20-9237 (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 Cevision 8 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date _
709af.7 CUP
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 & Professio�vll
l
Code). �!'
O I am exem • t under Section B&P.C.4,6—r this ,ea o� y
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:.
Carriers' 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 tha.Wf I should become
subject to the workers' compensation provjsions of;rSect,ofi 37 0 of�''the abor
Code, I shall 'rthwith comply with those provisi s.�� ✓'
Date: ��-�- Applicants'.
f �F
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this.applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and�$,tate laws relating to the building
construction, and hereby authorize repre�entativ9 of,.thi&ity to enter upon
the,above-mentioned property'for inspectlowpurposes.
4Y
Signature (Owner/Agent) f��'`�+ Date Xw
y s
BUILDING PERMIT PERMITN
DATE VALUATION $21132 M LOT TRACT
JOB SITE III
ADDRESS 'J8 -4W H'jf y�,{' �,!•,�.'�
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
'.tsWO1xA;Y NO
VIt"LAUD1*R REMC01tMkA31;.yW_
LA QTMOA CA, 91253
VALLEY C109TER CA !M*2
Q 60, . 7 J - 1 2313 MIA
USE OF PERMIT `"^•
COY
DU30 I1ITF-RIOR'I4tt:3N:W.EF HT BRA t3W WAIJ., TO L:.7:t V.Fk. T INTEyRXOR:
OFWX10 '0 ROOM FOR RORlA;#�Ft.Aaki"1i$D�.+R10. �..R.
6,11. WALL, 1XI
COW 0.4.' 9lV.lwl gL+is:7.Jf'),Q
.�r.L�aSoJr�7
yy• �6n�F)3YWUATEJ;."
.&�.LL.LS.W�61�; .Ia,Xu iS BJ.iY.1.1V16�A.`C 7F :
CONSTRUCTION MM 101 -000-4 10-000
E
OCT 1 2002 "
CITY OF iLA f UINTA
Ff: eLNCL g) pT %
s:
mTEt-'Rme.ColrYs'��a'T-TaJf0Xi.*3:.)?:i;..t4 4:w: lr
$34,60
LESS 'PRITY,-PAW MM
1011.MI MIr YXIC, Iq D07 NOW
5454100
RECEIPT
DATE /
BY t^" ('
DAT /�FI LED �( �%
I PE R
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL'APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
exterior Lath
Drywall - Int. Lath
Y
Final '
_ _
Final ]�
BLOCKWALL APPROVAL .
POOLS - SPAS
steel '-
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test J
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power' —
Final
Utility Notice (Perm)
COMMENTS:
s
lt1
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wwwnPn aa4lo P" GPOUK% UNO M M-0 JOSWOO 0.0
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+��! 1M� Pw � r� LIOdp Lryo PTA!M•11ra1 atM=�!N�+►�f �!l��w9�'*a9 �11�P p �1l
mmmdParimsat ulp+ooMAUWo*Wmgjo-vm Papo maQatw""MRV Magotpni mslllowiwupN
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lumdin o.41" uo.. 'ia o !*L u .SMID n a sm o
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oot/oo.T� 4xys P P K' 4H'-Pueanotct`vaJ,
00.0960;$
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1 PapnPi?i sl liraind;nim Pili �^Q4s nom! iogej pus i.am.....m.
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«..«.. ~~.~,^st�ioput.pa� o('�q ag,razaaid•uT-XI�M 7uargU *A %_ �P SIi • •s�adSu�t~
;dOI- PTo4 1JAs4�182I_"Pib iazaa� u1w�I[en+LT8 x #8 x i .
ZO/80/80 A�q .6utm11 WUV n1unH jaa8 aLLT. �t
tpt d tOft mwwaDo Ma! *I Ram
:d i TE��9S08L Rau I nbel .jazunli jaaa C180:10 ' aD "Z t' 2nU
100 ' d WEM IS0 Z0/9Z/80
157 P01 SEP 11 102 16:23
C MMERCIAL COOLING
JIM I PA RANGINICURING, INC.
rw Bev, goweL.
J '
• r
Page TWO
'INSULATION
on c,!er:; and f reezPr :i loamed-� i n -place polyurethanO
is V5 . a.ec standard. Freezer floor panel :t. htsvre
adglVic�nal 10 plywood iuucierlain below top metal han.
DOORS:
Walk -As
doors are ram- i Lft ,sweep gasket?: fox c uolur
and al
arounci overlap for freezer. , Frue4vj. doors. �
have a
ectrical door heater, and.heated vents.
•° FDNC
panel will have a flush -mounted,. 2 dial
thercnl.)
Iter.
ris8�i%�a;sa
S'
4 Elects
cal and ref r i.gerat.ion components, are •UI, b Nst'
. Approv
d. Our. parcels arc NSF Approved. -
Our 1,0
ANGELES RESEARCH REPORT" NUMBER is 25314
We ari
also apptrpvcd as . "TYPE I FASK1c:ATOWt for
refrigeration
panels cooler3/fraezer5.
;- If you - ha
. any qur;:t. ictus, du not hesitate to c --%I t ` me
diiec:tly dl
(714) 484-0000. Thank you.
' •Joh Mil:�ni
Yrp3idei�t
,Cum CI11L
COs.1 NG ,
nyit►cu 'inq, Inc,
^ V
a
V
t
4
157 P02 SEP 11 '02 16:23
C"MERCIAL COOLING
. P
P ENGINEERING, INC -
E -IN COOLER t FREEZER SPECIFICATIONS
Naek—i'A
pa=16 ijrc c;oxmtrucLed of 3-f/2" thick cam—,
Iock modular
prelabricatc-d sections designed foo quxrk
field AssemblV.
