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04-5636 (AR)1504 ALLE TAMPICO "A, CALIFORNIA 92253 Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00005636 Date 7/22/04 . . . 50705 CYPRESS POINT DR 770-110-012-7 -25389 - . . . ADDITION - RESIDENTIAL . . . MEDIUM DENSITY RES . . . 3000 Owner ------------------------ BESLEY AMANDA C C/O MATTHEW T BESLEY UNKNOWN CA 99999 Contractor ------------------------ OWNER ----------------------------------------- ---------------------------------- Permit . . . . . MECHANICAL Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge. Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU •9.00 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and'Comments GAS LINE & MECHANICAL SET UP FOR NATURAL GAS BBQ - 16,000 BTU #416292 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - RES .50 Fee summary Charged Permit Fee Total 42.00 Plan Check Total 10.50 Other Fee Total .50 Grand Total 53..00 Paid Credited Due ---------- ---------- ---------- .00 .00 42.00 .00 .00 10.50 .00 .00 .50 .00 .00 53.0,0 j P.O. Box 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: r S 3 Date: Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S 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 Class License No. Date Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 1, 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U 1 am exempt under Sec. , BA P.C. for is reason Date 7 , 2 ^ O4! Owner RKERS' COMPENSATION DECLARATION 1 hereby arm under penalty of perjury one of the folio m clarations: affirm 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 and policy number are: Cartier Policy Number 1101-1 1 certify that, in the performance of the work or 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 a2fee that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision _ . 'Date1-92- Qui WARNING: FAILURE TO SECURE WORKERS' COMPENSOVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAR 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. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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. 1 certity that I have read this application and state that the above information. correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter on th ve-me 'oned props for inspection purposes. Date '7_IL-0A/ Signature (Applicant or A e Page 2 Application Number . . . . 04-00005636 Date 7/22/04 "AN ADEQUATELY SIZED DEBRIS CONTAINER IS REQUIRED ON THE JOB SITE DURING ALL A RE -INSPECTION FEE OF $30 ' HASES OF CONSTRUCTION AND MUST BE WILL BE CHARGED IF THE APPROVED ;.MPTIED AS NECESSARY. FAILURE TO DO SO PLANS AND JOB CARD ARE NOT ON •A'AY CAUSE THE CITY TO HAVE THE CONTAINER THE SITE FOR A SCHEDULED I Ows Q�� DUMPED AT THE EXPENSE OF THE OWNER/' INSPECTION. /I •,,��( CONT I NO EXCEPTIONS! OI TRI.ICTION HOURS October lst - April 30 Monday Friday: 7:00 a.m. to 5:30 p.m. Sunda v: 'None (1,10v °rliment Code Holidays: None '1`t - September 30th ridgy: 6:00 a.m. to 7:00 p.m. 5:00 a.m. to 5:00 p.m. a3: None .,.£y_ I snnent Code Holidays: None 17W instruction is NOT PERMITTED the following Code Holidays: New Year's Day Dr. Martin Luther King Jr. Day President's Day Memorial Day Independence Day Labor,Day Veteran's -Day a. Thanksgiving Day Christmas Day CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE-7/::?Z22 BY ' It 11 OUTDOORS NATURAL GAS BBQ INSTALLATION PECIFICATIONS NOTE: Vents must be provided for combustion air on both sides of built-in cabinet. When choosing a location for your gas grill keep in mind that it should never be located under any overhead combustible construction. The sides and back of the grill should not be any closer than 21 inches to combustible construction. DO NOT store empty or full spare tanks under or near this or any other appliance. Non-combustible construction Outer lips of B64 rests on edges 0 MODEL A 3 BURNER 23" 4 BURNER 31" 5 BURNER j 381/2 " I I I 1 5 Natural gas regulator LBY___� A QUINTA AFETY DEPT. OVED TRUCTION I Gas supply Vent BULL 01"I nr Products Inc. Ontario, California 91762 CIN OF LA QUINTA BUILDING.& SAFETY DEPT. APPROVED FOR CONSTRUCTION BY ASSEMBLY & OPERATING INSTRUCTIONS MODEL 0-4178 4 Burner Powder Coated, Built -In, L.P. (Propane) MODEL 0-4179 4 Burner Powder Coated, Built -In, Natural Gas MODEL 0.4168 4 Burner Stainless Steel, Built -In,. L.P. (Propane) MODEL 0-4169 4 Burner Stainless Steel, Built -In, Natural Gas MODEL 4.16282.. 4 Burner Stainless Steel, Rotisserie, Built -In, L.P. (Propane) MODEL 416292 a Steel, Rotisserie, Built -In, Natural Gas TABLE OF CONTENTS PAGE SAFETY INSTRUCTIONS ..... ................ ......................................... .....................:.................... :.:... 2 . INSTALLATION INSTRUCTIONS .................................................................................... ......... 4 LIGHTING & OPERATING INSTRUCTIONS........................................................................................ 9 CLEANING & MAINTENANCE........................... ........ ................................... 12 TROUBLESHOOTING PARTSLIST............................................................................................................. 14 WARRANTY.................................................................................................................................. 16 READ THE FOLLOWING INSTRUCTIONS CAREFULLY AND -BE SURE YOUR GRILL IS PROPERLY INSTALLED; A99EMBLIED- AND CARED FOR. FAILURE,TO FOLLOW THESE INSTRUCTIONS MAY RESULT IN SERIOUS BODILY.INJURY-AND/00 PROPERTY DAMAGE. IF YOU HAVE QUESTIONS CONCERNING ASSEMBLY OR OPERATION, CONSULT YOUR DEALER, GAS APPLIANCE SERVICE REPRESENTATIVE OR YOUR GAS COMPANY NOTE TO INSTALLER:. NSF LEAVE THESE INSTRUCTIONS WITH THE CONSUMER AFTER INSTALLATION. NOTE TO THE CONSUMER RETAIN THESE INSTRUCTIONS FOR FUTURE REFERENCE. THIS OUTDOOR COOKING GAS APPLIANCE IS NOT INTENDED TO BE INSTALLED IN OR ON RECREATIONAL VEHICLES AND/OR BOATS. 1 Revision 01103