9609-022 (3&4)-LICENSED.C6NTRACTOR DECLARATION
.11 Hereby affirm'under penalty of 'pe'rjury that I . am licensed under provisions of
=-C hQpter 9 (commencing with Section 7000) of Division 3'of the BuSIn6Ss'and .
Professionals Code, and rhy License- is in full force and effect:
License # bass Exp
..Date
/ateContractor ate Signature
OWNER -BUILDER. DECLARATION
I hereby affirm under penalty of,perjury that I am exempt from the, Contractor's
License Law for the following reason:
1, as owner of the property, or my employee's, With wages as th`6ir-.sole
compensation, will do the work, and the structure is not intended or'offered for
sale (Sec. 7044, Business.& Professionals Code). -
1, as owner of the property, am exclusively. contracting, with'..licensed
contractors to -construct the project .(Sec...7044; Business & Professionals
Code)..
O I am exempt'under Section B&P.C. fo . r this *reason.
Date —Signature of Ow6er.
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of.. perjury - one ofthe following declarations:
maintain I have and will, a certificate of consent to self -,insure foi,.w6rkers'
c6m:pensati6n, as provided for by Sect'On 3706-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 requi4d'by
Serction 3700 of the Labor Codb"for the *performance of the Work-for.whibh this
permit is issued. My workers! Compensation insurance -,carrier & policy no.. are:
CaAer Policy No:
7-,
(This section need not be com pleted if . the permit Val uation. is for $100.00 or less).
O 1 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 t ' o - the
workers' compensation laws of .California; and gree thatT.a `if,k-shobld� b ecome
subject to the workers'*compensatiomprovision"i of Section 3700 of the Labor
de,.l shal14ort6with comply4itwtliose p
rovis
/)at6: A9Z �pp icant -
I 1�.- 41
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties ancicivil fines up to $1'00,000,"in
addition to the cost of compensation, damages as provided for in Section .3706'
of the Labor,Code, interest and attorney's fees.
9
IMPORTANT App lication is hereby rnade to the Director 0'f'. b6ildin' an&S4fe`t"
y,.
for a. permit. subject to the, conditions and. restrictions set forthon his.
application.
1. Each person upon
on Whose behalf this is application is made & eactiperio6 at
whose request and for whose benefit work is performed under or pursuant.to
any.permit issued as -a resultofthis applicaton agre6s to,* & shall, indemnify
.&.hold harmless the CityofLa,Quinta, its officers, agents and.employees:-
2.'Any permit issued as a result of this application becomes null and. d void •If
work is. not commenced wi ' thin .180 ,days from 'date of ' issuance . of , such
permit: or cessation of work for'l 80'.days,will sUbject'p6rmit to"danc'ellation'.
1,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 othe-building,,ec
construction, and hereby authorize representatiVes".of this City to "enter: upon.
the ave mentioned 'property for* inspection purpOSes.,,�;X
-(Own
,
6?/Agent)`r�'�,� '�'Date
6ature
<. 4,,;
PERMIT# CONTROL#
` .BUILDING PERMIT ow)zq�7, % . -
..3934
DATE VALUATION 4,0t) LOT' A�%,DGT -
_�"9/06 .$43%14, TR
L4-
,ibB SITE
S '(010N -0,4
ADDRESS rAl-701 WM RtNt wr�406
APN. .,7 94) 040
OWNER
CONTRACTOR/ DESIGNER ENGINEER
• 'A Pr
US T FLIN, D
A P W P V. K TIES,
2200-81)OUGLAS #450
(IA 96551
USE OF PERMIT
a, 0a P ma's 4.8 ry
YR'Aq1'0ONSTR1iUfJQN 7;£s880)
GARA0MMPM -c6
a
EffrMAXED C09f OF CONST9.WrION
439 .748.0
cowagumowrvy, 101-OW419-0' $109.,50
Calfs -01.4
101,000-420-000 $A71.60
tOJ-000-4,19-M)
3.97
920.00"
�.7,54)00.44_ 3Q. 6,400,00
:Sua-IxAm. .'CONS 11kU0iLV AN.0 PLAN CIMCK.
$14,,622.93
LESS PRE -PAID PEPS
4250.00
Ft Y 4.10TAL PIP R M117 FE1T,$'9lIJC ISIOW
S11,37.2-93
a'
PtCELRT-
DATE
B. , DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Stab 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
UL Ivi
POOLS - SPAS
BLOCKWALL
AP ROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
4L
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
//
Neater 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
COMMENTS:
'
Final
Utility Notice (Gas)
ELECTRICA A PROVALS
Temp. Power Pole
Underground Conduit (p
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)
I a
5 s
i °SOF
U
Owner
CITY OF LA QUINTA y'
BUILDING & SAFETY DEPARTME '4
777-7012
INSPECTION REQUEST LINE
777-7153
Contractor U.S.A PROPERTIES �' I �` 199Q
U9609-022 !AIfz!r1, rpri-
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 50-701 WASMNGTONU, O
TYPE C UNITS 1-8
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS B ENjASIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK /7/7
T POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVERA40 WORK UNTIL ABOVE H#EEN SIG
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
L FENCE & GATE
EW PTIC TANK -0 /p Qi. 11-7
FINALS
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
1/96 TURN ON UTILITIES OR OCCUPY BUILDING
vc
Occupaefncy
Cityof La Quinta
Buildin and Safety,Departmen 4'M OF °
g
T ,his 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: 50-7.01 WASHINGTON ST. P-16
Use Classification: MFD Bldg. Permit'No:: 9609-022
Occupancy Group: R-1 Type.of Construction VN. Land Use Zone. CN n
Owner of Building: USA PROPERTIES A , Address: 2200 B DOUGLAS # 150 "
City: ROSEVILLE, CA. 96551
By: PELLETIER
Date: 6-30-97
Building Official
�. POST IN A CONSPICUOUS PLACE O`