ii` (D P I T I fi hur B. Pyle A w ! _ GG DITKD -AL1.. ' Owner '/A' [ // I ,{ I/ {y/ // 11 //} . (jam, G _yp' ` [/ + ' (/1,\, I' j ph "(^' j _...y+ . V /- I f V V 1 G ''° ^ 1 -• •' ! i •' . :Y kyS .'r. f n '• M A . !. tl r i= ' / CCE 14D F( i a.Rf'ii9 4Y! 1 {-' t'sw• I cq ---- 1. l .. c pp x x ■ p / q j " {a 78-365 Hwy 111, 0147 . r , . `4i + 4: r 5 11 Q d i fi E L./ fl + r SUBJE i TO f TQ.Ti' LLATI0k1'A,s i` _LG' ' yi1 L 9 • r ' i SITE V 1'1 619-398-1 56 92253 t I• , a . t.s`,1, OTS T SCH Ur ., 1 - AND AF'F'Ql AIOLE CX}OE:S %1 NO'EXCEPTIONS! DATE 7 BY UL ylt Op ,f, 2 x AT i (e . 71, -- I ISrnrf"F.P. O 2 x A- ' 1 . ?- • t _ — l 2. ' / IJI J I ( CSI Q ,( I IN.• 3 I`" rztjfL- Ix4'_ - O PLYor l — } .Ii►Jd-.Nig . I.3& N p, 1,0 GpG N v e P o C! co cope,p/.V 1'T v - OC p W CL < cc D - — < C 1 P 5 I?, I•# • T f' a T _. 2x/IAT ILO ' li / Ziu I_n , i.B,I . w -- iTll ro 1"d NQrCµ c Tvxi sTGi ILSGI a ( , I II CQ + c) W D Lir f©U Ne Building Address 44-091 Mar Owner T 0 44 0 it!t Q" Cad! P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing .1 Address 43-875 Washingeam 5t. _ City Zip Tel Tel .. 'alta Desert 92260 X45-7,641. Contractor City State Lic. City & Classif. 49391 Lic. #Z 2.31 Arch., Engr., Designer Address . City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter 9, (commencing with Section 7000) of Division 3 of the Business and Professions Codeand my LARATION license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DEC I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. '7031.5,Busihess and Professions Code: Any city or county which requires a Permit to construct, after, improve, dernofsh, or repair any structure, prior to its issuance also requires the applicant for such permit to Be a signed statement that he is licensed pursuant to the provisions of the Canbaclor's License law, Chapter 9 (commencing with Section 7000) o/ Division 3 of the Business and Rofessbmrs Code, or that. he is exemp.t therefrom, and the basis for the alleged exemption. Any vkmlation of Section 70315 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five Hundred dollars ($500). ❑ 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, Buisness and Professions Code: The Conbacfor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold wdhin one year of completion, the owner -builder will have the burden Of proving that he did not build o rrprove for the purpose of safe.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Processions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractors) 8censed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. far this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self•. insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not =any person in any manner so as to become subject to the Workers' Compensation Laws of California Date Owner NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions o this Permit shall be deemed revoked. NG AGENCY CONSTRUCTION LENDI I hereby affirm that there is a construction lending agency fo Code.) r the performance of the work for which this permit is issued. (Sec. 3097, CIO Lender's Name Lender's Address This is a building permit when properly filled out, signed and va ays. lidated, and is subject to expiration if work thereunder is suspended for 180 d I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 051$2 BUILDING:.TYPE CONST. OCC: GRP. A.P. Number Cactus Flower Legal Description Project Description Pi ase 1, Plan, 2C% Let 9 Sq. Ft. 1621 No. No. Dw. Size . . Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ IEstimated Valuation $87.514 8 514 s PERMIT I I AMOUNT Plan Chk. Der Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure 1.969.07 TOTAL - 192.4.91 .5i'? REMARKS — ' ✓ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 22/29188 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 3 ZD H PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. @ FORMS SEWER OR SE IC TAN ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® (ROUGH) "11 ETER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SQ. FT. ® GROUT WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. BOND BEAM URINAL SQ FT ® =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FRAMING F O WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES REMARKS: WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB MESH INSULATION/SOUND SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK UND PLUMBING q W UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 3 ZD H PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SE IC TAN ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. ZI ( -l% (ROUGH) "11 ETER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. AL INSP. FRAMING F O FINAL INSP. ROOFING G Q r . J alv, xg?!s+ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 12(11 - % 11 -MESH MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS ' GARDEN WALL FINAL