PAWL CONST) LUCTION:
Panels
are turmed inne.r and outer miltal paris, with 3 -
named -.L11-111ace j.)oLyu1C6ane* rlisr. ' .1 noti-CM
-0
in. vi ),i
-!ri.muL4!r lligli Density Tnidgue
Jion with pi (;roove
Foam t �..ming
-)r l.ever-
ft maximum strucLuidl :Aren(Ith.
acLuAdd
cafti-loCk tastenert; secures
Cam to
n arp lever.-arl-ing with ecCentric hookc-d iock
wi t. h
1,tt.itig *pin acclire.1y finchored .-in tvaming of
adjace
t Panel:-, to w.surc ease 91 ol ignmen I, and
posit i.,
t. a Access ports fnr nam lock—shall be
coveIrp
-
by snap-itt p Luq-,i Exterior .and inter ic ..r -ire
26-gaia
e :il.ucro vinhosaed qalvanizcd Steel.
'
1.
Foam
used in - the construction of the walk-in
coolf:r
freezer. is Aut.1infrot.li: 9142 by "BASE" alid is
lisl.o'd
with DILvcl,or u t Certified Insulation Mareri 1
Depa t L
unt of Consumer Affairs under #CA-*r0*?1 -nested
y.
at UL
iLh flame spread 20 and smoke 289.
AW L
ic 'metal used is?(o-gouge galvanized sLucle' .
sLut_:(.v
emuossed with minimum thickness of G.W911 MTV
WANUL
CHEM TREAT DRY A'>27 G60 COAT.
The L
Umm-rature. i-; 914 degrees F and the self-
igiii t i
n tempprdl.are i*; more than 966 degreen Fjo
ASTM 1
29
157 P03 SEP 11 '02 16:24
NSF -FRMER
Qm:jittyRtsm
.+ 112, luwt a GROOW laox Iom
LAC DOWN 0 U IW;
NV' FLOOR: .U♦O STUCCO ALUMINUM
e
!=A 4=1
INTERIOR: 26 GA NIUCCO GJ,
CFIUNC: 70 GA. STUCCO GJ.
TX"%U ►XTrR10R: 29 GA. STUCCO G1
UNCIPOSCO. EXTERIOR: 2e GOL 5wWO at.
st
ry
VOIX••W DOOROVERLA(SEI.I �q.OSWC)
(1)30' rSl 11
r,/i0
FINISH 7o MATCH ' PANELS
..CFC
Z
MOOR
R�
-
DOOR tATlril 1
1(2) Pfd DOOW
DOOR C1OSFjT (1) HFA uuOH
a'
'
IFNED 'DOOR JAMS A: MFJIWED DUKE uLLLF HENT
NSf LISTED 2' DW 1HFRMOMNEIERACCE r
i
WALL --
MOUNTED INCANKSCEN1 VAPOR PRW 11CI/T
nXTURE 0) SHIPPED loos[
A
N/A
RLOUIRE
14 QU1RtO DATE:'
OEuIC w UATC:
WOU X -IN INSTAI CATION: _
Rcmc. IIOOK UH: �...�,
*LLCTRICAL WORK:
PLUMBING WORK:
SCULL: AS SHOWN
MUM Off: KRWKE
QATE: j- 9191021
SHEEI:
OF 1
AM=
ALI�o REFRIGERATION
(ESCONDIDO)
J0B 2-•466
N.O. 167315
e
st
ry
157 PO4 SEP, 11 .'02 16:24
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ry
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X X
„L17
1
CI OF LA.QUINTA
s-
Z_j ` . BUILDING & SAFETY DEPT.
APPROVED s
FOR CONSTRUCTION
DATE/D-// U2. BY !lj '
��11
153 P01 SEP 11 '02 10:26
orb.. r -,&I
07*-
sj Ta
— Q D C r4Li�IeoE �DR Er+�1E�t Ic C3rsrs
rte/w
&E3.% Aeso
•
el -0 z CO__.._.
CS _
BUILDING & SAF y FA
EPr
FOR �CoO VEL)
S7 -RUCTION
l
_ _ ...
DATE L.
6ABY
0
09/18/2002 144':48 /"7603246172 ALPHA ELECTRIC PAGE 01
SALAS ELECTRIC
35-659 'TRANQUIL PLACE
CATHEDRAL CITY CA 92234
RE: NEW FREEZER
ATM: RONNIE YONEKURA
760- 321-1174
DATE 9/17/92
THE FOLLOWING IS THE PROPOSED PRICE FOR THE ELECTRICAL INSTALLATION
OF POWER FOR NEW FREEZER.
TO INCLUDE MOLE 20AMP BREAKER FROM PANEL A.
WIRE FORM PANEL A TO ROOF LOCATION. HARD WIRE OF CONDENSER BY OTHER.
INSTALL POWER FOR LIGHT AND SWITCH IN NEW FREEZER.
PRICE $475.00
NOT TO INCLUDE ANY PERMIT FEES OR ANY FEES.
PLEASE CALL IF YOU HAVE ANY QUESTIONS
RESPECTFULY SALAS ELECTRIC
CITY OF LA
QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE-- BY
I
COF LA
CIS y
BUILDING & SAf
"T
®.V E®
-PFIOj
A pc;ot4sTvl6cTloN
FOR
OpAni-IcS
X;r.
coo
rl�
ki