Loading...
0303-025 (ELEC)H NW _ N O M r ur) IIW� CZ ti C O' I" W W I- a Z 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 ©ate Signature of Contractor M 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. VKI 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 STATE at' D Policy No. - "?=• M J (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 ori his application. 1. Each person upon whose behalf this application is made & each persomat whose request and for whose benefit work is performed under or pursuanNfo 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. `J,Signature (Owner/Agent) `a%%^+ 8^ Date nor- c rM'i BUILDING PERMIT PERMIT0.1 025 - y. DATE J � VALUATION s mm) LOT TRACT JOB SITE ADDRESS - a HIGHWAY 11.1 APN . OWNER CONTRACTOR/DESIGNER/EN INEER MEfi;C`ts"Td: JA,AM) WA 99LUO RfiiNCHO CCI"C. S(. W CA 917-140 (909)M-7232 Mvf r•; , USE OF PERMIT INS'f.A.F L Y 114TEM� ,J4LY ILLi71UiiN,AanIO C*L4+NI M1. L -MI x EK SION s, pwa POOL SUPPIAES) VAOLUAVON ,a,1M1(?.00 i; 03, CX)NORUCH-ONT SM- T C 6' IAL CQ, r H'i`.t OC -41i i1V' tkWLYPT-A l CM(:�: IMS PRF-PAIX) MUM a EMA5 2003 ' U CITY OF LA QUINTA LI RECEIPT FINANCE DOM "t,'4'TAL PH.M.Tr �i `''I S ` ATE NOW BY IDATEYINIAEZ I 4M00 $33.00. $0.00 .P43 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 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 Was; a Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure ShoNer 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: CTY OF IA 01ANTA t r• 1-1 Plannina Com • Remote wired Letters APPR EQ FOR �'R Re►rlote wired Illuminated channel letters with white tares. A num J returns painted black. All seams on letter returns i„ to o �/ °3 - -- letters. Interior of letters sprayed white. Two weephDJes Faces decorated with 3M vinyl (colors listed below). Mall criteria only allows Black, Red & White for colors VINYL FACE DECORATION ACTUAL LETTER RETURN Letter Cross Section Detail Color Key ❑ #7328 White Acrylic Black-Returns/Trim Cap #3630-53 Cardinal Red Vinyl #3630-22 Black Vinyl Border CmiN�p�rfe44et� <<_ --_ LETTER DECORATION Tro N.4L0&)a 09S 3/8" BLACK VINYL BORDER A transformer housing B transformer C conduit 1/211 min. D listed disconnect switch E primary electrical source F 5"(040) aluminum return G 1" black Jewelite trim cap H 3/16" Thick #7328 white plex I Boots & Sleeves J 15MM neon: #6500 white K glass tube support L weep holes 2 per letter All electrical to be UL Listed and Labeled 2/+n /, 7' Face I A B C D Sq. foot LESLIESNE IN -U 2'-0" 1 9'-81/8" T-4716- 10'-83/4' 36.16 3/8" Allowed so.00 Corporate Headquarters: Designer: JAB Location: La Quints CA. 837 R1v.dront Oc, Su Be 300, t Approval: Sheboygen, WI 53081 Revisions: x PHONE: (220) 208-0828 FAX: (920) 208-0988 �e+�e Changed to Black/ ed (DW 2/25103) ,address: 78595 Highway 11 I.D. # 00riority Sign Region.] Offices: Artwork # Drawing # x[.73 Cry.thi Lake, IL Birmingham, AL " Date: 2-25-03 See Above C1 7232P1 INC Atlanta, OA Knoxville, TN X ' Winston Salem, NC f, Remote Wired Letters Remote wired illuminated channel letters with white faces. Aluminum returns painted black. All seams on letter returns to be placed on top of letters. Interior of letters sprayed white. Two weep holes per letter required. Mall criteria only allows Black, Red & White for colors Color Key #7328 White Acrylic Black-Returns/Trim Cap Letter Cross Scction Detail A transformer housing B transformer C conduit (1/2" min.) D listed disconnect switch E primary electrical source F 5"(040) aluminum return G 1 " black Jewelite trim cap H 3/16" Thick #7328 white plex I Boots & Sleeves J 15MM neon: #6500 white K L glass tube support weep holes 2 per letter All electrical to be UL Listed and Labeled Bank Elevation 24' D A B Sq. foot 1'-513/16" 15'-11/2" 22.69 Allowable 50.00 Corporate Headquarter.: Designer: JAB Location: La Quinta, CA. 837 Rlverfront Dc, Solt. 300, UP,rajority Sheboygan, W1 53081 Revisions: x PHONE: (920) 208-0898 FAX: (820) 208-0989 Address: 78595 HighWay 11 Changed to Black/Red (DW2!25/03) Si}gn Region.[ IL l Dema Changed to Pool Supplies only DW 27 Crystal Leke, IL Birmingham, AL 9 Pp Y ( � /U3) Date 2-25-0 INC Atlanta, OA Knoxville, TN x Winston Selem, NC iApproval: I.D. # Artwork # Drawing # see Above ( C17232P2 R Cl