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0201-178 (PLBG)LICENSED CONTRACTOR DECLARATION - I hereby affirm 11 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 5 997 68 C20 C t+ ' 071741 t9- t Date Signature of Contractor %'""'� 't 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 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,, aria agree that if I should become subject to the workers' compensation pr6islons of^Section 3700 of the. Labor Code, Lshal , forthwith comply witti thosetpPovisions.: r Date: 7 - -r"' � Applicant P Fi�� -f '7_71— - r v t 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,!' Date Signature (Owner/Agent) BUILDINGPERMIT PERMIT# TRACT DATE �. ,_� '' VALUATION LOT TRACT JOB SITE APN ° ADDRESS Ype M`fes S4-JG-0 OWNER CONTRACTOR/DESIGNER/EN (NEER .t7�`7'!'3'T02�I 7J ��L� ,Ay3A�ir l�:U!!�F7`e3i ATl7' 54-3 60 AV 1DA RMM 7 t-899 w aura Rom, gams i ott SQA(jIJWJ:A. CA Q2253 PALIADnWf C'„i3.. 92211 (7fiC11��Jfln�2{3 C',�iVI 4822 USE OF PERMIT PI'LUMk D40 65 LAY. OAS LINE FROM MISTING VRDPANFt TsRNK TO OAS KILN P VALUATION 500. Do :ice WMANJIM C'MrOF CtDR MUCi 014 PERMUTEE 07" ARY Pl Bng0t > M 103-000-41.9-000 $19.50 •4� AMD F?1. KN CM'90,K $1 q.io PER,4�rY 10 ES DX731 Now &19 'so a FEB 04 1002 I�1��1 CITYOFL�AlUIPi RECEIPT DATEf AAr' 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 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 Pibg. 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 _ Z Appliances Final Final -QZ 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: e, S TA s s 7a wirl, F L�x Lo A;d T t. ic- Kob awwo V , p- -1,' 7 r ST A� 00; 4 CCI1--Al S� A/ t- r -5 M 31" -'T A.%) 0"If g IL x -W _�A Zx 4 N 0- WTc. rk2. A 2A to Y. ti N®R v. r. OA4c Q ZZ.. -M a. is. .17 4, .30 - FEE -`OF.,. A RE -:INSPECTION &T WILL.BEL CHARGED 1� HE APPROVED q4 "ANS ANDJOBTARD ARE,MT� 154 PL -o-A-7an"n -Ag Tliti' SITE--�JOR'4r,' �,.SCHED`ULED'�.," INSPECtioN je NO EXQEPTIONSI it Kil 3 Ml '�. 1 -IF IV NTA".- 'PTY,0F, INQUI Ty BUILDING &8AFE A DE "M P R 0 V E D fill Y12 CON U FOR N., Bir DAi & Rk '�A 3- -ffss W5 Fri f -7 1 * , a 'y L T N. • P �10 �jr Ya T ma.:tip y 4 k V q; X , e, S TA s s 7a wirl, F L�x Lo A;d T t. ic- Kob awwo V , p- -1,' 7 r ST A� 00; 4 CCI1--Al S� A/ t- r -5 M 31" -'T A.%) 0"If g IL x -W _�A Zx 4 N 0- WTc. rk2. A 2A to Y. ti N®R v. r. OA4c Q ZZ.. -M a. is. .17 4, .30 - FEE -`OF.,. A RE -:INSPECTION &T WILL.BEL CHARGED 1� HE APPROVED q4 "ANS ANDJOBTARD ARE,MT� 154 PL -o-A-7an"n -Ag Tliti' SITE--�JOR'4r,' �,.SCHED`ULED'�.," INSPECtioN je NO EXQEPTIONSI it Kil 3 Ml '�. 1 -IF IV NTA".- 'PTY,0F, INQUI Ty BUILDING &8AFE A DE "M P R 0 V E D fill Y12 CON U FOR N., Bir DAi & Rk '�A 3- -ffss W5 Fri f -7 1 * , a 'y L T N. • P �10 �jr Ya T ma.:tip y Yl- R .Fuel-Burning kilns i The potter's choice of fuel is usually limned to,-gas or oil. is'used'for little-other th- l eav\� industrial,ceramic product and wood is:beeonirrg hard to fi:id. The decision - b.etyveen .gas Arid oil .wrl;l' depend upon availability of'natural Ygas. Mal iufactured gas does `not b'urn wi as hot a flame as the natural.,product. sp,: if�,the•latter is not av able; oilwouldbethe -better choice-for• the hotter. Oil is ehea '• than. gas ,but-.a bit m6re.troti4lesonie to fire. =' Gas.gird.oil-burning�kilns iequire..speciall:y designed burners usually equipped: with blowers. Thee also.'require chimneysG Despite the growing scarcity of:.wood, some potters.are.still.- able `to use it as a fuel: Thrs creiite's a lot of smoke so kilns have " to be n'relatively isolated areas .«hen-stoneware is fired with y:y wood,, sone of the ash almost in ariabtv lairds. on the glazes;:% this produces ara accidental mottled effect �c Bich is pleasing Note: In soine�parts,of the world, primitive potters still fire . their work in open .pits,. using• wood for.fuel. (I have seen a potter iii Mexico use old. ruli:lier tires, much to the distress of his a re�ighbors.) For studio potters, some experiments vi-ith open;pit firing may 3 Up draft cylindrical gas kiln, r ring avail l.)Ie: California Kiln Company. 202