9706-026 (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
Date L Signature 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
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.
4 11 to I•ii k li-Le ^\•^7[!/f•f
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(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
sibject to the workers' compensation jprovislons'of Section 3700 of the Labor
ode, 1'shall forthwitcomply with those` provisions.
Date: f r ` 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 autfiorize representatives of this City to enter upon
Le above-mentioned property,for inspection purposes. p
gnature (Owner/Agent)-/ �� `rt Date �•
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PERMIT# CONTROL#
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DATE VALUATION l t�Y �i; LOT ( 1 a TRACTJOB
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APN 094041-01;
OWNER
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JUL 2 9 1997 •rcp"Il", PFRA11'r I)tfs;,N(>tv
CITY 0'17
RECEIPT
DATEBY.}
DATE FINALED
INSPECTOR
J%
Af
P.
C
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
A
Return Air
Steel
Combustion Air
Root Deck
O
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
/
Compressor
Insulation
/ 0 9
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
lz
A61 4AS6 Add*
i/
watt
7
Final
Final
—S —
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:
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Final
Utility Notice (Gas)�
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Vokage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
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CHARLES D. GARLAND, ARCHITECT
33-163 CATHEDRAL CYN DR.
CATHEDRAL CITY, CA 92234
PHONE: (760) 324-7146
FAX: (760) 770-7025
6 November 1997
City of La Quinta
Departmentof Building and Safety
78-495 Calle Tampico
La Quinta, CA 92253
Proj. Bella Vista Tract
Fred Waring Dr.
Re. Progress Project Observation
To Whom it May Concern,
On October 30, 1 visited the subject project site for the purpose of performing construction observations.
This visit was to observe the Phase I units framing and foundation. The following is a list of my findings:
- I found the units of Phase One to be in substantial conformance with the structural design
intent of the drawings and the calculations. The work has been performed in a competent
manner consistent with the highest of industry standards.
The job superintendent requested that I certify the that unit at Lot 20 is ready for "Pre -wrap".
Upon completing my observations on this particular unit I found it also to be in substantial
conformance with the structural drawings. I pointed out a missing post base at a post under the
small girder truss at the front of the house and the need for additional studs under one end of
the hip master truss at the garage. He said these would be installed immediately. When these
issues have been addressed I certify the unit at lot 20 as having passed "Pre -wrap".
If you have any further questions about this or any other matter pertaining to this project please do not
hesitate in contacting me.
Sincerely,
Charles D. Garland, Architect
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