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04-4288 (RER)BUILDING & SAFETY DEPARTMENT P.O. Box 1.504 (760).777-7012 78-495 CALLS TAMPICO . FAX (760) 777-7011 LA,QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760.) 777-7153 BUILDING PERMIT Application Number. . . . . ., 04-00004288 Date 5/17/04 Property Address . . . . .. 54111 SOUTHERN HILLS APN: 775-101-041- - - Application description 'REMODEL - RESIDENTIAL - Property Zoning LOW DENSITY RESIDENTIAL Application valuation 8000 D e - Owner Contractor ------------------------ ---------- --- WO , PGA WEST RESIDENTIAL ASSN. INC OWNER 54320 SOUTHERN HILLS CITY OFLAQUINTA LA QUI NTA CA 92253 FINANCE DEPT:. , ----------------=---------- Structure Information -------------------------=- Construction Type... . . . . TYPE V - NON RATED Occupancy Type . . . . DWELLG/LODGING/CONG <=1011 Flood Zone NON -AO FLOOD ZONE - Other struct info .,. . . . CODE EDITION 2001 CBC Permit . . . BUILDINGIPERMIT Additional desc P Permit -Fee . . . . 99:00 Plan Check Fee,L. .00 Issue'Date Valuation . . . . 8000 Qty Unit Charge Per Extension BASE FEE • 45 ..00 6:00 9.00007HOU BLDG•21'001-25,000 Special Notes and Comments. r VOLUNTARY.SEISMIC STRUCTURALwIREPAIRS Other Fees .. . . . . . . . . .S.TRONG MOTION (SMI) - RES .80 Fee summary Charged. Paid Credited Due Permit Fee Total 99.00 .00 .00 99.00 Plan Check Total .00 .00 .00 .00 Other Fee .Total . .80 . 00 00' 80 Grand Total .99.80 .00 :00" 99.80 a P.O. Box 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: Architect or Engineer- AW �&LBf: I -I Architect or Engineer',17 Address: c. No.: C 1 9 � �g BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S 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 Clbss License No. Date .. Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their stile compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , B.8 P.C. for this reason Date �. b Owners_ WORKERS' 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 `or workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 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 int ce carrier and Ii number ar ,, ra er S i`R'Tt? rev, olicy Number ( gg 454 4L - 7Jab - _ 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 shou(�� come subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall n „) forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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 agre to comply with all city and county ordinances and state laws relating to building construction. and hereby authorize representatives of this county to ente upon the ove o property for' on purposes. `� Sig urnat a (Applicant or Agent): DAVE STEAVENS ,f Inspection Services PROJECT(�,� ADDRESS SLA- \ k \ nA N, -L BLDG. PERMIT # 0'A `14 �2 9,R ENGINEER ,, j S1,) w C T1, INSPECTION TYPE PROJECT # ;100 5- X-1 CLIENT_, DATE :215- -AvL C, a 00 -5 ARCHITECT 6 Lv-I CONTRACTORA-4,.6 r c INSPECTION REPORT FOLLOWING LOCATIONS EPDXY SRAPSON ETF. EXP. \ V_ 01S ' HOLES DEPTH CHECKED, BRUSHED AND CLEAN OF DEBRIS: APPLICATION AND INSTALLATION AS PER ICBO 4945 -t -� _j a�4: t_v�S �.�. s- 1y� Lr_rJ(_-r-A. �� ,��rh ey.T. MtAS.e�o�- a �u�S- lAot_c5- A Ll.. • �� �. '` 11.E � A LI�.S S ►� � tJR. i2. A.J A l �. i tJ v -' �.:..t'� rr. 1 t_:. r� I ' � . -30 Gam. �.) a � 5 IAT � - �,•�..�., �, :.t� QLL �00��li�\-AX,_S ip-f, RPbzV4v.3 b, _T*jStAt-A-ttok)-\'OvKJLc7 r CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted0 , substantially complies with approved plans, specifications,,and applicable sections of the building codes. This report covers the locations of the worksinspected only and does not constitute engineering opinion or project. control. CERT. NO. 0859348-50 DATE � � I _-C :2 INSPECTOR NAME DAVE STEAVENS (Print Clearly) INSPECTOR SIGNATUPE 4TT'--- to f & I iv. L.Vvj --- V77"il. "i I I U CTVI Dunn Saveft Im. 28&& CNMF&hMd3L Ocaaa offt CA -MG54 fell. t7fic) . %kfA-Q Fax: (M)MG-SM lea& TcL* .5taveHartioL.ReconstuctianMbjw4W.. Fm m:. RKEt411 -S&VC)1E of: PGA Viest ResklentW Association. Inc. Email: dM@suffdsi.=n Fax 76®-771-5676 Pages: I including cow sheet Phomr. 760711.1234.x'17 Datin Wednesday, OctPber IQ, c Re-. PGAWntRMW%.%MW�%&W"- Tho GAwfas (41 un1b) SUrgent 'M For Review D Phne CommentO Playa Reply® Please Recycle RE: Galleries RF1 4 8- Bldg type G3A, (SO) will Southem HRIS It is understued IhM eubmive upgrade interior &lishm occur In Wo locations that Impeft the Ins.taftficit (owner refinwWof Ownferenee& detail& Owt MqViW Interior access: EW&31§2.. 2) alt 1P2jM>tvw- It Is Undefstood that all the specAftd mpalm that could be accomplished from the, URN"Or thdvw rads ILM-00 lit-patf bnnet. Pleawbeffree-hrconct-me*youhwe-any"her-quesbom. 'Fina AkerRhat..