0108-281 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
ChapteN (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
11633811
Date " •? " ? Signature of Contractor / f -�
„-....�,,,_,_,t r
OWNER -BUILDER DEC
I hereby affirm under penalty of perjury that I;,am exemptJrom 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. Jor 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
S c ion 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.
14KNI'M S Col ZW,2"001;
(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
hJthose provisions.,
Date:-'' Applicant ,,-^`
r
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/A ent , Date EA •'� � ' f � f
BUILDING PERMIT PERMIT#
,
DATE 1 VALUATION LOT �-aArA/ll
TRACT
$320, 7. Ztf �- i ` "
28444
JOB SITE ,
ADDRESS- - — -
APN
OWNER CONTRACTOR/DESIGNER/ENGINEER
C APIVIK)gn C3ftTW3 Wfq;sr, L11C T.NNOVrAATIVE MSOWr CC?lvS.i [T:4.OVi188, WC.
200 X WJ01—TaWT014 AM, VM. 1 UC 200 In- WJ 7M- -K—r N' AVk it100
&SM)IMID0 Cj%- .92025 RSCONDI 0
CAS 92025
C7W)83P,8238
CBTh 54,13
USE OF PERMIT
ODMIS FAN
Sn,' - PLAN 2.2fi IX_)P V. PERMIT .00E -SNOT INCI UDE PdOI.&PA
OWCY WAL10 OR DRUVEWAY APPROACH
AUG 2 9 2001
CTM OF LA QUINTA
CUSTOM t: ONSi'R5)CTICiN �006.90 ,V)
FINANCE DEPT.
POP,0WRATIO 799.00 SY
0A13.AWS ARPORT 738,00 S
j
CON161 RUCTIf3N1IEE 101-M-418..000 $1,4133,00
PLAN CHECK ftZ 101••000.439.318 $11,145.51
MECHMIC'.A , !?Twit; 101.000.421.000 3111100
ft, .l:/�:;TPJCAL, ITH9 '101-fICM-420-000 $224.12
1'141a1'f:113C np, 101.000x411.000 3705,75
STROYNO MOTION FEE, . PMIFJ 101-000-247 -000 $37.08
ORZ,AI IDG FRX 111.000.423.000 $2.0.0
41MAS'I'RUC'I'13i't FEE 225-000-443-34.2 �I,�tCf 7:ffp
A 1CT M PUBLIC PLACES - 1 IEZIC Z/0.000-44.5-000 $301.97
'.�YtI3i_'.(X.''WA, Cg1+is1'1°IMC^!.`l'C33tiT MID 1>1:A)IT OBE1:C;K
T5,360.4.3
MEW PRF,?AFD:PTM $0.00
RECEIPT
DATE
J" 7 , /
BY
I IN PE R
xiAty?'t•
��
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
/�
Underground Ducts
Ducts
Slab Grade
_
_
Return Air
��
Steel
Roof Deck�8
j)
�(
Combustion Air
Exhaust Fans
O.K. to Wrap
b�
6 N
F.A.U.
Framing
_
Compressor
Insulation
/ �� 6y
j
(¢/
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall Int. Lath
-
Final�l0
Final
V 0�-
_ _
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
_
9/+/1��
Electric Final
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
/ 3 Z
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 Y
Final
Utility Notice (Perm)
4
CITY OF LFe
�BUILDING & SAFETY
OF7 k NIEf�T
777`012 r�.. =! /�;,,• •ii
INSPECTION RE@tJE,t"�LN,
777-7153 4 yC
,FSI. �•
Owner CAPSTONES GOLF WESIT UC
Contractor INNOVATIVE RESORT COMMUNITIES
Permit Number 0108281
POST ON JOB IN CONSPICUOUGO PLACE
INSPECTOR MUST SIGN ALL APPLICABLE ;;PACES
JOB ADDRESS f-80-580 WEISKOPF
SFD - PLAN 2-28 LOT 57. PERMIT DOES NOT IN CLUDE
BLOCK WALLS, POOL/SPA OR DRIVEWAI' A1PP.ROACH
TYPE OF INSPECTION DATE INSP,
FOUNDATION & SETBACK
FOOTING STEELT"--
MAIN GROUND SYSTEM ;
GROUND PLUMBING
PRI=-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS bEI:N,S
CONCRETE SLAB
JOISTS & GIRDERS---"
ELECTRICAL GROUND WORK ,
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC I —T' i
ROUGH GAS & GAS TEST
HEATING & VENT- A/C
ROOF
BOND BEAM
D.K. TO WRAP 2
GROUT D 4' O 8'
INSULATION o
PRE -ROOF
moi, h ',' 1;..1^--•
COVER NO WORK UNTIL ABOVE HAS BEEN SIIGI4ED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER —
POOL FENCE & GATE
SEWER SEPTIC TANK p?r
FINAL5 „ r' \
ELECTRICAL
FINAL GAS TEST
HEATING • AIC
HOUSE NUMBERS
JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDERIGH7'm
t�
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
Owner of Building: CAPSTONES GOLF WEST, LLC
Building Official
80-580 WEISKOPF
vnl
Bldg. Permit No.: 0108-281
Land Use Zone: RL
Address: 200 E. WASHINGTON AVE, STE 100
City: ESCONDIDO, CA., 92025
By: DANIEL P. CRAWFORD JR.
Date: 9/6/02
POST IN A CONSPICUOUS PLACE