0202-218 (SFD),
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chaptert9 (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
Date Signature of Contractor A•
OWNER -BUILDER DECLARATION
,l$6reby;affi�m 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`(._ ec7044,; Business & Professionals Code):
( ) I,`�asiowner`,of: the property, am exclusively contracting with licensed
contractors';to: co'ristruct 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 370.0 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).
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any personin 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 • if '_rsio S.
'Date: Applicants
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. r
Signature (Owner/Agent) Date,
BUILDING PERMIT PERMIT#
DATE VALUATION LOT tl^2 TRACT
_
=79;$37AG 45 299M
JOB SITE v v
APN
ADDRESS
79-6 70 RANCHO UK PAS CUAL
.649k 400-015
OWNER
CONTRACTOR / DESIGNER / ENGINEER
Imo: L& QpI s\,, 1,w
TRANS W.EST HOi3'E3NG ill C
9968 RMT Mre'ST, DIM 102
8.401 F lUGHWAY 111
sm- =00 CA 92131
LA oi(1"m i.A CA Q225.3
C76(fP 71-33,63 i, Uk 437'
USE OF PERMIT
`-
SM � .LOT 45, K AN 4CR. RZ,.KMIT &9OL0 :NOT 'INCIXIDE H OCK.
WAt,M P004 PA OR DRIVE WAY'.PsPlyROAt"1
TRAMCONSTRUCTION
Crt; NSTRUC TIC7N 7Ia?,Si1J f9F'
IyOy - 'p^�i3.000 By
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{1
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229,,W -x,41
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CM43 'RUC' ION FEE 101-000-418-000 flm i,50
kPLi4Zx10";'HFCK Ir%a ?, 101_000_43!?•;316 3108.11
1 I Z'.1iEi131C i, F+ 1?, 101.000.421-000 VJs.OG
aitWI RIC,� L 1IN+I 101 -Ow -420-000 t8�."lti
lyuaw3ma Fig 1011=0C�l0-4413•�tW, 51105.00
tt,
:i7'1?if�Y�6(3 �41(Yfl!)),T AriZrJ."• • RE5..10 y 6 1-N81O••2AI -00
ORA#�I2mC1 � IGI-0004231,601
J2ZV_VJX1PXR IMPACT M,
T t?J 1'I3 �C' 1'Gl1.t:1 �3 » :I1 . I I�i•C#E3U^ X15 CrO�J M84
5IM-7'TUYAL CONMRSC~''!°z09ANT.) F%.AR CRECK
$4,490.16
LESS PIMhPAID MM
S0100
L`1'C%E NOW
FEB 2 ':x:01
�i
RECEIPT
DATE
BY ...•
DATE FINALED
Eqpft
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
_d'2
Underground Ducts
Forms & Footings
Ducts
Slab Grade
p
Return Air
Steel
Combustion Air
Roof Deck
— _�
Exhaust Fans
O.K. to Wrap
X,✓Q _
F.A.U.
Framing
Compressor
Insulation
_ _
i p
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
—�
Drywall - Int. Lath
Final -
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
p^-�'
�d'-
Plumbing Final
Plumbing Top Out
J
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
nL, zPool
Cover
Sewer Connection
_
Encapsulation
Gas Piping
ep
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring ,r '�•p� (-
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) cy-U2
COMMENTS:
FROM
PHONE NO. Ap'-. 11 2001 08:40AM P2
b5i2dI2yN2 j:'2� 8585763264 SW460W ASSOCIATES PAGE 01/01
7�
-- .24,�
2114,,,
Sucre lv1
Wn Dino, CA 11111W
;,r"W (ss) maew
RM (858) 575M64
May 20. 2002
iblcComic Consolidated / Trans -west Housing
9968 Hibert Street Suite 102
San Dicgo, CA 92181
Atte: Herb
Sub).: Ixispccttotl
STRV i# 9� PiUA�iI$ARY
Tate apt iA data(ma
Inspection bate: a
Model Number / type: Plan( 1.2,3,410, 1ts 42�thru 4_5
Construction Phase: Phase 2
The framing inspection consisted of ,a visual review of the structural Lateral System and
verificauan of shmvralls, hardware, and building "anchorage. The as built product was
compared to the -approved plans. The trained portions of the lateral system were tb=. d to t)e
in s:abstmitial cotnpl=ce with the approved plains, and the previously discovered
incomplete work was satisfactorily completed.
The visual inspection is limited 'ti the lateral bracing elements normally installed at
the framing stage. Intludirg drag strips, plywood bracing panels and hoidown anchors.
Since a portion of the project may re:y on stucco plaster and drywall bracinq panels, no
opinion is expressed or implied about the compliance of the stucco/drywall nailing.
This letter is pro%ded at your request and is for informational purposes only. It is
intezlded to con$rm the ftwzitg subenntraetw's udderstl�nding of the structural plans and
Installation of the framing elements shown on the approved drawings. It does not provide
a guarantee or warrantee against defici=z cies or performance of the build-ing product yr
provide evidence of building agency approvals or special inspections.
Respectfully submitted,
Mar Swanson. PE