0108-207 (CSCS)~ LICENSED CONTRACTOR DECLARATION
I, hereby affirm under penalty of perjury that I am licensed under provisions of
' Vpter 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
742569 R
Date Signature of Contractor
"k,� �� "`.��oOWNER;B'UkVCV CLARATION
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).
p I, as owner of the property, am exclusively contracting with licensed
o tractors to construct the project (Sec. 7044, Business & Professionals
{ Code).
F O I am exe pt and r Section , B&P.C.,for this reason r
Date Signature of Owner mow,, " �P
�'�•, .�,,. —MORKER'S COMPENSATION De6LARATION
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
Seeon 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 Policy No.
?`�AT.'i. F fix 142499
(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 forethwith comply with (those provisions. j .St
—Warniog:,"Failurg to secure Workers' Compensation coverage is unlawful and
shall subject an employer Cocimirial 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) / '0 "dpi' �� ���° ✓� Date
BUILDING PERMIT PERMIT#
DATE / VALUATION LOT 091;207 TRACT
,
JOB SITE
APN
ADDRESS "
OWNER
CONTRACTOR/DESIGNER/ENGINEER
FA TI, li+'kMal
UOINT kEART ^C't:5:1�' IRUC1'T(31•T, W(l
3007 R 1AIQ MI, 0109 �' o
a F3',i�.iA3 I Wr.". JA L^.R's, 92210
PALM ST'F.Z.INC.70 • CA. 0226 r
(7,6.0)322-1553 M1.4 3SJ62
USE OF PERMIT
CohWERCIAL
TISK J:lAW t IM'i RO"M1..9W P191:.APPt`CY IKO PLAINS
UA-EJiIA'DT)!9YN .Ny8moo AA's
(1100' (Aw C0149=0(>i:'.�9.C. N
yi,��hf AX)
L yy� ��,(� y'+y� r)',{�y� ry'g A p ��@F�y'3':1:'"ib�3.ATT&ai
PA1A4§.L4J' .6r k rg 6'441.I:f.P-1'd it+�C� 8
PLAN CH11: K Tar-'.', 101-000-433-318-s3slio
I(XYRISTYd:f1w.9`aION'►y'iIc 701_0(k.418_000 454.00
MAXITRUIM6 HIM, 101-000-420-000 WOO
b TI;O"i�fCs frlfC°IrtIDW InZY, - COMM I00-£I00—PAI C60
.Y
s
,i1C°! CC3�u' f31?1.ir`F?i��r )
$934.�?
LT -23 PRE-PAMEAUS
$0.00.
2001 MIT V Y KE I DT V, 0W
AUG 21
CITY OF LA QUINTA
tti .
FINANCE DEPT.
RECEIPT
DATE %
/ `.
by:
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—OL�
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
Finale ( �"
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:
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)
NOV-28-01 WED 4:37 PM RIV, CO, FIRE P&E INDIO FAX N0, 1 760 863 7072 P: 2 ".
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
210. West San Jactnto Avenue- Perris, a I omla V557U • • Fax 10
Tom Tisdale
Fire Chief
Proudly serving the
unincorporated
areas of Riveiside
County and the
Cities of,
Banning
.•
Beaumont
C•
Calimesa
.;l
Canyon Lake
Coachella
N
Desert Hot Springs
Indian Wells
Indio
Lake Elsinore
.y
La Quinta
r�
Moreno Valley
rr
Palm Dcsen
Perris
Rancho Mirage
San Jacinto
o�
Temecula
Board of supervisors
Bob 13u5tor.
putrid I
Jobe Tavaoiane,
Mir! d 2
lin Venable,
Dialrid 3
Roy W ilwn,
District 4
Tom Mullen,
Distria S
c
November 28, 2001
City of La Quinta
Building Department
Re: Fire and Life Safety Clearance
The Riverside County Fire Department is granting a fire and life safety clearance for the
occupancy of Fast Frame.
Respectfully,
FRANK. KAWASAKI
Chief Fire Department Planner
By Terry DeSoucy
Fire Sa Inspector
EMERGENCY SERVICES DIVISION • PLANNINO SECTION • INDIO OFFICE .
M
. il.
City Quinta
of La
V �
Building -and Safety Department
tis
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following;
BUILDING ADDRESS: 78-446 HWY 1 1 1
Use Classification: COMMERCIAL Bldg. Permit No.: 0108-207
Occupancy Group: B Type of Construction: VN Land Use Zone: CC
Owner of Building: FAST FRAME
t
Building Official
Address: 46-391 MANITOU DR
City: INDIAN WELLS CA 92210
By: KIRK KIRKLAND
Date: 11-29-01
^ POST IN A CONSPICUOUS PLACE