Loading...
0303-264 (RPL)H N_ U) W O M LIJ i ~o Z ((OOO H(D -u V � U) Z M LO N ON 0 °' CL Q Z `rQoc 0 L X w L — m V U O a rnH v Z W 5 �0 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 690CA5 B.RIC 6/30/04 Date _ • ��' Signature of Contractor' ti ' 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. ^( ) 1 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 STATE FUND Policy No. A5813906-02 (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. Date: a ' Applicant 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�insp�ection purposes. Signature (Owner/Agent)�� 1'10, Date BUILDING PERMIT DATE VALUATION LOT JOB SITE i ADDRESS .5 106 CAMWO 1P)R.YV'.1t,DO OWNER 111;3''1' 11011 LLC PO ROY S 10 LA Qia'N-r.A CA. 92253 USE OF PERMIT POOL .ANIS/OR. 3PA PERMIT # MIM -2641 TRACT APN r rRACTOR / DESIGNER / EN INEER 3 42.5 3? W1V1MNTY S)R VE TILMENM ' AZ M34. (602)257--1656 CBU 4990 PLACE AT PRE-PLAriTER iht3PECT1014, EOU'1PMENT ENICLOSURVIO f 11101UDED POOL ANDIOR SPA M4100100 xslnmrxD COST OF C0 4STRU X00 PJAN CHECK, RX, 1137, -M, 11-4.39-13118 W5.30 CONSTd?t3t;i'{ON FEE 101-000-419-000 $162.00 1ARICHAMC"AL FEE, Pool, 101.000.421.000 $24.00 Ei.ipCTRIC.AL ME — POOL 101-t'f(20-420-000 $45.00 PLUM?f ING FEE -- POOL, 101.000-4.19.000 3?MOD .15,000.00 SIM -'i'arAL C 01 MUC"f.7n1s.,,�1nT•.D�:f.'�9T�..�AN+�yC-1m. �(� T $363.30 /�� 11IL'.cili LEL7�"�R•A1.i.P .i� "�!/©�t3U MAR 2 7 2003. GlTY OF �A IQUlNTQ NANC FE DEPT . RECEIPT DATE BY DATE FINALED INSPECTOR -� • .� :� �� � " ell �1 - �- ..mss INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Fomes & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans OX 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 steel POOLS - SPAS 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 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX 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 Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: - 10A RVII 17 7,M477"T.- N . Ill yog 0 ( W Z' DIN 0 9,91" ovd 0" 9 c z:: j 21 John Hardwick RJT Homes, LLC 79700 50" Ave LaQuinta, CA 92253 11-27-02 RE: Structural Observation of: Phase 26 Lot 102 John, C, 14712 SW SCHOLLS FERRY # 328 BEAVERTON,OR 97007 PHONE: 503-5248268 FAX: 503-213-6222 E-MAIL: mjnelson@attbi.com Sample observations were made of the above house to ascertain whether the intent of the construction documents is being followed. Of the structural items that remain uncovered and easily observable, it appears that, in general, there is reasonable compliance with the intent of the construction documents with no unresolved deficiencies. Please call with any questions. Sincerely, Mike Nelson, PE Page 1 of 1 INSULATION CERTIFICATE This is to certify that insulation has been installed in conformance with the current energy regulation, California Administrative Code, Title 24, State of California, in the building located at: 50-115 CAMINO PRIVADO, LOT 94, LA QUINTA, California CEILINGS: TYPE: BATTS MANUFACTURER: Certainteed Thickness: R-38 WALLS: TYPE: BATTS MANUFACTURER: Certainteed Thickness: R-21 GENC106V E L CON C R: RJT H S LICENSE # 6 TITLE:Aa ON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 TITLE: ADMINISTRATIVE ASSISTANT DATE: 11/13/2003 14712 SW SCHOLLS FERRY # 328 BEAVERTON,OR 97007 PHONE: 503-524-8268 FAX: 503-213-6222 E-MAIL: mine lsonftattbi.com John Hardwick RJT Homes, LLC 79700 5e Ave LaQuinta, CA 92253 RE: Structural Observation of: Palo Brea Single Family Tract 29858-1 Lot 94 Plan P3X 5021-15"C066Privado John, ' A limited sample of observations were made of the above house to ascertain whether the intent of the construction documents is being followed. Of the structural items that remain uncovered and easily observable, it appears that, in general, there is substantial compliance with the intent of the construction documents. Please call with any questions. Sincerely, Mike Nelson, PE Page I of 2