Loading...
0304-022 (SFD)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 Dates - a ! ' ' Signature of Contractor 7 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 SeCfion 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 A Y!+°;'IIAL UQ).l,N Y' Policy No. M330.4 (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. Dates. Applicant 1 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 !, �(- 1 ' Date \` I•' ' 4 i BUILDING PERMIT PERMIT# d�.';tJ-i-432 O DATE VALUATION LOT j� TRACT ;30023 ADDRESS I RI i �Z14 �aT% APN 7"- •270-017 OWNER CONTRACTOR / DESIGNER / EN (NEER ;h©•3I s 8I-wis MMM, 62 I'A QL'T.'T h CA. 922i 3 I7itN�I - AT, CA. 92PS3. (909),833-8996, 6076 USE OF PERMIT ."at•n LAW i 1.:.� Y'A .S't ; . VJa. :�p:,tcf7< a itt+a+t a•<..r1 �aa•�.a,.�:.ra.,u fJ!..a.�•„� , WA KKA, VA Olt stn,I. C:Oyyh�MIIIII?fI11.?1014 4421A- V itPuf r,fr ''t4y�,t'(j�JpyC11 1r ,'Ei✓N.,i`i�i i(�9 /Vi�6[, tl��(?�?tf.4dtti`'•A`kl"l.:t{.A. 'Yg�a+�� NP CtiP7�?TI3t�G:^'3�3�'.t�i•F: >f')1-U£��It`�-�itt� �f,fia),;�3 PLS( C;t��CF" ��.: i(i.-{i1:=�I-rl:a'S'•:�1 a $fila, i:� . ?,�i Gt3r's'kalC Ya £?E �t3I-000- a-000 S1.EC' TR11 CA lr PFZP 0i -0111)-'49 iI`U 154J ��3(�AV�.i[olla Iw?''I��)"s+;4eiBk�!fi t��: i41-U^3ib•�113: •+{:`!,rS(.�)'�l! M w1i0,N FrW,F - nu'Zx L'. klg-004t'24- ORANING HEY, f.7.RT IN PUJOl. C Pi«.A1:2Y.415 - 270•0-N-4446-000 I: 3-"s0 l.. :��-i "".i"►7;1C."?'i+�i'�t AMD P�WIt.��Ak) 0�`{{#1///:,,"a7'1�'. TA ,6S.a.�L": r aa +L1L'rLi1T �'. r.�r''.{�A•1Li i+ , '�a7 ' 0,�0 � W w PERIgl.T"(17-0 ,9UP, Nog1►l APRe� d"R O 8 1P LA QUINTA RECEIPT DATE". D T�E ALED INSPEC INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings 1A 1 41Ducts Slab Grade Return Air - Steel Combustion Air Roof Deck44W5 Exhaust Fans O.K. to Wrap '3 F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS -SPAS Steel Set Backs Electrio Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING PROVALS Gas Test Electric Final Waste Lines jj 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 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) APPROVAL '�- COMMENTS: IDMainiero, Smith and Associates, Inc. Planning / Civil Engineering / Land Surne��ing 777 East Tahquitz Canyon Way. Suite 301 / Palm Springs, California 92262-6784 Telephone (760) 320-9811 / FAX (760) 323-7893 • e-mail info@mainierosmith.com • www.mainierosmith.com May 7, 2003 Department of Building and Safety CITY OF LA QUINTA 78-495 Calle Tampico . La Quinta, CA 92253 Re: Form Certification Tract No. 30023-2 Construction Sequence 1-F Gentlemen: This letter is to verify that the .following building forms have been checked for elevation and horizontal location by Mainiero, Smith and Associates, Inc. and found to be in substantial conformance with the approved Precise Grading Plans. Finished floor elevations for lots 127 - 135 and lots 167 - 171 are as follows: Very truly y rs, Steven J Va , L.S. 6500 SJV:tt cc. Hector Guzman, Engineering Department Mike Groessl, Shea Homes Sip LAND S��G STEVEN J.VAN F� v REG. E(P 6 3° N0.6500 Q �!�9Te OF' C A� Pad Elevations Lot # Address Plan Field Difference 127 81759 Brittlebush Ln 426.90 426.87 -0.03 128 1 81771 Brittlebush Ln 426.20 426.18 -0.02 129 81783 Brittlebush Ln 425.40 425.39 -0.01 130 81795 Brittlebush Ln 424.70 424.70 +0.00 131 81807 Brittlebush Ln 424.10 424.12 +0.02 132 81819 Brittlebush Ln 423.40 423.41 +0.01 133 1 81831 Brittlebush Ln -) 422.60 422.61 +0.01 134 60356 Sweetshade'U ' 423.20 423.20 +0.00 135 60334 Sweetshade Ln 423.70 1 423.72 1 +0.02 167 60380 Chelsea Ct 428.50 428.53_ +0.03 168 60402 Chelsea Ct j 428.10 428.12 +0.02 169 60424 Chelsea Ct 427.30 427.29 -0.01 170 60351 Sweetshade Ln 423.50 423.51 +0.01 171 60329 Sweetshade Ln 424.10 424.18 1 +0.08 Very truly y rs, Steven J Va , L.S. 6500 SJV:tt cc. Hector Guzman, Engineering Department Mike Groessl, Shea Homes Sip LAND S��G STEVEN J.VAN F� v REG. E(P 6 3° N0.6500 Q �!�9Te OF' C A� IDMainiero, Smith and Associates, Inc. �- Planning / Civil Engineering / Lon d Surveving 777 East Tahquitz Canyon Way -Suite 301 / Palm Springs. California 92262-678=1 Telephone (760) 320-9811 / FAX (760) 323-7893 - e-mail info@mainierosmith.com - \va-w.mainierosmith.com May 13, 2003 Department of Building and Safety CITY OF LA QUINTA 78-495 Calle Tampico La Quinta, CA 92253 Re: Form Certification Tract No. 30023-2 Construction Sequence 1-E Gentlemen: This letter is to verify that the following building forms have been checked for elevation and horizontal location by Mainiero, Smith and Associates, Inc. and found to be in substantial conformance with the approved Precise Grading Plans. Finished floor elevations for lots 121 = 126 and lots 157 - 166 are as follows: Lot # Address Plan Field Difference 121 81-687 Brittlebush Lane 431.80 431.78 -0.02 122. 81699 Brittlebush Ln 430.80 430.75 -0.05 123, 81711 Brittlebush Ln 429.70. 429.62 -0.08 81723 Brittlebush Ln 429.00 428.98 -0.02 81735 Brittlebush Ln 428.30 428.27 -0.03 E12 81747 Brittlebush Ln 427.60 427.62 +0.02 _ 81-858 Bir ittlebusfi Lane. 434:90' 434:92 + 0.02 158 60-431 Lavender Court 431.70 431.72 +0.02 159 60-407 Lavender Court 432.20 432.23 +0.03 160 60-387 Lavender Court 432.50 432.51 +0.01 101 60-392 Lavender Cour 432.50 1432,51 +0.01 162 60-414 Lavender Court 432.20 432.20 +0.00 163 60-438 Lavender Court 431.70 431.70 +0.00 164, 60419 Chelsea Ct 427.80 427.84 +0.04 165- 60397 Chelsea Ct 428.30 428.33 +0.03 166- 60375 Chelsea Ct 428.50 428.52 +0.02 SAND SUG Very trul yours, ��� STEVENJ.VAN O Steven J Va , L.S. 6500 I REG. D(P G °3 SJV:tt fJq� N0.6500 O��Q cc: Hector Guzman, Engineering Department F OF C Mike Groessl, Shea Homes - Of IA-