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0201-062 (BLDG)".."w�u �.v,.,nM1.�VuL�. ►.MI'WII�JIV _-w-,..w.w +•j,,.'%�'"`'�'�i � PERMIT,N �. n:BUILDINGPERMIT°; 5 I hereby affirm under perjury that l am licensed under provisions of _ ,, `� • ...ti t ,.,,,- ,, , '3 F ` 1£ " 1-6 Chapter 9 (commencing with Section 7000) of Division 3 of the Business and oATE ` �,,.. . rx. vaivaTIO ` :'~y, h LOT'. •;TRACT ;• ' G ;' ", ',: ;, r Professionals > , ' W Code, and my License is in full,force and effect:= ,� ; A { y ' License # p M - - � , - LIC. Class . c `Exp'. Cate ,...� , s jos SITE yr+" + 1. i� ]APINI��,ADDRESS ft MIMI Z � Date $Ignature Of Contractor OWNER c «: CONTRACTOR /,DESIGNER / ENGINEER .Q rte.. .� ,. ,` -+ _ ,, ` •• 0.0 J U OWNER-BUILDER DECLARATION POA MMIMMMAI ASSOCU CM ` DEL MM PACIM 0El /1i CONN iRACM ,1 W W I hereby affirm'under penalty of perjury'that I am exempt from the Contractor's Pot ' 100 25 3 3 iount Comiiij iwiy ~ co License Law for the following reason: 3.,A QtTJN'1'A CA • 92 233 �:ATt1�11=V BX' SLA. CA 9=. Z . ( )' , L as owner of the. property, or my employees with wages as their sole 4760)3"-95W_-- CBIA • 3823 compensation;,will do the work, and the structure is not'intended or offered for` sale (Sec. 7044, Business & Professionals Code). USE OF PERMIT ( ) I, as owner of the property, am exclusively contracting with licensed v t contractors to construct the project (Sec. 7044, Business & Professionals WOMANMU s a ' Code) � () I am exempt under Section B&P.C. for this reason BUILD-MO 14, 80-SA SO.W, 80.5S% 8L MIX VOLUNTARY . Date Signature of .Owner 3TRUCI1J'tl[W Folompickt41lS;CY), U Q, WORKER'S COMPENSATION DECLARATION o 2 Z F `.l ,hereby affirm under penalty of perjury one of the following declarations: Fz p �( )� I have and will maintain a certificate of consent to self insure for workers' VALUATION ag0�l,pQ WS w� _ J�� `� 1 X W — compensation, as provided for. by Section 3700 of the Labor Code, for the FJ mJQ perf rmance of the work for which this permit is issued. -- Q U 17 I have and will maintain workers' compensation, Insurance, as required by WYO LAQUIRTA tj U Q Secdon 3700 of the Labor. Code, for the performance of the work for which this _ i=e'A permit is Issued. My workers' compensation Insurance carrier.& policy no. are: t , .'— 'Carrier Policy No. 00 STt M 1fUN13 Q46a1fyNYTO00o419 ` r;Si'lR�dfl'I'&l(D G'o rt'OF c<ali kniVanc* 20�d>A g ' (This section need not be completed if the permit valuation is for $100.00 or less). O I certify that in the performance of the work for which this permit is issued,. C018TltUCTION 1W '101-ON-418-000 83t+°l.00 t 1. shall not employ any person in any manner so as to become subject to the STRONG MC1TIt7N I • RZSIV 1©1-000.41-OQO Sx f10 workers' compensation laws of Califomia,'and agree that if 1 should become Subject to the workers' compensation provisions of Section 3700 of the Labor 4 Code, I spall fo with comply with thosebrovisions. 