0106-071 (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
74-25659 11 { i 71;5OW
Date ' Signature of Contractor=s
+
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).
( ) 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:
Carrier Policy No.
(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
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 ' z
BUILDING PERMIT PERMIT#
DATE ! VALUATION LOT 0106-1071. TRACT
-M, 1??6
JOB ADDRESS r�rr } 9: APN
OWNER CONTRACTOR/DESIGNER/ENGINEER
z�s�[.'7MOl+i DFIVIIIIPI-IT'rMl RIT 1.45�7 T. ;A i° C`;01MI.61'C" rlow, WC
91381.115tOVINTT .d3'k.k':MUE 30 01 &'!'a.HOx ru-4$109
ONTAP30 CA, 91762 PALM SAMM CA 92262
(?60)322.1553 C'1:3 35167
USE OF PERMIT
PI,1:.eMMMG
PAIAl IA�L ifs -11). +1?..+.4'YatllJd�D L?.4i.��JY31)el.'A'N i'viC Y ISI�..w',!Y
BLD 5 i' ER APPROVED PLANS
VAk.;1:f,ATION
131M.00 W
111.4141BI O HE 101-000-419-000 S111SIOD
e
JUN 2 7 2001
CITY OF LA QUINTA
n ,ANrF OFPT
MD PLA14 Ck3WIt
PKEM.Tro 10S DUE VOW
BY I DATE FINALED
INSPECTOR
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
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
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 Pipinq
Gas Tess~
Appliances
Final
COMMENTS:
( '
s' -
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Law Nottage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Derectors
Temp. Use of Power
a
Final
Utility Notice (Perm)
,
ADDENDUM N0.2
r
f
4
i
Project: Point Happy Buildings 4 & 5
t
Date: June 1,, 2001
To: -Lion Heart Construction
Attn: Stanley Asaro }
The following'items are hereby revised and/ or clarified as hereinafter described. The
Contractor shall delegate the items to the appropriate Sub -Contractors who shall examine
each item to determine the effect of the change on their own work.
The General Contractor,.shall be responsible for coordination of all changes with sub -
trades prior to fabrication, ordering, or installation of materials.
Enclosed is a revised underground .plumbing plan for .the Building 5 Shell. If you have
any questions, please do not hesitate to call.
Sincerely,
t
l
cc: Ed Alderson
11
a
T
Tom Tisdale
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
4.
Beaumont ,
.;.
Cahmesa
.;.
Canyon Lake
.y
Coachella
4. ,
Desert Hot Springs
Indian Wells
Indio
Lake Elsinore
La Quinta
Moreno Valley
Palm Desert
Perris
Rancho Mirage
.;.
San Jacinto
.;.
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jan Venable,
District 3
Roy Wilson,
District 4
Tom Mullen,
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
0 est San acinto Avenue Perris, California 0 909) Fax 909 940-6910
CITY OF !, A 01 eINTA
August 24, 2001 '
AUG 2 4 RECD
To: � John Vuksic, AIA
Re: Falls Restaurant
This letter serves to document our meeting and conversation regarding the exterior roll -down doors at
the exterior bar area of the Falls Restaurant. As discussed, the proposed doors could be used at
anytime without conflict with egress access requirements from the "enclosed" area if the occupant load
is less than 50. As roughly calculated, the bar area would have approximately 40 occupants with the
doors closed. The final occupant load calculation should be confirmed with the Building Department
and, if approved, be posted for both conditions.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering staff at (760) 863-8886.
Sincerely,
FRANK KAWASAKI
Chief Fire Department Planner
By
Wafter Brandes
Fire Safety Specialist
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072