0010-287 (SFD)N C/)
W
O=)M
r- Cf LO
' W
It
o Z
�0
C:)H
J
co
Z
M
u7
N
ON
Urn
Q
Z
to CCO
0 JJ
•mUU
O
���
It Z_
ob :5
�a
J
,,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
A'ate ! f i 4, i 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 & 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 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):
(.),11 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' compensationprovisions of Secti6p 3700 of the Labor
Code, I shall forthwith comply with those prov;sions.
Date:/E ✓:�Q Applicant I
I
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,
{,Signature (Owner/Agent) r'`+•��,' J Date
t -
_
BUILDING PERMIT PERMIT#
DATE ))' VALUATION LOT .16j't TRACT
I t it'�ri I "IA7.1
JOB SITE %
APN
ADDRESS
76.1 *M� 014
OWNER "
CONTRACTOR/DESIGNER/EN INEER
LA QUNI.(!., CA 922:3
LA QY, WfA CA. 922Sa
(760)5+4.4692 CXV:231
USE OF PERMIT
rS'1xJf.°KY FAMP.°� T)'IA1'EL'.T NKI
SF),l � LOT 40,i!t.ft,:N 3A • .PKRWT L`O.ES NOT fNCI.UDE ffILOC;t
W.0, Y.•100-01JA.PPROAC°HDRIVEWAY, k'RAMIT WE IWCI,k3;< FS PI,.A X Cf RCK
DEPOSIT OF $609.
CUSTOM COtda'I`Io,TJCTION 4,327,00 OV
S?OE2GF•tlta/ TIO 9X6.00 3r
0ARAOMYCARP01VT (0) 0490160
NIXITE3) CONT 1' F CCa�l" 9rft�;'CTf0N
sem; ,'0
F, yp y� �y ��p /y �'91S
COP101sR1:3C'l,'IU]i I 1,01pE300-418-000 $11710.So
PIAN f HPPIICK Peg 141-000-439.318 V,T16.74
.MEC:kWN1G'K1.+FFE 101-000.921-000 5I4;9a
"
IF.f.,Frfi"3'I2.16",.,AL'FEE 101a000-420-'000
S1'RUND ImtY CON FEr o IWID 10)-000-241'4}0 940.50
r
0PAY)THO I?L?1~ 101-00423-000 $20.00
DEVWXMPrA lilRi'IAC:`i I+Va iygirl.00
« y 4
ART IgI+� b'pp'+�liBLIC' PbACES - R a)+�5y-0000 5511121-$S
w-4
y�'I-9911E (?Gpg1-0000-
SIT -119
A,.ti
`4'Ua-' MAL Ct7lRYMTSff. 110 A k'+3...AllOIMM
$6,167..2.4•
LLEBO FRE -PAID F -179M
4600.0
TOTAL FLUMIT TYRUNIDIDE NOW
RECEIPT
DATEBY
DATE FI E
INSPECTOR
•1 . , •";ILI 1( -1
��k
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs _ _
Forms & Footings - �- - -�1 . _
Slab Grade l�%
Underground Ducts
Ducts
Return Air
-�8�
Steel _ _
Roof Deck JjII(o!
O.K. to Wrap ej'�lgr
Combustion Air
Exhaust Fans
F.A.U.
Framing/� �yv _ _
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall r
Exterior Lath Sa361
Drywall - Int. Lath?/L�p
f8— _
F
Final �/�/g/��"/G(�
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
-PLUMBING APPROVALS.
Gas Test
_
Waste Lines
Electric Final
Heater Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral _ _
Pool Cover
Sewer Connection �/��1��
Encapsulation
Gas Piping
Gas Test U Z�
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)
APR -8-2002 01:20P FROM:
TO:7777011
la� 7 0
CITY OF LA QUINTA
• �� �S` BUILDING &SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-7153
Owner WEVSKOPF PARTNERS 1, LL
ContractoriLjjX,i,A CUNMTlC.I4N1 �.-.
Permit Number 0010.287 _,,i
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN Al I APPI ICABLE SPACES
JOB ADDRESS 47-635 BLACK DIAMOND
SFD - LOT 48, PLAN 3A - PERMIT DUES NOT
INCLUDE BLOCK WALLIPOOL/APPROACII
TYPE OF INSPECTION
FOUNDATION & SETBACK
INBP.
FOOTING STEEL
MAIN ;GROUND SYSTEM _
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB fr ,.f
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL A80VE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS a GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP : <
GROUT ❑ 4' U 8'
FRAMING; !,'• __
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN $IGNED
DRYWALL INTERIOR
EXTERIOR LATH _
POOL PRE PLASTER
ROeL-FENCE_& GATE
SEWER EPflC TANK
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS_
J013 COMPLETED
TEMP POWER
FINALS
P: 1/2
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification:
Occupancy Group:
SINGLE FAMILY DWELLING
57-635 BLACK DIAMOND
R-3 Type of Construction: VN
Owner of Building: WEISKOPF PARTNERS, LLC
Building .Official
Bldg. Permit No.: 0010-287
Land Use Zone:. RL
Address: 55-161 SOUTHERN HILLS
City: LA QUINTA, CA.,.92253
By: BILL GORDON
Date: 4/8/02
POST IN A CONSPICUOUS PLACE