0008-302 (COMM)LICENSED CONTRACTOR DECLARATION
I
he 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
l/A#e�+ (tttnLic. Class Exp. Date
04
/
,,D ie �� w D Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason -y,,
( ) 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).
( )1 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.
%Q' 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.
i`
(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
subject to the workers' compensatIgn'provisio -s of Sectio(/0 0 of the Labor
Code, I sfl fl fo kith comply with those p ovi '
11 c
[ °�,
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 auth9rin reprTsentatives of this City to enter upon
the'above-mentioned property for iq§pec Io pu�rppoys•es. /1.0" /;
Signature (Owner/Agent) :� 't Date'/ 2�/1(�
�+
BUILDING PERMIT PERMIT# If •5
'DATE VALUATION LOT 0. 6 TRACT
JOB SITE
APN
ADDRESS
:1
217-.37,9 ST AMM -W5
t
OWNER CONTRACTOR / DESIGNER / EN (NEER �• • '
MIMI
MERME CA. 925(M ]RIVERITIDE CA 92104
(909)M4-0840 OUR 5357
USE OF PERMIT
•N4aGoi A'AT�).L_�n .•av n ,
.3'C7�,.. .vel.' wSa
HZRM13.d%.CY }: ,P00L BYJI .,,1)11;0 CSC 08 i:LiDE t.iPI.).P TE ;
Ar�C;Poa (
r��-,rte �•�; �r3'�d; y�
• K 1
T
OAf" Cff: l" Sri
,
ESTWKM COST OF CONMIi7'MIGN
G,��' w
(`0N J:'RUCTION FEE 161-000.416.600 $90.00
PLAN CfiWYi; VES $109,222
MECHANICAL F U, 101-M-421-4100 S-20.09
''!.'i*1CA L FM 101-000-420-000
%J91"?
1;[.,tJMB1'NG yea 101.000.419-000 $126,00
..
STRON'O MOTION "Z 4::i MA4 100-.000-241-000 SIX
.
C#,R ADIFI G FRE 101-000-423-000 $201011
laRT .IN PUBLIC PL AC%13 - COM? 701-000-253-000 $31.75
-'COTA L CC3MMUC^UOIT AND MAN CIMC
$426.76
LESS P=- -FA3D IW3
50.60
RECEIPT
DATE
,BY"
I DAT INALE
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms &Footings
Ducts
Slab Grade
�/An�
Return Air
Steel
Combustion Air
Roof Deck
_ _
Exhaust Fans
O.K. to Wrap
Framing
_
//b
F.A.U.
Compressor
.Insulation
2�/a�
Vents
Fireplace P.L.
_
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath5-
Finalaa/(���Ot��O/1%
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
Gas Piping
PLUMBING APP OVALS
Gas Test
Waste Lines
/
�OJ1�(}
Electric Final
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral_
&I
Pool Cover
Sewer Connection
3 i0
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)
City of La. Quinta
Developers Project Approval Form
�j
Prior to the issuance of Building Permits for the project listed below, the following Departmental
clearances must be obtained. Please return this form to Nickie Gormley, Building and Safety
Department only after approval. Contact applicant for resolution of conditions preventing or
delaying approval.
Project: Pool Building located at 57-320 St Andrews on PGA West
Tract 28603-1 Lot E
Applicant Contact: Dan Beal. Steven Walker Homes. 909 784 0840
Applicatio / Circulation Date: 8/21/00
Date
C Development Department
a �
Christine i Iorio, Planning Manager Date
Public Works Department
Steve Speer, Senior Engineer Date
Building and Safety Department .
Greg Butler, Building and Safety Department Manager Date
Health Department
Date
Fire 'Department
Date
Schools Fees Paid
Date
i
i
S
P")66A'C-U3�s
City 6f La Quinta
Developers Project Approval Form
Prior to the issuance of Building Permits for the project listed below, the following Departmental
clearances must be obtained. Please return this form to Nickie Gormley, Building and Safety
Department only after approval. Contact applicant for resolution of conditions preventing or
delaying approval.
Project: Pool Building located at 57-320 St Andrews on PGA West
Tract 28603-1 Lot E
Applicant Contact; Dan Beal. Steven Walker Homes. 909 784 0840
Application / Circulation Date:
Community Development Department
Christine Di Iorio, Planning Manager
Public Works Department
c
r
St e Speer, Senior E gineer
Building and Safety Department
Greg Butler, Building and Safety Department Manager
Health Department
Fire Department
Schools Fees Paid
11
Date
Date
Date
8/21/00 YX
Date
Date
Dat
Date
III
IN
Certificate of Occupancy
City of La QuAwnta
Building and Safety Department
This Certificate issued pursuant to the requirements. of Section 109 of the Uniform Bui/ding. Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating bui/ding construction or use. For the following:
BUILDING ADDRESS: 57=320 ST. ANDREWS
Use Classification: COMMON AREA POOL BUILDING
Occupancy 'Group: B Type of Construction:
q
Owner of Building: STEVEN WALKER HOMES
Building Official
Bldg. Permit. No.: 0008-302
VN Land Use Zone: RL
Address: 7161 INDIANA AVE
City: RIVERSIDE,,CA., 9.2504
By:. BILL GORDON
Date: 4/22/02
POST IN A CONSPICUOUS PLACE