0101-028 (SFD)LICENSED CONTRACTOR, DECLARATION,.
I h reby.affirm under penalty of.perlury that I am licensed undi er..provisions of
446idpter 9 (commencing with Section'7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and efferEx
License # Lic. Class ✓y fDate
SsDate' Signature of Contractor
yr y --
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).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code). -
() I am exempfunder 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'
1.
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
rpermit is issued. My workers' compensation insurance carrier & policy no. are:.
Carrier S,PATIF,' AMD Policy No. 22%m,0 ► UXIT 002,0104 1;
(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 as4o become subject to the
workers' compensation laws of California, and'Agreejthat if' I should become
subject to the workers' compensation provislon6,,;f Section, 3700 of the Labor
Code, I shill forthwith comply with tFiose provisions. r� .r
Date: / Applicant 1:
iy1 ' ro-.
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to cryminal 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. t
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 person4t
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.
Signature(Owner/Agent) , -- -� Dated
f�a
BUILDING -PERMIT PERMIT#
DATE VALUATION LOT 010.1-026 TRACT
J{j /y
g ry� y p p yr q Yy
JOB SITE
ADDRESS 9.110 AVYWIDA =11Wi. UA
7a-172,013
OWNER
CONTRACTOR/DESIGNER/EN (NEER
JAMES 'I'13A MI A?_
3ry.A DAC,�UW C110),4L9"-f,'�R{��yF��"y"K(5:.diC+r1�
J ��� V �.0"kVFl.�d"Til��i A'w:..� `
P •� u� i..t �.�:.i`{ YS:��99✓J.J J:i��� V Ei'
'L,A QufN.r k CSA 92253
PAIAi( DEE67M CA 9226-1
(760)34p4628 ' MW 5Z48
USE OF PERMIT
(�
0401Z FAMILY ��vv.icee+ETIRE
SMI-PMAMIT 7f?S NOT 04C;Lt!"VE,
APPROM1,14. V1:t3C'aD PI.AIW PERMIT C ONI`i#IMED.
TRAC! CONri 11)CTI 0H V68140 3F
1
9?t??y��.C'IyJ� PA;.TIY 1,U60,i1ti F
q
'.Mlao S
TIMAirI7[d'F" N'(IMM"ARY
C 01 X37 RUCT10 Y1FFZ 101-300-418.000 M09
PLAN CHECK 1Y.Z 015.117
MECHAMC;AL FEE 101-000.421.000 31303D
1j:.1:.lBC:'Y1;1,K-Af,,r8Z 101-000-420.000
PLUMBING 101-000.419-000
9r32:014t3itFOT1014 trE:• ,t ;sd + 101-000-241-000 g19.ti
01Q¢1A:yyl:��i,?(ry�GF'k:' :y�q� 103.-000-423.000
.Llio�,L: ti./0.iP'.S�;r� 2457 R",l"iTf 1` 1't:I& ia4 'M I��V J, id!f
PREC,`I iR PLAN 101.000.441-343 31diOW
ITIM 3):5?Z OSI`i' 3 t11-t�(DCE•�-39' 3 X 8 �i SQ.UtI
1310_11 ' VSVCaZ 3TR,U( d3;0K A111) P1.414 Z"1aTl::C K
4,%21,a
• Irish SI :PRB-.M. D FE Z
42 ,0.00
1` ((� I
_ ►lta
1i NITTMIS1)'L7 SCS
,df7,(ra�;a
1111 o 1 11J111
a,
CITY OF LA QUINTA
RECEIP
BY
DA FINE ��
INSP
r,,
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap-
Z -O S
F.A.U.
Framing
_��, p
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
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
09
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 Test2
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole O/L,
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:
SG�R tic
1.
Concorde Consulting Group � Y
a
Construction Management s Project Management ® Engineering a Development
December 31, 200:
Mr, Joe Dolor
Contractor
Palm Desert, CA
Re: Battin Residence, La Qainta, CA ,
Dear Joe,
Per my inspection, we find the framing to be in compliance and inaccordance with the approved structural
plans and per the code. ;
If you may have any questions, please feel free to call us. • ,
Sincerely,
'. Narayanan - �i ���itkr;.
'Vice - President
Concorde Consulting OrouO,Inc,
Consulting Engineers
N0. '
CC.. K.M Kripa, SE, PE Yp. g�03
OF
i
4511 E. Sunnydanes Read Ste. #•E Palm Springs, Ca 92264 Ph: (760) 322-8626 Fay: (760) 416-1893
..•.... _ , _ � ., `� ,• . - . ...,..tib...:
„, TO 39Vd 3CINOO100 BBEE919619 69:EZ 2007,/0E/ZT
I
i
FROM : Feiro Engineir-i,ig. ±-l::. F'FIX NO. 751:)
I�ILIIIIl�I86t3�08111ii1® :.
I ,,me�qq
101f1 Bllldf� t�9
Aug. 15 2002 03:27PM P1
41-525 Eclectic Street. Suite C-1
P.0_ Box 12980
Palm Desert, Ca. 92255
(760) 346-8015
(760) 345-254$ Fax
www.feiroeng.com
August 15, 2.002
7 15�- ?to /vU6S7fA
a.
L- ,- Certificate.�Of Occupanc0 0Y
OBuilding,A'Safety 1Department
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 . wiW the
provisions of the Building Code- and the various ordinances -of the City regulating building ,
,construction and/or use. = -
BUILDING ADDRESS: 78-710 AVENIDA NUESTRA
"' Use-classification:,SINGLE FAMILYbW'ELLING Building Permit No.: 0101-028 ;. •�
' Occupancy Group: R3 f Type of Construction: VN _ Land Use, Zone: RL
Owner of Building: JAMES F. BATTIN JR. Address: 78-710 AVENIDA.NUESTRA' -
City, ST, ZIP: LA QUINTA, CA 92253
By: KIRK KIRKLAND r
- Date: MARCH 26, 2003
' Building Official
POST IN A'CONSPICUOUS.PLACE