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Home My WebLink About9706-039 (SFD)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 / 4WIU It 12/31/V7 Date �' f tSignature of Contractor— 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). ( ) 1, 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 Sdbtion 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. STATE IF IM 626.L"% (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 ode, I shall forthwith comply witl (those provisions. /Date- Warning: PPlicant (: 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. 1gnature (Owner/Agent) 04 I <. Date BUILDING PERMIT PERMIT# CONTROL# DATE VALUATION LOT - TRACT• _ %113,I{'147- !!! ADDREJOB SS ADDRESS i:1l�I NAFLU V1 APN �..t OWNER CONTRACTOR / DESIGNER / ENGINEER riE EXCHANGE GE CROUP. INC ROGER. SNELLENBERGER & ASSOC. I 1 l,tA(0MNA DR. 41-W5 BOARDWALK. SUM 212 RANCHO lr IkAGE CA 92270 PALM DESERT CA 97211 (764)777-7766 CBLO 1858 USE OF PERMIT SPU SFU L(YI' 7 PLAN 4OR TRACT CONSTAt ('TION 2.2M.00 SF IkAMPAFIO 110.00 '.w 0ARAG1 K*AR1A Xr 471.00 8F CSTIMATtEll COOT OF COMMKUCTM 130.1" FV*MfT F" SUMMARY 00K%%rM1 KTit'.Nd FEW, 101 -00 -41 574&00 PLAN ACIF{X F FF 101-000-4-0-318 $618.74 t CHANIC'AL FEE 101-000421-tlAti $60.00 iU3ir" 1AWAL ,1:EG 014)00-420.4i() 3134.92 PL'.N0940I•'S1. 101-000419t?Q $10,75 '3'1'010) WIT10N RM - RIf+:BID 101 -MO -241 -OW 113.113 URADM'FM 101 -01X1 -•1123 -OW Sm -tea 1M1!"311ttX11'f" Hai 2725 -WO -443-342 52,895.36 ART IN KW4,11C PLAC"Rti -'RFSW 701-000-25-5-M 375.39 P1, AN Cnprx FIFF "l1 -0W439-318 4464.06 RUI )"AL C(3NS'MUC`nON .ANI? PLAN CHECK $A.706.39 a n + LESS PRI~-PAIT3 FEES 4+164.06 J U L 929, V97 TOTAL PICKMIT 111'111~4 DUK NOW U,242.32 RECEIPT DATE 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 p Return Air Steel Combustion Air Roof Deck /Q Exhaust Fans O.K to Wrap y6 i F.A.U. Framing ?%A.0 Compressor Insulation14 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath j Drywall - Int. Lath 7 Final Final BLOCKWALL AP ROVALS 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 71 Encapsulation Gas Piping Gas Test Appliances Final Final 77 Utility Notice (Gas) ELECTRICAL A PROVALS 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: