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9910-012 (RER)i LICENSED CONTRACTOR 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 # _ Lic: Class Ezp. Date Date`©� Signature of 'Contra o 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). 0 , ( ) 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- - 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 Sectioh 370Q of the Labor Code,'for the performance of the work for which this p6rmif 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). —H-1-certity-that=in-the-performance-of-the-work-for-which-this-,permit-is issued— Ishall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ;agree that if I should become subjegt to the workers' compensation �provisions�of Section 3700 of the Labor Code; I. s l al �fo�Rt)with com`ply,with thos1'provisio n -s Date: Applicant ► . r I IN Warning: Failure to secure Workers' Compensation overage is unlawful and shall subject an -employer to criminal penalties and civil fines up to $100,000; in addition to the cost of compensation, damages as provided for in Section 3706 of the. Labor Code, interest and attorney's fees. IMPORTANT 'Application is'hereby made to the Director of Building and Safety for a permit subject to the conditions and . restrictions . set forth on his application. 1. Each person upon whose behalf this application is. made &'each person at Whose request and for whose benefit work is performed under or_pursuant to any permit issued as a'result of this applicaton agrees to, & shall, indemnity & hold harmless the City of La.Quinta, its officers, agents and employees. '2. Any permit issued as a result of this application becomes null,and void if work Js not commenced within 180 days from date of issuance .of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, .and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspect ori purposes.' j / `,..«• Signature (Owner/Agent)ent).Date- n PERMIT # BUILDING PERMIT DATE VALUATION I,$y i LOT ; TRACT M6101 JOB SITE ADDRESS ("—SW382 iSPANI +wfs APN OWNER CONTRACTOR/DESIGNER/ENGINEER Li7:N'117Xi Z34.dlrM 2.280 Nk.1,50 2.2go 1L'.ARJ)LG,%V C'ucu." Sum .150 CORONA CA 471720. 'CORONA CA 91720 t )��•19=gym CF L41 Y161 USE OF PERMIT ;31if�l i, �►i43:�3�ist , ;&`61.0kt1�tW i" 4# ?t't- `si.i Ci t�IFit� Al [ cJ ii u.i3 i i3 TJ.W1P01W0r SALES t ►F.fR; . a FEE MU'l) 49.1554 'VA.LL,fi'1 014 3,00.00 Ls w :Aa- D ii '. ° P i±ci�� A.�I' a ON CON S4110FC 1100 FIT, rw� -- MY:rC' 1,11,1C� A" : 1!t 1D1� t 1 �?0 gr.,�f1 • 4"7 E.Y.LCTRJC:AT.'Fr;✓ `.�: Y tgU a20-ftfl{D ' 27.32 : �,y <-! ^; 1?1 CJ1L#?1i'i�fii FTiB IC?:1_(YUf9 ,Y}}7.43rJ9J $27.00 wC1w€d. 1,nm__R8.111 LESS Sok E-P..rl D FEES .00 t+. RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings i Ducts Slab Grade Return Air Steel Combustion Air Roof Deck ; Exhaust Fans O.K. to Wrap ` F.A.U. Framing Compressor Insulation i Vents Fireplace P.L. I Grills Fireplace T.O. s Fans & Controls Party Wall Insulation Party Wall Firewall Exterior Lath , �1 3 —� Condensate Lines Drywall - Int. Lath Final Final: POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I 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) EEp tcss�8��-�`! R6qu�+zTs CITY OF LA QUINTA BUILDING & SAFETY DEPT. rt � APPROVED' FOR CONSTRUCTION &,q sei Ti cw— Coel . 6 ' or r - . 1 Z GUEST SUITE 2 UTILITY 9'-6' 1'-10' TEMPORARY SALES OFFICE A/C UNIT FRAME IN SPACE AT 14'x6' G.I. SCREENED 2 VENTS HIGH AND LOW --7 II II / i REMOVE DOOR REMOVE WATER HEATER AND PLATFORM OFFICE 1 10'-0' CLG B 28'-6' 5'-10' STORAGE SHELVES AND COUNTER BY OTHERS i I' I CO _ _ JyORAGE 0 10'-0' CLG 200 AMP ELEC SERVICE GDASeMETER � OFFICE 2 10'-0' CLG 2'-0' R-13 INSULATION AT ALL EXTERIOR GARAGE WALLS N -v O 3070 is >_ 3070 0 __ -- - _OPENING = ►- -- 8'-8' CLG - --OPENING—..-- OPENING_ ..- - - - - - - ----.I.. -- --- - - . -- - -- ... . o. . - - - _ __ _ -- - _- - - r j` ;I N Ir-------_---- ----------- — — — — — — - N I I LIGHT COFFER ABOVE I ,I 1 a — DISPLAY SHELVES AND I i I .I . �N I I TABLE BY OTHERS A -- -u-- SALES QFFICE� e A--1--�--- - ' I iI - - 10'-0' CLG L- - - - - - - - - - - - REMOVE. DOOR J ------ =----- 1 8'-8' CLG A A TO MODELS I AND DESIGN] I - CENTER I i ;TO PARKING 3'-6' I 24'-6' "2-6' . _NOTE: � � - .. :�,•. TRAP FENCE, REFER TO uJrjl AC.E'%�,f�_.IQ�tR�I� LANDSCAPE ARCHITECTS. DRAWINGS -rc��o-nQ a civ AI=`Fia�:�n FI� j I 1 in FLOOR AREA TEMP SALES OFFICE- 622 SO DOOR SCHEDULE SYM SIZE- DESCRIPTION O PR 3068 MULTI -LITE DOOR, TEI 3068 HOLLOW CORE WINDOW SCHEDUL, SYM• SIZE DESCRIPTION G 6050 MULTI -LITE WINDOW, O 2040 FIXED GLASS WINDOW 0 2040 FIXED GLASS' WINDOW W ?. GUEST SUITE 2 F=== TEMPORARY SALES OFFICE A/C DISCONNECT . A/C UNIT 1- — — — — — FRAME IN SPACE AT 1 i I 14'x6' G.I. SCREENED 20 VENTS HIGH AND LOW 1� (2) 4'-0' LONG tL r — FLUORESCENT TUBES. I I F I 1fHB C — S1TCJpA �� I ,' C' SOV REMOVE-DOOR OFFICE 1 1o'-O'u CLG E ' REMOVE WATER HEATER AND PLATFORM 10'-o' CLG OFFICE GUEST 10'-a CLG SUITE 2 OFFICE. 1. — — — 10'-0' CLG C'= ___ �--------- - __-------------- �� _ ` �- _ - I = _ -- �____--------------- --------------- =7=77 ___ ----------1 I r — � O 3070 - OPENING ' I. ---------------------------- �- 1 � I r (- DAYLIGHT - �I i I r— �i'd FLUORESCENT I--- -----, I n�-----------_M � TUBES 'LIGHT COFFER ABOVE. - \. Vr--DISPLAY SHELVES AND I ASALE$_QFFICEJ I I TABLE BY OTHERS 1W-0'.:CLG. � I _ CLG I — 1 o, ' �----- -�-u-- __ p _ - ----- �L---- REMOVE DOOR I UTILITY y