9603-089 (PAT)LICENSED CONTRACTOR DECLARATION
I i:iereby affirm under penalty of perjury that I am licensed under provisions c
Chapter 9 (commencing with Section 7000).of Division 3 of the Business an
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
678256 1 /9;1
;
Date, f ' I Signature of Contractor " °' '� `
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'
License Law for the following reason:
( ) I, as owner of the property, or my employees with wages as their sol
compensation, will do the work, and the structure is not intended or offered fc
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with license
contractors to construct the project (Sec. 7044, Business & Professional
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 declaration;
( ) I have and will maintain a certificate of consent to self -insure for worker:
compensation, as provided for by Section 3700 of the Labor Code, for th
performance of the work for which this permit is issued.
( ) I have and will maintain workers' compensation insurance, as required' b
Section 3700 of the Labor Code, for the performance of the work for which thi
permit is+ssue�q., Kyaorkers' compensation insurance cgryler,,Ayolicy 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 issuec
I shall not employ any person in any manner so as to become subject to th
workers' compensation laws of California, and agree that if I should becom
subject to the workers' compensation provisions of Section 3700 of the Labc
Code, I shall forthwith comply with those provisions
Date: Applicant C r � Y.—
Warning: Failure to secure Workers' Compensation coverage is unlawful an
shall subject an employer to criminal penalties and civil fines up to $100,000, i
addition to the cost of compensation, damages as provided for in Section 370
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safet
for a permit subject to the conditions and restrictions set forth on hi
application.
1. Each person upon whose behalf this application is made & each person
whose request and for whose benefit work is performed under or pursuant t
any permit issued as a result of this applicaton agrees to, & shall, indemnif
& hold harmless the City of La Quinta, its officers, agents and employee:
2. Any permit issued as a result of this application becomes null and void
work is not commenced within 180 days from date of issuance of sucl
permit, or cessation of work for 180 days will subject permit to cancellatior
I certify that I have read this application and state that the above information i
correct. I agree to comply with all City, and State laws relating to the buildin
construction, and hereby authorizefrepresentatives of this City to enter upoi
the above;mentioned property
yfor=tfispection purposes.
Signature (Owner/Agent) / �^,- ^-!�" Date,
Ift►x
BUILDING PERMIT PERMIT#
CONTROL#
2994
d
DATE VALUATION LOT TRACT
,
JOB SITE
ADDRESS 49-255 VU 401AMO
APN 1
OWNER
CONTRACTOR/DESIGNER/ENGINEER
SA11I IIANSON .
A'C1.AS AtVNINI COINiP.ANY
49-25513OL1r:RO
754 WILLLANIS kG)AD
S
IA?
PAW SPRIW-iN.
CA. 92264
(619,52 S466
f_'.IIL# 1825
r
USE OF PERMIT
d
S
4't1,`1'IO
LA.'1` CE PATIO
�
f�0ittvl frNA'I!t r MAN) SV
Y
s
1:b.1 UNIAWD COST OF COIN`STRUC"',CtON
4,256.40
PERM IT Ia'.1+E St1MMARY
111AN 01J:t:'Kn! _11"s 101 -WO -439-318 *+16.80
I,
CON.T1'dOX-11ON IMS 101.-000»418-000 s77..tlil
r
,
1
i
i
v
s
'
t
5111B IMAL CONSTI{:U010N AND PLAN CHECK
1I1'.80
LESS PRU-PAID FIRES
$000
y
f
- _ '1 YI'Ai,;1'Eatt►IUMMS DUE NOW
5.118.80
1 (,_ —.
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS 't
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 I 2102MYK,
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
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)
COMMENTS:
V .
ATLAS AWN:I=NG Co.
61'3278467
PARC LA QUINTA HOMEOWNERS ASSOCIATION
ARCHITECTURAL COMMITTEE
Heinz U. Hofmann
78-680 Maracas Court
La Ouinta, CA 92253
March 12, 1996
Mr. & Mrs, John Hanson
� U2F5�5 via Bolero
L a, C 92 53
i
Dear Mr. Hanson;
Thank you for allowing me to visit with you yesterday to have a look at the
proposed Patio for your home.
The committee has approved your plan as submitted using the Alumawood
in Desert Sand color to mach your stucco exterior. You also stipulated that
you will have plants Installed on the side patio to assure privacy as'the vines
attach themselves to the lattice alumawood covering the sides.
You are to finish the project within 90 days of the city issuing you permits
to construct the patio cover. Your contractor must insure that all proper
permits are In place. _ .
Sincerely yours r
r"
Ho �an n�
cc: Cam Anderson
Avail Property Mann,nt
.'