Loading...
0205-129 (RC)M LO N ON U °) O_ Q Z Lo a 0 tL 0 J J m< O a0� v Z co Z) �O J LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisioq*-of-th"e Business and Professionals Code, and my License is in full force and effect. License # Lic. Class %% Exp. Date 69301/7 H t -.. ovo zoo Date47—A-r,1. Signatu OWNER -BUILDER DECLIARATION I hereby affirm under penalty of perjury.tliel 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). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct 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 7 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 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 & policy no. are:. Carrier rggg7,, Xq1NDPolicy No. (This section need not be completed if,tt () I certify that in the performance of I shall not employ any person in any I workers' compensation �aws of Califor Subject to the workers' compensation-) Code, I shall forthwith comply::with Dios Date:ra Applicant -� 'Permit valuation is for $100.00 or less). le work for which this permit is issued, inner so as to become subject to the a, and agree that if I should become )visiohs"of Section 3700 of the Labor provisions:- Warning: rovisions- C Warning: Failure to secure Wofkers' Ciffipensation cover�gei; uhlawful and . �f shall subject an employer to+c� f, jr mmal,penalties and civil fines up to $100,000, in addition to the cost of comp ensation, damages as provided for in Section.3706 of the Labor Code, interest Ad attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his . application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that -the -above information is correct. I agree to comply with.all'City, and State laws relating to the,building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection. purposes. r Signature (Owner/Agent);'Z' j "'a' .'� r Date 4-.,—1 �. BUILDING PERM_ 17 PERMIT# DTE^y�j' 021J► /VALUATION R LOT TRACT JOB SITE P � w ADDRESS 7:�-449 €`�Rr0"{`� 8;` W1.% _ DRIVE4f I OWNER CONTRACTOR / DESIGNER / EN (NEER JP41L OERHi$DFR N"V L4M1Ay ANdtR AYSdlC 77-5I0 PyRIVELD A,AN+y SUM u LA QUIN TA CA 92253 PAT -)b4 DESERT CA �Y2218, d7014If"63a WIN 1395 USE OF PERMIT TiftS SW. + iU,. 7.'l RD" OCCI1IAt9NCIS-4,1 , QW1' C►; Jt C' tC1i` V1_ :&ST AI t; (,' GbCONSI'l:',RWIrION PRUMI'iIF, SUMAlt"v (MS7rP-_M1N feivil air. ---W6-418-000 $2"50 H AN CE ftX -M 1,01-aw- 9-318 -261.59 hffiCHWICAL P i.d)�-fi#3t? j12-IiJif$l .SA PU.ITIVIDE 10 -boo- 119 -off s .c ___STR:{'SNG M10`D`iO1.�'. - CO M W -CM -241-000 $6.30 �C .4 IS.>WIXMUT CONSTRUCTION AND PLAN (NUCK 1.02 LESS YK&WIdD M!111A Wm D G=J ".AlgidYr tii U, ] rMS �� NOW — i s7iAeM CITYOFLAQUIRTA, y `f RE NAN,PT. BYf w` r^^' D9irE NALED INSPECTOR <% V 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 F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wail Firewall Exterior Lath Drywall - Int. Lath �O Final Final r �2 POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test 'inal 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 COMMENTS: Final 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) Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Farming Bedumont Calimesa Canyon Lake Coachella Desert Hot Springs Indian Wells ❖ Indio .❖ Lalkke Elsinore La Quinta Moreno Valley Palm Desert Perris Rancho Mirage San Jacinto Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, District 4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPAR:YMENT In cooperation tivith the C alif�rrnia L)e�crrttvent of Tbrestry and Fire Protection 210 West San Jacinto Avenue & Perris, California 92570 • (909) 9 . Fax 909 940-69 0. May 13, 2002 Orr Builders 77-570 Springfield Lane, Ste. D Palm Desert, CA 92211 Re: Non -Structural Building T/I Plan Review 02 -BLDG -123 / Knight Chiropractic Fire Department personnel have completed a review of the plans you submitted for the above referenced'project. Please be advised the following conditions or corrections must be completed and approved by the Riverside County Fire Department before a building permit can be issued. 1) Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire Department for review, along with a plan/inspection fee. The approved plans, with Fire Department Job card must be at the job site for all inspections. 2) The building sprinkler monitoring system must be extended to provide an interior notification device within the tenant space. Plans must be submitted to the Fire Department for review, along with a plan check/inspection fee. 3) Provide either a separate Knox Key Lock box, Model 4400, 3200 or 1300, mounted per recommended standard of the Knox Company or provide key(s) for inclusion in the general building Knox Box. If the building/facility is protected with a fire alarm or burglar alarm system, the lock box will require "tamper" monitoring. Special forms are available from this office for the ordering of the Knox Box. This form must be authorized and signed by this office for the correctly coded system to be purchased. 4) Install portable fire extinguishers per NFPA, Pamphlet #10, but not less than 2A10BC in rating. Contact certified extinguisher company for proper placement of equipment. 5) Approved building address shall be placed in such a position as to be plainly visible and legible from the street and rear access if applicable. Minimum of 6" lettering is required for suite identification. In strip centers, businesses shall post the business name and suite number on back doors as well as the front. All addressing must be legible and of a contrasting color with the background. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Sincerely, FRANK KAWASAKI Chief Fire Department Planner By Walter Brandes Fire Safety Specialist H1PEMPOATA\LAOUIMAPROJECTSUN IMPRV%02-8L0G•I23.doc EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE 82-675 Highway 111, 21d FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072