3 ' `Date: ,Applicant_"i_ $fi , 7 77 Marning: Failure to secure Workers' Compensation coverage is unlawful and ; shell subject an employer to criminal penalties and civil fines up to $100,000, in ' I. �. �. ,addition to the cost.of compensation, damages as pr"ovided for in Section 3706 , il!of the Labor Code,. Interest and attorney's fees. AmPbRTANT,!Application is hereby made to the Director of Building and. Safety , '-for a permit subject to the conditions and ,restrictions set forth on his. F -��application / �._,I. Each person upon whose behalf this application is made &each person at - w whose, request and for whose benefit work is performed under or pursuant to "-tMAL CON8MUMON' AND PLAN CHN. , . . " $2U5i Oil ; any permit Issued as a result of this applicaton agrees to, & shall, indemnify _ j� p'RK:QAiDF1 �p,Og > &' hold harmless the City of La Quinta,, its officers, agents and employees., } r rw f2TAny permit Issued as a result of this application becomes null and void if r rW DUN NOW work is not commenced within .180 days from date of Issuance .of such ; ' y j p to cancellation. ` e.. 'permit, or.cessation of work for.180 da swill subject efmlt L , correct That r eave, read to Ecom Ihlwith all Cf nand state and Statehat the aws relating information Is r 9 P y City, g to the building :construction,, and,hereby authorize representatives;of this; ity to enter upon the above-mentioned property for ins ection p rposes. RECEIPT DATE BY ? DATN /n SPECTOR `° » 1Signature (Owner/Agent) t INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Duds Forms &'Footings Duds Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor insulation Vents F!re P.L. Grills r�xeplace T.O. Fans & Controls Party Wail Insulation Condensate Unes Party Wall Firewall Exteew hath D - Int. Lath Final BLOCKWALL APPROVALS Final 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 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 APPROVALS Temp. Power Pole Underground Conduit Rough Wiring(/— Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: . ,� �,1 yy'.w'.Y��.-q•,,'•srzs.y'*�..•.,^•Y^-^a •- _^'-•'-,s^-- ryr.----s-pr'i%C' t'iS'�;s �,� �;;- w .y t� -}• Page_.._ rof'41 <r, ;'w ,n � , ' D t rVE°,STEAV -NS..- Y.r s:r��' w �- `.1Z� s 5� ✓ •'� f� Amw { , , "„,'`y.` ti+ .,°Ins"ection..Servicesy rr ��;• `�. J t.a 3 � ii may, �, ..i fv t: .; •J �- -+d' r r t -* � y '� lri=•t•tti { '.r ;y r �' .t-* fiat • << -, ! }' t _F. f'..• a' '� -l.•i. .":'4(+`Y• ' PROJECT �P OJECT # r.:' `�_ • ADDRESS:�S"I�.� .3'�+*i, "'��.►.. r+ G Cit;IENT`' t�.J� S�.t ,.. DATES l ° MW_ ZZ* �.• r " �� IS.h•ytG �Q .-a ., a C L j t } V 11 a. _ - - • f ": t� •'VL r a '..'� "'F tee.. '� .' � � •�� r r ry BLDG. `PERMIT # ARCHITECT - , • ` - �- i,CONTRACTOR ' • INSPECTION TYPE `� f,. _ , y k • " :, � y. •� j * � �; xw .N" r a ... wia �•'�.. r= .° ? _ t.;e' S '' .T `F �. y '- r_ •�� 'T(. •. _ � ;' „' sit r � ' r iT w •< ✓ : � M r+ � t , '�' � i • �` •L-�P_.,Oi_� f 1 V � f t £ •e ^ i' * f � . r}INSPECTION '; ✓, r.V i J'.` ctR 'f -�r�! ;., .. .. ... i• �. 1-a _ ,,`. { �, rR` �,, 1 F" 1F r:•(a Y•.itf �`" t'�...t_i �i?j' Q "►, i`f,r / ar.- ` ,. ' _ ' :-..+�1" :i F q.J- tr; ; S a T �wa.lf.., `+_ } .,3 .d ,.>ac vt. ca•-- �. + �'•y' _�, _ .• - J "-x" - wF•iT 1 Y i (•` tk -'Y (f/i T.T�3 r •( tC'1r4� a�kiv«✓ •v 1"''r _,1t ,e ;'• , e� . • a 's i.