0303-225 (PLBG)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
517161 C36 Ric 9/30/03
Date-3� ��{rl' Signature of Contractor �� ��� J' '•�"%,%
OWNER -BUILDER DECLARATION
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 notintended 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
P rformance 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:
Carver wi'A>'z 3i !"b�'fJU Policy No. D46.02000'ftPS
(This section need not be completed if the permit valuation is for $100.00 or less).
O I certify that in the performance of the work for which this permit is issued,
1 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
Code, I shall fort t3wT/ ith comply with tf_ose provisions.
Date- �> A licant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $1.00,000, 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) =. f _ �' cif Date ,,L0 % •
BUILDING PERMIT
DATE?j�Z��'4 VALUATION $1510 %U.(0 LOT
wt)3-1,25
TRACT
JOB SITE
ADDRESS, �4111�14aY�3 APN
OWNER CONTRACTOR / DESIGNER / EN (NEER
MR_ �'(`i�I�TiZt 'J lwr.liivlel►1.. wmto, LirTv.
W; 13.3 Cl•:f:UMI, AM[..LS T' 0.F',0X 656
LA, Qiulw i D, CA 922:3 C" -A" FlL?L1 ZAL CTi V l',A 9'i235
(760)2428-2,045 M1,4 4740
)F PERMIT
}"'I i MFS190
V ALZJATI JP1
15'000.00 !:a
ri
D
. 11
MAR 2 1 2003
CITY V
FIPIA
L J� (UINTA
rr DEPT.
,11:STZ' AT1IDt COST 01:1 / ON111_:rVU(ww 1T0N S3,�tl�f,f3U
1'LlU,4,IW01 E 103 000 ! l 971)00 woo
:31.11 -WTAL C. 0N0TRUC'I!0W' A1TD PUW CHECK 118,00
U,323 Pk E -PAID .TSUS $0.010
VITAL L PERMI :R•';Ft. S T)i7E VOW I $18bo
RECEIPT I DATE; r p, I BY , I DATE FINALED I INSPECTOR 1
;; r' I
INSPECTION RECORD
.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
FA.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
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
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:
' X1913 /� e4a",041 �� r
77
r r"/'�i:�
V1
BUILDING DEPARTMENT
CITY OF LA QUINTA
OFFICE: (760) 777 7012 INSPECTION REQUESTS: (760) 777M53
TO: DATE:
ADDRESS:
CORRECtION NOTICE
INSPECTIQN:
ERMITNO.:
D C� 6 -I-#o L, 6 ' la,411(,-77-,11%v XV " - - :
x
Inspector
Z2
x
Inspector
FROM : LIFETIME PLUMBING
FAX NO. : 760 328 3115 Apr. 18 2003 08:47AM P1
Lifetime Plumbing
A D. Box 656
Cathedral City, CA 92235
(760) 328-3045
To: City of La Quints
Bldg. Dept.
Atte: Danny
Fix: (760) 328-3115
Fax Transmittal
,From. Ed Bradley
Date: 4-18-03
No., OfPages (Including Cover Sheet): S
FAX NUVEER: 777-7011
REMARKS:
Dow,
Dere are the PGA West Reconstruction Legends Phase 2A.
Thank You
Ed
FROMi: LIFETIME PLUMBING FAX NO. 760 328:3115 Apr. 18 2003 08:48AM P2
04/17/2803 08:39
Dura+ SayawAric,
Sbypt"rdl Enolnoom
00$ S. Cleveland 8t.
oeoaaslde, CA 22064
Tsl: (790) 0664366
Fax: (?W)269-8360
Dir'ti SnVCIE
PAGE S1'
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Id uryi a EF For Rr4bw In Fleece COmmNA CI ploaae R@* 0 Please Rocyde.
s Comments` gft'lSW plan 30M wall per entail and photos reed Apr 15. 2003 (from JH)
shear wall 12 at
It appears from the photos that herimntal cuts were mads, at exterior PlYab �
the kitdm rear and type 11 at living morn aide -
1? The stuoca out made by the .plumber will need to be enlarged in heapht in order to
fl:lcifltate repair of the plywood and also to praAde proper bldg paper laps in older to
malrdain ft .VlWg* of the wails wG91her procifing (ask DMP or GOLBA for detail on
l n�rl.
2) The plywood may be •elwired by cutting out ad dilional plywood top and bottom so that
new 3X4. bkxft W be InstRIM above and b3iow the plumbing conduits irn order to
provide backing to lacil1we the ek a palling of horizontal Onis at the new Plli cod to
be spliced in. Please see the att OrM sketch.
3) It.sppears frorn phots 37 that the conduits are % inch diameter copper lines with black
Styrofoam hviuwdan wrapped around them (a,t opposed to 2'A diameter black pipe).
plem conf nn out Ow holes in the etude cr+e a r=nrstaly 1 inch diameter for
the % inch pipe and NOT UP to :2 %, inch diameter for a larger black. conduit.
which w*Wd t+osult in A aomptorltiae of the 2x4 studs which are only 3 % Inches
in depm. This seenarlo would require etre coning of the studs.
Feel free to cail'if you have any further questions. Thanks, Rhea R
:2.K5