0102-166 (SPIN)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 Exp. Date
Date 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:
( ) 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
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: 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 10
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 inspectiori purposes.
Signature (Owner/Agent) Date ;
BUILDING PERMIT PERMIT# --
DATE / VALUATION LOT ()102-166 TRACT
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JOB SITE
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ADDRESS
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OWNER
CONTRACTOR / DESIGNER ENINEER
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USE OF PERMIT
RE, QUESTED SPECIAL INSPECT1014 01PSM BY OWNER.
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'RECEIPT;
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DATE
B 4
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DATE FINALED
INSPECTOR
y
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 & Control
Party Wall Insulation
Condensate Lines ,
Party Walt Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
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 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
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:
-
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
March 14, 2001
Mr. Andreas Angelopoules
53-065 Avenida Diaz
La Quinta CA 92253
Dear Mr. Angelopoules:
(760) 777-7000
(TDD) (760) 777-1227
Per your request, a special inspection was performed at the above address and the
following code violations were observed:
1. An fold down ladder had been installed in the garage to access the attic
area above. This in. and of itself is not a violation, but the ladder is located
in the fire assembly that separates the garage from the house and the
installation has diminished the integrity of the.fire separation. To rectify the
violation the ladder should be removed and the opening covered with 5/8
Type "x" drywall and the joints taped. If you would like to keep the ladder,
as an alternative, 5/8 Type"x" drywall with taped joints may be applied to
the garage side of the entire wall which -separates the garage attic from the
house attic.
2. A patio cover has been constructed without a permit in the rear setback
area. This violation may be addressed in two ways. The first is to remove
the structure completely. The second is to cut the structure back so .that it
is at least five feet from the rear property line as required in Section
9.60.040 of the La Quinta Municipal Code and Charter (Attached).
3. A flourescent fixture has been installed above the outdoor spa in the
aforementioned patio in violation of Section 680-41(1) of the California
Electric Code (Attached). This fixture must be removed.
I understand that the aforementioned violations were existing when you purchased
the house. I will be happy to work with you to develop a schedule to gain
compliance, but these items must be addressed as soon as possible. Please
contact me if you have any questions regarding this issue.
Sincerely,
Tom Hartung, Director of Building and Safety
777-7013
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