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0304-133 (COMM)LICENSED CONTRACTOR DECLARATION y I hereby affirm under penalty of periury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Buslness:and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp: Date 1"'^. ..�� Date Signature of Contractor 11 1 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). ( ) 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 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 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 person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subjecilo,the workers' compensation provisions of Section 3700 of the Labor Code, Is 'l ftorthwith comply wit h those,provisions Dater Applicant 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.. Signature (Owner/Agent)�+_�~ �-^ Date PERMIT# . - - ' PERMIT /BUILDING DATE LOTTRACT t y. / EVALUATION JOB SITE ADDRESS 60_3il ',1 C)ay P.J Ay ': All OWNER CONTRACTOR/DESIGNER/ENGINEER SI-i1~'.A HON.ifa,.'1 8) -260 .AVE�= E2.. fi i �264� Au t�lcrwr a .C:l+. QURM CA 92883 T., A QUW.+A C.P. 92$83 (909)833=8995 CXAIA USE OF PERMIT C:E)1viltr9MCML GOMM> � 2,319 SC2,F"3'.-SF�Hrt�i7.,:� ci-`l�o L9CC;. 7'Y1�LClftd:°t11VS'J'R. . SP4 INKLERED. IaFRhVT .Db..F v NOTINCLUDE I3.1=K WALLS, POOL l' R ; SOPA. FORCHYRA TIO . 13100 SF• . SPRIN1C:I YER i 319,00 SF' .. Al•C , COMM:ERCI.AL . 2 39.40 SF F 1«:03+17'12ACT AMPU14T IV,313.10 U9 :ES'nAJ,�t�'TFD COYr OF C:0Vr_nWC7W073 CONSTRUCTION FEE • • 1f?.) -000-416-001 �7;t iso ' 1;LAt4 CFiE:CIC �Ff� 1011-001114119-318 $653._i7 M9CHANIC AL FRT 101.000.421-000 $43.00 F1-ECTRJCAL, ;PSE 101-000.120-000 $121.30 PLUMBING ME 101-000-419-000 mom ST£ OHO MOT1014.FEE COMM 100-000-241-000- $29.64 ORADMO VKX 101.000-423.000' $15,00. 13EVE1.f. PER IMPACT IME $tti31.66 ART IN PUBLIC PLACU - COMP 270-000.415-000 ;�. MUB-TO'i.!'1L CGyAtMUC7I0N AND PT CHECK $7,M,64 r 1i6FENS I 1 L�8•lVY 13�: 5YL AUG 21. 1003: . CITY.OF LA QUINTA /. FINANCE DEPT. ✓ RECEIPT DATE BY DATE FINALE D INSPE TO 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 Wall Firewall Exterior Lath Drywall - Int. Lath Final Final z a BLOCKWALL A PROVALS 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 r 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 y i Utility Notice (Perm) COMMENTS: L' Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning r. Beaumont ee Cahmesa .;. . Canyon Lake .;. Coachella .;. Desert Hot Springs Indian Wells 4. Indio .;. Lake Elsinore ,. La Quinta 4. Moreno Valley 4.1 - Palm Desert 4• 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 Marion Ashley District 5 .RIVERSIDE COUNTY FIRE DEPARTMENT „J In cooperation with the California Department of Forestry and Fire Protection 82-675 Highway 111, 2nd Fl., Indio, CA 92201 • (760) 863-8886 . Fax (760) 863-7072 April 12, 2004 Williams & Paddon 2237 Douglas Blvd., Ste. 160 Roseville, CA 95661 Re: Non -Structural Building Plan Review LAQ-04-BP-059 / Spa Bldg. @ Trilogy Fire Department personnel have reviewed and approved the plans you submitted for the above referenced project. Please be advised the following conditions apply as a part of the conditions for the issuance of a building permit. 1) Fire Department approval is based upon the 2001 CBC requirements for Group B occupancies. It is prohibited to use, process or store any materials in the occupancy that would classify it as a Group H occupancy per Sec. 307 of the 2001 CBC. 2) The Fire Department is required to set a minimum fire flow for the remodel or construction of all commercial buildings using the procedure established in the 2001 CFC. A fire flow of 1500 gpm for a 2 -hour duration at 20 psi residual operating pressure must be available before any combustible material is placed on the job site. 3) The required fire flow shall be available from a Super hydrant(s) (6" x 4" x 21/2" x 21/21) located not less than 25' or.more than 165' from any -portion of the building(§) as measured along approved vehicular travel ways.. 4) Install Knox Key Lock box, Model 3200, mounted per recommended standard of the Knox Company. If the building/facility is protected with a fire alarm system or burglar alarm system, the lock boxes will require "tamper" monitoring. Special forms are available from this office for the ordering of the Key Switch, this form must be authorized_ and signed by this office for the correctly coded system to be purchased. 5) All egress doors shall comply with CBC Sec. 1003.3.1.8 for proper door hardware. 6) Install portable fire extinguishers per Title 19, but not less than 2A10BC in rating. Contact certified extinguisher company for proper placement of equipment. 7) 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. Building address numbers shall be a minimum of 12" for building(s) up to 25: in height, and, 24" in height for building(s) exceeding 25' in height. All addressing must be legible and of a contrasting color with the background. 8) Electrical room door shall be posted "ELECTRICAL ROOM" on the outside of door. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE 82.675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072 te.of OccupancyCertifca o o t y' Buildin ' & Safety Department14 : E .., This Certificate is issued pursuant to the requirements of Section 109 of the California Building x i� Code, certifying that, at the time of issuance, this structure was in compliance. with. the t r provisions of the Building Code and the various ordinances of the City regulating building 4� construction and/or use. { BUILDING ADDRESS: 60-311 Trilogy Parkway i z` I Use classification: Commercial Spa Building Building Permit No.: 0304-133 t i Occupancy Group: B Type of Construction: VN Land Use Zone: RL Owner of Building: Shea Homes Address: 81-260 Avenue 62 City, ST, ZIP: La Quinta, CA 92253 ,��.. By: Gary Hartman Date: 5/21/04 Building Official d POST IN A CONSPICUOUS PLACE � i