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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. ,
Lipense # Lic. Class Exp. Date
DateTe Signature of Contractor
f 11 - r..'
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. •
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.
STATE FUND 229.01-601M9
(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,
r 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: s , e -1 ADDlicant
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 propertj for inspection,purposes.
I Signature
Date
BUILDING RFRMJT PERMIT#
DATE�N�- \ VALUATION LOT TRACT
JOB SITE
APN
ADDRESS
H.MK.D'AT.V C.'0UW)r
OWNER
CONTRACTOR /DESIGNER / EN (NEER
VAV1e1k-T? Jv:D GROUP
:>~AVER C0N0rfLI.JC:11U1q
30.525 P V DRIVE'ExT
1;,5,05 W 261 at 0'ri"Kis"Y #1.100
1UWCH01?AX) VXN'.DL S . VA
14ARBOR CITY CA 9rJ`.Y 10
i;
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings _—T_Rff1(_ s, �_�_tr - p tl 5;1
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing �2 f .- b
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 l2 _IYG_l
.POOLS - SPAS
BLOCKWALL APPROVALS
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
,Appliances
Final
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)
'Tradition
September 12, 2001
Reid-Faver Group, LLC
Attn: Jeffrey Faver
30525 Palos Verdes Drive East
Rancho Palos Verdes, CA 90275
JRe: 78253 Birkdale, Lot 27
Dear Jeffrey,
The Tradition Architectural Committee has reviewed and approved your re -submittal of
plans and colorboard for the proposed remodel of 78253 Birkdale.
You may proceed to the City of La Quinta to obtain your building permit. Thank you for
your patience in our review of your plans. I look forward to working with you further on
t� this remodel.
r Sincerely;
fn
m, V
Mindy Qutierrez, Property Manager
Tradition Community Association
PCM/DESERT RESORT PROPERTY MANAGEMENT COMPANY
POST OFFICE BOX 4772, PALM DESERT, CALIFORNIA 92261-4772 - 73-550 ALESSANDRO, SUITE 5, PALM DESERT, CALIFORNIA 92260
PHONE: (760) 346-1161 - FAX: (760) 346-9918
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE TRUCT. STEEL ASSEMBLY O S01
❑ POST TENSIONED CONCRETE 0 ASPHALT OTHER �T
❑ REINFORCED MASONRY ❑ FIRE PROOFING
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JOB LOCATION 78 Z DA{�
REPORT SEQUENCE NO.
TVP F��Sifi�}jC\TURE (�
PtERMIT NO.
OA G/ O
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT
INSPEXT R
HRS. CHARGED
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ASSISTANTS,
HRS. CHARGED
INSPECTION GENERAL SUB
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CONTINU D NEXT PAGE O
PAGE OF
CERTIFICATION OF COMPLIANCE
i HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
6ftNAT RE OF REGISTERW
IINSPEUOP.
DA E OF REPORT REGISTER NUMBFR