0311-126 (SFD)LICENSED CONTRACTOR DECLARATION
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
F- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
WProfessionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
I-Qu7
W 13 ITIC1 /05
oZ r� 'Batu' �-�' I - i " Signature of Contractor-
CD
ontractor CD 0'
S 1 f
CD OWNER -BUILDER DECLARATION
WW I hereby affirm under penalty of perjury that I am exempt from the Contractor's
N License Law for the following reason:
Z_ ( ) 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).
L')() I am exempt under Section
LO B&P.C. for this reason
N Date Signature of Owner
O0)
a Q WORKER'S COMPENSATION DECLARATION'
C) Cr I hereby affirm under penalty of perjury one of the following declarations:
O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W L= compensation, as provided for by Section 3700 of the Labor Code, for the
O � Q performance of the work for which this permit is issued.
m Q I have and will maintain workers' compensation insurance, as required by
O Q Section 3700 of the Labor Code, for the performance of the work for which this
L)
Il CAH permit is issued. My workers' compensation insurance carrier & policy no. are:
't Z Carrier Policy No.
Ob 5 SM 17, FUND 0001-1164NI342
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, 1 sh 9 joi ith comply with those prove ions,
Date: u / Applicant— 7 , 0 „
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 inss%ection purposes.
!—Signature (Owner/Agent) �/ w Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0311,^126 TRACT
r $171,W4.70 168 2906
JOB SITE
ADDRESS
APN
48 -Li kTIG U. '' 1).1�§
OR E
140-002
OWNER
CONTRACTOR/ DESIGNER/ EN INEER
IrAMOR LA QDWYA COW, LLC
MAUS W= HOUMNG D4
99a nuan m...�?�:�°, M, 3 02
9968 Hi13 J? <T X37 S'r1,;. 02
SA).gDI GO Ci. 921.31
S.AVMWO CA 92131
(858)653.3003 031Ji 4972
USE OF PERMIT
MMY113, D"WEII-MO
SFD . 1.X39' 168 PLA.Ai 288- PERMIT DOES NOT INCLI DIP, >3UXX WAJL1 %
P004 SF'A OR DRIVEWAY APPROACH
TRACT CO'NSTRUCT1011 2;"3.00 SE
€ ORCKMA T IO 546.00 Si
r Al AOFICARPORT 635.00 OF
.P.aVJDAtl MA) C�4J9 014✓4•Ns7"MUC'.L 01
I Wyy 041. 0
MRAGT .Pri :di. 9UMIURY
MNsTRUC• ION � �E 101.000.418.000 S>;9I.SD
PLAN CHECK FFX 101.000-439-318 04S.„�
MEC'IWI1CAI. FEE 101-000.421-000 $79.00
Ir..Li;�:.:1 P Ct 1.. FZZ 101-000-420-000 $159.61
PLITNIBINO FEE 101-000.4'19.000 $114.50
STRONO MOTION PEE- RMID 101-000-241-000 $17.10
0RAD1140 FETA 141-000-423-400 115.00
LE:,ELO.p;E. R.I.MP.ACT 3tZE s%4nno
FEZ DEPOSIT 101.000.439.318 -11'850.00
Tr-
FEB 061004 .17�Sk;.M�'1t � 'S DMP, N�.9�'
[A
,7�2.�i9
CITY OF LA STA
RECEIPT
DATE ,� v r/
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
3 —
Ducts %
Slab Grade
- g
Return Air (9�
Steel
3 —
Combustion Air
Roof Deck
41
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
— ti
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
6 A
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
Waste Lines
— — .o�
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
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) . t
COMMENTS: /z/az/ay /��j�Cc�'PJ✓� ,�s.
Jun.23• .2004 2:19PM
3914 Murphy Canyon Rd.
Suite A-130
San Diego, CA B2123
Phone (858) 576-3260
Fax (8581576-3264
McComic Consolidated /
9968 Hibert Street Suite
San Diego, CA 92131
Attn: Matt
Subj.: Inspection
Transwest Housing
102
STRUCTURAL FRAMING INSPECTION SUMMARY
Bidden Canyon - Ridge View
Inspection Date: June 17, 2004
Model Number 2BR, Lot 168 48-485 Big Horn Drive
Construction Phase: Models
Summary of Findings: City of La Quinta Structural Observation
No -3818 P. 5
June 23, 2004
The framing inspection consisted of a visual review of the structural bearing wall, framing
and lateral system including verification of shearwalls, hardware, and building anchorage.
The as -built product was compared to the approved plans. The framed portions of the
structure were found to be in substantial compliance with the approved plans, and the
previously discovered incomplete work was satisfactorily completed.
The visual inspection is limited to the lateral bracing elements normally installed at the
framing stage, including drag straps, plywood bracing panels and holdown anchors. Since
a portion of the project may rely on stucco plaster and drywall bracing panels, no opinion is
expressed or implied about the compliance of the stucco/drywall nailing.
This letter is provided at your request and is for informational purposes 'only. It is
intended to confirm the framing subcontractor's understanding of the structural plans and
installation of the framing elements shown on the approved drawings. It does not provide a
guarantee or warrantee against deficiencies or performance of the building product or
provide evidence of building agency approvals or special inspections.
QOFESSlO��
Respectfully submitted, SPA• S
CO W,gy�Fy�
y
C 44594 2
�
Mark . Swanson, PE it Exp. 3/31/06
s� CML
q� OF CA��FeQ