�- ...Q Ao r s ^' �.. 7 ,. i:a. .. tici F �,..,.Y `.r' ,;. e1 l � c _ t -,•, i ... '--i•4t. - �" !� ' +�. J 'OSS � �.}+'s`t- .♦ M E.. �< • •._ � - ,4 .� ...'< - r K /S `i� h;� •.'ti`! � , `J•^�j..f'7� J:r .+. Y w X. . • '� . � ♦: . s. .. �.J: : y - f ry a ^ _ "-' ••�� t` �'iLL•'L?.trFa'� !'!L,ti',�i �f' 'j , _t F '? "' ' .i nr"i'` 5t'ilUj .� =r- tv i• -'+ S.- .. . - ,,:-. a '� - `' _ yam' . • _ _ . � ,. 7 .. y .+Y�, • d . - .1 •" , w �, � y � � r}} �; �.4 7 ,. •- -� r ,ti � L . s x!� + ,L,.' rr I � if C6 rl 'j•• ti � `F t'F' ! . � ; } ` � _. .ie r ♦ � 1 ` `'' Ci! aw r A ,4 � t r .. t :t... d ,' I•f' .S'• t _ .,: � f _ e-r.r.-$1' a .r r'L+' � rr y: -.i?,. _Z•_ ~ z' 'tar v • �* ♦aj , •� _ • t r •�, -��r. r *'"}- y4V i.�• �,x.4. ...a—s yf j,,,�g w � . � y •. � s ti • v l . Y � .. '. }• r t _ - ._- - t '-r: i.Y.. r `' fi �` •' a - �' _ � � .. � ' r , V <,� � ,. 1. E ?F' S ,, ,..� i_.. r i •- r t• ,•„ r .i • �• ? 1 � ,i IiA� r ,' v.iz . r `t _��'• i .��: ."'r•a �:. -.^,•. K.kMYaR P•fj M `�.N •*V,f 4� `}'Sf3�•'i tip`.. 1'_ t... Ja -.. �� .�y t _ '• aF' t "µms „�. 2 4 �, �' - - , h s<� r- � - -r • r! ,.ice <41 �' ,••,.e ,. - "� ��. ,• r . S - 1 4 •F r+4 .+. t, .. a • �` � f- J' rT Ir -.•. 1 r.. �•nS 'tF i'r/ r. ir' .n.r; ••I ..... r .. v• � .., f �_ _ _ �._ _ _`7 _� ' � .-Ir � ` ..4 i .r -`T.. ...J ! s•�" 4• E n ) • '!s • `r ^' i.. �'�•t '•' 'R. �L � a t - ' vii'�c'' • '%+a• %� r . •� , .e � r • -I`ve ,- f � � •� 7 -�- is 4 �CERTIFICATIQN p� COmktANCE To the best of, our knowledge; all of the reported.work, unless,otherwiso noted,`=� ' substantially,corr �vlfi�h appF6Ved plan's"r specrfications,and applicable sections,of,ttie building codes'This report`covers .r<tie focat+tf t1;tr,spected onty ertd does not constitute erigirieeririg opinion or projecf control: f ♦ .. , f '}.,tY�� y�Y ♦r4` t i. ✓4 a"1r 73.,- J ._� t v.. v � y 1. .� r. u4 ki •t ��. r�to i.� � �' „J ` r :Y �ti::•� p,- �^ � r e 't ' CE' R_TnNO INSPECTOR . P•,E Q- ,T ;O• ' R^NA_ MC E`TUt RDATE INSPECTOR SI NA..'.�_T� ,k. . t '� �i��_ I�S��„q�:w.. S' i_ s � � ,�„•� •�.. + _ y t:'� a S'af ' 1 . -i'� L • p. lt.� + { � . f^a. r 1 , r, .�•-� w if U - ITr" VxIL A 4-' 1avk STIEA.x paO 7 4"1 nspectiow e ,fro w M.,ces.-,7 k4_ e k� VRO -WIL%T LPEC"c"al- CLI L; I E N1 �ePfe.; K tv �,.�'AbDRESS -�!2 a �6, 11 �jd . _ Q %R�, 1, nf� w A" 73 .7 Y BLDG: W44 -1 17V C p- �,,,�ENGINEERMC ONTRACrOlk IL..��,i 40fiF" - J: lr� 14 'INSPECTION j %jo rl R�T SPECUT 01 MUM - t -A V^•:'r Yr 3 A• A r- 47" 41i) eloi _9:'Me—jJQ /AJ_ 4t 4, 7 'iS. • s A, 4V7-4 W.V_ - a 7 ,t I -7- 7__ - 7 4"s A; xv..: 11A.i=� z 1�4 qp 4 id iri. I-, fob `tea' I T4 /M AS— 11� a..F -X Z?v�r- vl•. %4 , vc 44 Z_ 0 -�,s'CERTIFICATION;OF,COMPLIANCE:,T6 the b st of our;knoiv-�je; allwo unless ottWrWi6 % 14 f tfie reported," ' rk, e noted; sCjbsta�iQ�'cZin- issmith'a approved plans,�s*A_ s6cti6ni-6f the'buildi-nii,codes-.Ihid-ro�COVWS,-,,., 46d `j— fr"86—s iiiid'a liciWie" p .p Jed b6 vtn'spikCedbii�.kAj 'dc;t— p 4' pp thW kandi�i 6i 66'Work engineering Op'iAion or f. j7 -;ko A% SXx *,-t A Xi It I ` 'AZh CE RT. NO. INSPECTOR NAME 5 A i&k) AQ, 7 Al, DATE w Via; p INSPECTOR SIGNATURE 4 % it -. 4w "'' 4.4.