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0005-074 (SFD)LICENSED CONTRACTOR DECLARATION _ I` I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter'Acommencing with Section 7000) of Division 3 of the Business and A'ofessionals,Code, and my License is in full force and effect. Lice i9e # Lic. Class Exp. Date 71415 ,_x , , /` 10f31d2e Dates—/Signature of Contractor �r�'tt���7 OWN ER-BUILDERsDECLARATION 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: Cartier©Ofl,'[� N RAMP. INS, Policy No. NWC ,544058-02 (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 sbbject to the workers' compensation provisions of Section 3700 of the Labor ode, I shall forthwith comply with those. provisions. Date: r.�:`�r.'a!:°f 1Applicant �? .;�i . `?dr�.•` '�✓`�. 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 tie above-mentioned property for inspection purposes. , Signature (Owner/Agent)✓ (1'�' �,� Date �'1�/Gi BUILDING PERMIT PERMIT# DATE VALUATION LOT ()74 TRACT x216 s JOB SITE APN ADDRESS 79-520 C1 rM0 769-4913-042; OWNER CONTRACTOR /DESIGNER / EN (NEER CENTURY CROVM L COMNfUMMIES CENTURY CROWIL.L COMIvi[J1 UMS 1535 SO. UDI U'.E MI STE 0200 1535 so, "1")" MR.FE ', VrE x#200 SAN BIIMARD A O CA 92408 SAN BRRNA1•'i.DWO CA 97A08 (909)381.6007 CMIN 2120 USE OF PERMIT X14 GU 1?AM MY i7Wli i,I.MG VD -LOT i PL, 3BR PF.dWIT DOES NOT h4CLUI&I BLOCK WAI,LS OR POOL, 75% PLAN CHECK FLEE REDUCTION FOR MUL'i'ME ISSUANCE OF SAME PLAN Type CUSTOM CONSTRUCTION 25g"1.00 S PORCWPATIO 212.00 SF' OARAC1.EICARPORT (OF) 111938.00 F.SJW. i4,'rKD C09T O:F COX=Y7 -MON �lL�i,9�r9d3 1?ETOW M S131U:R"Ry L CONSTRUCTION FRE 101.000.418.000 %1,049.00 PLAN CHECK FEE. 101-000-439-318 $212.26 MKCSHANIC.A11 ME 101.000.42.1-000 $91.00 ELW,TR10AI.IEE: 101-000-420-000 $136.50PLUMBING FEE 101.000-417=000 510130 i ., STRONG MOTION 1'{:•E RESID 101-000-24.1-000 $21.70 ORADINO FIX,, 101.000.423.000 $20,00 DEVELOPER IMPACT FU $1,907.00 ART IN PUBLIC PLACn - RESIE %01 ^0004255.000 $42.46 SUB TOTAL CONMC1'C:'I`iON ANIS PLAN C13EM $3,1541&42 LESS PRE—PATZ)1W $0.00 TOTAL Ii tN��"�"�S DLA $3MM-42. C' RECEIPT DATE BY/ (I / DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS tet Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck r Exhaust Fans O.K. to Wrap �� F.A.U. Framing. _ Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath �9 Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines — —e7e Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: .�s�n,�✓o'h_��6 VANDORPS C 6U ASSOCIATES, INC. CONSULTING ENGINEERS QA 296 N. Rampa&$tmet, Suite A Orange, CA OMB Tel: (714) 978.090 Fax (714) 978.9926 Atte. Jack Fisher Century Crowell Communities 1535 South D Street, Ste, 200 . San Bernardino, CA. 92408 Subject: Mandarin (La Quinta, C&) Tract 28179 Since 1979: Facility Planners Cotte Consultants Structural Engineers Fire Protection Engineers August 11, 2000 Dear Jack, The beam shown in Figure 1 attached email be connected to the supporting beam with a HHU610 hanger. 1f ou have any questions, please contAd.Sharad Patel of our office. Very truly yours, VANDORPE CHOU ASSOCIATES: 4ROChou, S.E. SP Art: Figure 1 F:VobFiles\20001CCC 1682\Fidd04 (Plan 2 Hiager).Wk.-. o 9?0FESS10,A,, y SHEUNS�c oWc a No. S-003618 � EXF- 03-31-04 "A�CT USA f of CAO 1 i I Jun 15 00 04:53p Sladden Engineering'. 6782 Stanton Ave., Suite £, Buena Park. CA 90621 (562) 864-4121 (714) 523.0952 Fax (714) 523-1369 39-725 Garand Ln., Suite 0. Paim Deaert, CA 92211. (760) 772.3893 Fax (760) 772-3895 Junc 15, 2000 Century Croweil Communities 1535 South "D" Street, Suitc 200 San Bernardino, California 92445 Attention: Mr. Jack fisher Project: Tract 28719 Mandarina at the Citrus Course La Quinta, California Project No. 544-0049 00-06-259 Ref: Geotechnical Update prepared by Sladden Engineering dated May 20, 1998, Project No. 544-9038. This memo has been prepared in order to provide formal confirmation of our recent telephone conversation regarding floor sisb design for- the above referenced project. Specifically, recommendations for floor slab sectiur.s and mcislure/vapor barrier ins:allutien were. discussed. As we indicated, a ��isqucen tnembrsue,'vapor barrier is recommended for areas where moisture sensitive iioorirg is exrecied. Typically, the membrane is to be protected with 2 inches: of sand above and below to prevent damage during placement and to allow for proper concrete curing. Because the surface soils or. this pr jeci,are generally free of gravel that may result ;n membrane damage, it is our opinion that the 2 inch sand layer underlying the rnembrxie may he emitted. The membrane niay be placed directly upon the native soils and covered with 2 inches of sand. If vbu have questions. regard ir.g thi> letter, Meese contact the undersigned Respectfully submitter, SLADDEN ENGINTEFRING 0 Biett L.i Principal Letter/pc Copies: 4/Century Crowell Communities p.1