0304-216 (RC)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
B T.Rc 11/3(W2C
IDate 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). .
( ) 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 STXyS r.Ut41) 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.
D / � ate: Applicant �!' r✓ "- �A
Warning:'Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000,, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Y
ignature (Owner/Agent) Date
BUILDING PERMIT PERMIT#
030ddJI4r
DATE t � VALUATION� LOT TRACT .
P.1 29736
JOB SITE
APN
ADDRESS � /ry1�
604•-0.50-042
OWNER
CONTRACTOR / DESIGNER / EN (NEER
MARY T. Mlk4AU0 TRUST
�3�,C;tl�1.E'l�t'�"'1'i'�« GROUP, INC.
44-650 LM- PAWAS K-133`►`? A
1409 3,600 W. TJT- ;Ca'
PAl::M1,71dMT CA 92260
k3Ce`[7%ii'11u.il.., UT RAO10
(801)(591.7270 CSA 41,12
USE OF PERMIT
CCJ ID.VJ->:�.R.t:1./ lI R...tvlon- EL
'POS SCS.'F'!. RP.ALA,PA' -• OUTLYDOR, t. ,VNI tO STh'UC'rUR,lf. °T'Y'PLV-I HR
- 0Pk3.1XKLErWD, ACCESSORY TO All OCCUPANCY', SUPPLEWEN'T.M, TO
PMM IT 140.0703.155.
SPT1;.11 XIIER W61.002F
X.s 17ffiA*k ED CUw t' 0F C 0.K9Z'RXT(n, '1 N
-
CONS'CRikC'i'1O2A Ful 101 -WO -419-000
PLAN CH1.1;CK FEE ]d81-t1GQ-4�g-3Y$ �1 ��.07
ELECTRICAL FEE -101-00' '-420.000 $29,12
PLUMB11110y1.<R' 10.1 -000-419.Q00 $23.10
0TRONG MOTION FEE-, - COMM 100-000.241-000 Mo
'
DEVELOPER IMPACT, tFf:
ART IN PUBLIC C'OMf 277.000.445=000 320,00
-✓ p... Q
.®•t
wre�h. �,T-a��7+.. �•1. /,.,�Yp�t;r•,�t.»
=014AND, L.JL3l'aWY1..
tt L 9
��Y 0 7 2003 lE-5441 �;.•PAMF s �'
$0.00
CITY OF LA QUIIHTA a
FINANCE DEPT.
RECEIPT
DATE�I
BY
DAT
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
- (o • 0 3 ?
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
a 'r
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 1-7-16-05. 1 YL
BLOCKWALL APPROVALS
Set Backs
Footings
Bond Beam
Final
Final
Steel
Electric Bond
Main Drain
Approval to Cover
Equipment Location
Underaround Electric
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 I Fncaesulation
POOLS - SPAS
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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)
Tom Tisdale
Fire Chief
Proudly serving the
unincorp6rated
areas of-Rrverside
County and the
Cities of:
Banning
Beaumont
4.
Calimesa
Canyon Lake
Coachella
Desert Hot Springs
Indian Wells
Indio
4.
Lake Elsinore
. -I.-
La Quinta
Moreno Valley
e. -
Palm Desert
4.
Penis
Rancho Mirage
4.
San Jacinto
. 4*
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jim Venable,
District
Roy Wilson,
District 4
Tom Mullen,
District S
s
- RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
210 West San Jacinto Avenue • Perris, California 92570 • 909) 940.6900 • Fax 909) 940-6910
February 18, 2003
Bruce Bushore
Cal Mobile Management Services, Inc.
3778 Escoba Drive
Palm Springs, CA 92264
Re: Decorative Thatching Material
SDP 2000-688 / Las Casuelas Quinta
Fire Department personnel have reviewed your request to use thatching material on the ceiling of the
outside palapas areas. It is understood that the following will occur.
1) The thatching material will be chemically treated by the manufacturer/supplier and will provide
CSFM flame retardant certifications.
2) The exterior roof will be of Class A rated construction as per La Quinta City Municipal Code.
3) The palapas structure will have fire sprinklers installed in accordance with the 1999 Edition of NFPA
13. The thatching material will be properly maintained in accordance with the manufacturer/supplier
to retain the flame retardant qualities of the certification.
Based upon the conditions noted above, the proposed decorative thatching material may be used on the
ceiling. .
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 '" �0'4'
Walter Brandes
Fire Safety Specialist
Cd:—La Quinta City = Building Dept
HAPEMP DaWVa OvYta1PROJECTS BU5ft PCtiSDP2000N" 3(d).doc
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 21d FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072
�La Qc
�0c&t,, 4
v � >
OF T
To: Greg Butler, Building & Safety Manager
From:Oscar Orci, Planning
To CDD: 4/30/2003
Due date: 5/02/2003
Status: 1 ST review
Building Plans Approval
(this is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for
the following project:
Description: LAS CASUELAS PALAPA.
Address or general location: 78-400 HIGHWAY 111
APN .and/or legal description: '
The Community Development Department finds that:
O ...these Building Plans do not require Community Development
Department approval. .
...these Building Plans are approved by the Community Development
Department.
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