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0312-225 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 04 W Professionals Code, and my License is in full force and effect. O =) ch License # Lic. Class Exp. Date WC7 51,9186 B 10131 l2( ti oZ Date Signature of Contractor u� too , f` JI.— CD OWNER -BUILDER DECLARATION W W rl- I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ d 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). CY) () I am exempt under Section B&P.C. for this reason L N Date Signature of Owner p C'J 07 d< WORKER'S COMPENSATION DECLARATION Z I hereby affirm, under penalty of perjury one of the following declarations: p () 1 have and will maintain a certificate of consent to self -,insure for workers' K W �= compensation, as provided for by Section 3700 of the Labor Code, for the D _ Q performance of the work for which this permit is issued. n Q V ( ) I have and will maintain workers' compensation insurance, as required by j LO •Q Section 3700 of the Labor Code, for the performance of the work for which this L 0) permit is issued. My workers' compensation insurance carrier & policy.. no. are: ,It Z CarrierSTATY FL114D Policy No. I�4811.31QW(4".'A) �d 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 37,00 of the Labor Code, I shall forthwith comply with those provisions. Date:(ir Applicant`""=, r � I t Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is • correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter on the above-mentioned property for inspectionC purposes. / Signature! (Owner/Agent) " `� 1 I Date t • •.- BUILDING PERMIT PERMIT# ZkAy DATE VALUATION LOTTRACT S20%V730 2' JOB SITE APN ADDRESS 47•*20 CAX,,XO .i A'Y - L(YA 2 643 -200 -OW OWNER CONTRACTOR/DESIGNER/EN INEER I.AI+.1r FRONT INVRIS T ORS, NC. S.'T. alkylws, INC. 74770 WGIiWAY 111, S ITE 205 416365 B0ARD`d�/P LK 4204 7I`7LiIAka CA 92210 PA1.14llP.�T ZT CA 92211 (760)340-0850 CV -4 3024 USE OF PERMIT SINGLE "FAMILY DVOMNO SFT.. 9,386 SQ.TF`I'. I,fVTNG () 'l N 7 MEDITERRANFAN) @ 1..0'I 01. PERMIT GOR NOT INCLIgHTRY GATi.% BLOC.KNA.LLX. POOL, SEP, DRPd EWAY .APP. PL,rZMT'T' & INSP. BY PUBT..iC WORKS R2Q'D. TRACT CONSTRUCTION 31396.00 SF ; P RCPJPA T10 815.00 SF c3ARt GIVIC*A.RPORT 71$>00 3F E2.1rJTMd?RIND C09T OF CONOR00:70M 209,49710 >i.'E.R1"f 6' �s''E111 WARRY CONSTRUCTION FEE, :i 01400.418-000 S1,02*50 L PIAN CHECK FEE 101-000.4.29-316 $860.67 MRCHANICAL FLZ:& TO1.«000.421.000 `81111so EL C:TRICAL FEE 101-000-420-000 PLUMBING ME 101-000.419.000 $19150 S'TRONU MOTION FRE • RESID 101-000-W-000 $20.95 ` tRAW40 FEE 101-ii0.423.000 $15.00 DZV?, OPF,R IMPACT "KZ $2,409.00 ART IN PUBLIC; PLACKS - R.RSII 2:70.000.445-000 $23.74 Pr A SU , I -OTA ) 2.UCTIO11 AND .PLA rT C1:�CiC $4,962.47 Lr,,,5S PRE -PAID FIMS $0.00 JAN 16 2004 cYrA L PERMU VUlv N ONV $4,862,47 CITY OF LA QUINTA FINANCE DEPT. RECEIPT DATE By DATE FINALED INSP TOR INSPECTION RECORD OPERATION DATE I INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVA SrMECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap 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 > o o 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 APP OVA S 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 Gas Piping er Encapsulation Gas Test Appliances Final Final // 63 0< 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 SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 78-194 Elenbrook Ct. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF �� INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING Oak £P�Kki ❑ OTHER JOB LOCATION �0.�v REPORT SEOUENCE NO. TYP F STJWCTURE CA PERMIT NO. DATE DAY OF wE K MA IAL DESCRIPTIONARCHITECT ���� INSPECTOR HRS. CHARGED �act x Z 1 zo(zS °�,� ENGINEER �a�,^saw �� e�►Se� ASSISTANTS HRS.CHARGED ` ,INSPECTION GENERAL 2��� �� t ACL- SUB 'DATE CONTRACTOR 0. l d O f� CONTRACTOR n 2- w Co (\S)r wfzF w i t ").A n (2( d' Ice b Z r^ - AS z0oz, n Zr ""Ci ©• 0. C ► • COPY SENT TO CLIENT 0 CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF W 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. TURE OF REGI EO INSPECTOR 3 l 1ca3o �207-7Z I DATE OF REPORT REGISTER NUMBER n:_. t .....'-johns on & Nielsen . Associates Carl B. Nielsen Per T. Ron Consulting Structural Engineers Wen Y. L.n Lonnie P. Mount 647 North Main Street • Suite 4-B • Riverside • CA • 92501 • (909) 686-5122 • FAX (909) 686-6752 steer T D,onuett L o s A n g e I e s • R i v e r s i d e • I r v i n e Jackson K. Wu March 17, 2004 J.T. Hayhoe 17821 E. 17th St. Ste 240 Irvine, CA 92780 Attn: Scotty Perry Re: Mountain View Estates Lake La Quinta Lot 2 Dear Scotty, J & N Job No. 40-010 This letter is to serve as written confirmation of the complete framing inspection I made at the above address on March 17, 2004. Based on this visitation, it is my opinion, that the complete framing is in compliance to plans and specs.. If you have any questions, please feel free to call. Sincerely, ;!'QpOf►Oti pMp��t�► y v No. 3834 EXP. 3.312004 Lo ie P. Mount, S.E. 4% P Ct JOHNSON & NIELSEN ASSOCIATES "',- OF CA���� Consulting Structural Engineers C:\WPDOCS\0-FORMS\inspectn.Itr\FRAM INSP 40.010.wpd �- ��� Certificate ®f Occupancy C� OFT9� Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: -47=620 CALEO-BAY Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0312-255 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RM Owner of Building: LAKE FRONT INVESTORS, INC, Address: 74770 HIGHWAY 111 City, ST, ZIP: INDIAN WELLS, CA 92210 By: TOM MORRISON Date: NOVEMBER 3, 2004 Building Official POST IN A CONSPICUOUS PLACE