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9701-116 (RC)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury.that l am licensed tinder provisions of `Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is Aull force and effect. License # yriL�ic.-Ct�nass Exp. Date i9 /ate Signature of Contract�y 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 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). ( ) 1, 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 { q 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 sh II forthwith comply with those provisions. �te: �1APPlica�- Warning: Failure to secure Workers' Compensation coverage 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. ignature (Owner/Agent•) -.--- - �-.- ---p- Date ✓ PERMIT# _ °°NTR°`# BUILDING PERMIT 5>701-116 4 6 60 DATE VALUATIONLOT TRACT JOB SITE ADDRESS(-�y�%'��SMI<toltv31�Y1�'.t�t14 APN OWNER CONTRACTOR / DESIGNER / ENGINEER T:1f7 'C `UIiT'f T;tt . C -:M ELEI C; IT, IC 50449111 r"MHIW::IY3f+!' �I; HIC 41 BAIi.GN SS .L,AN L.r1. QT,3IWA CIA LAGUNA Nib M;I.. (`A '42677 (714)495-3773 (IRIN USE OF PERMIT cva_i,ii, i!i 811.1hiti X. 20, 46Ai ; sat' IV NO N W xLL. UL- 1,1r:01N' ON11 VS,1s S, 4.' i3ld!1�ta)oy�,�9.#t�3k-t+kt: l�c.C;K:f�1;�1�ci=)tJNly f':�).�;'D'.tfVrr# F3C Ji1�f�:i� JVSC)�jJJ; C�t.�)fvt/J'�'1,fEi ; 1l�it.f+1e! 11!`1 f, f� ►4 �ts� �.�. VA.LLIr'a.'F,.'OW i.f)(►i3.t> Llfi ' L��V g*�tY'gl'l A: i�ttt ♦W�/; !�! S�i��.��ti�7`L��.��r11„+9. i'�.A'4'�tl ��vyMOiY.i�i� Y.5sii:SJtVl:7��iit PJ A,114. HE+"K P1•Ti1fPj-C1tlU- ``;y=.39?Z ;F46 su C./ 19ft.rRl.ff1,00N $14-1 Igo l 01 00(1 000 frrl is31.(W113lNO F'ii%: Liif t?C}i1 i1' t3tla) $28.`iC! S°I=Ft )t�t:aA�C�t1h:?N av;0lk4M 1100-0(,134-241'-000 $1 lie'1't'11-A1.(°0NN'-11tfC1'i(IN ANt) PLAN C1'!Ff''fF 1 p I Jl��l 1997 3 . 1 1,i.I14�i1 ►�Ijp1i , : 01Wev�AY $235.35 RECEIPT DATE FINALED INSPECTOR 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 & Controls Parry Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Fin at Final BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam - Approval to Cover - Equipment Location Underground Electric Underground Plbg. 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 A 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: n ExIsTEY Hl N D I CA sc�i3 ASN L 10 pc[5"TJ� S cI g ANL , com BuSTI ON AIP, i-I�crfi LvW f!ex lo", oo SQ IN �1 VEFz-ncAL WALL NICU / ` A 36 — /,' ' I HOUR FIRE RATED f3oiLl`R RoaM (NEW ) I W-10'6",' L- lo' f4- 15' C� 1. 2-30" &:aMIN FIRE RA7c-:D DooR IWiTVI SELF CLOSING` DE-VIcs - i I it Z.2X4-X15 1 6 oc j U�- P_Om t1N E © © 50113 WASHMI, (Nr -W) j 3%3 4-1 i�yl240V �50 1-3A"P X14 1' ! j 5G L� I?RY1� gc,,coo 13T'u C NEW a , � � I20 V I � 10,5AMP 8,. VO4T Pr: NETRATTINq- THE RaoF i O 1✓xi-s7"�- CoNvlr Yop,, ISTD- DRy CLEAN i N�-�- j 800Lr..A FLc>oR N10 u N T1~ C> s7Z)Pa .� M U I M Etq T i I do V 1 10%5 AM p I� � I' it t' �JFMCVE NUN BEARINOr PARTITION WALL 3o'L'X15'H '1 W b0 HI BEAM o 0 �.� O i - C�LIN6- 1 Cs�L-uMN orENN INQ t,VALL 1 oD No M IBEA PUNG WALL I ; o• •wl`a LOAD SCHEDULE CIRCUIT DESCRIPTION WATTS w 1 1 P2012 LIGHTS 950 3 1 P2012 LIGHTS 950 5 1P2012 SHOWWINDOW 1200 7 1 P2012 I OUTLET 540 9 \ 61 \ 4323 11 3P20 6 DRY CLEANING UNIT 4323 13 / 6 / 4323 15 1 P2012 I BOILER 1020 17 2P2012 VACUUM 790 19 / / / 790 21 \ \ \ I 877 23 31`2012 AIR COMPRESSOR 877 25 / / / 877 27 21`2012 TOWER PUMP 998 29 / / , / •• 998 31 \ \' 1 s 2521 33 3P3010 ! SINGLE BUCK 2521 35 / / ! 2521 37 \ !�\ 1801 39 3P2012 WASHER(NEW) 1801 41 / /' / 1801 2 IP2012 iSIGN 540 4 1 P2012 ( BATH RM 1 200 6 1 P2012 )OUTLETS j 540 8 1 P2012 FORM FINISHER 828 10 1 P2012 ' PANT TOPPER 828 12 1 P20 12 COLLAR & CUFFS 50 14 1P2012 DRYER(NEW) 1260 16 1 P2012 CONVEYOR 1260 18 1 P2012 CONVEYOR 1260 20 2P2012 TOWER FAN 288 22 / / i / 288 24 2P2012 1 EXHAUST FAN 495 26 / 1 1/ 495 28 1P2012 ++'SWAMP COOLER 1260 30 1 P2012 ; SWAMPCOOLER 1260 32 \ \ ; \ 1561 34 3P2012 j SLEEVER 1561 36 / / :/ 1561 38 I r 40 42 I , TOTAL 125.9AMPS SUB TOTAL 16,774 17,887 17,676 TOTAL 52KW CABLE #3/0 VANEL "E" 200AMPS BUSS 120/240V 3PH 4W MAIN LUGS CONDUIT 2" i. . i DOUBLE 518 DRYWALLS oN cELINcT- I TYPE "K DRY WALL_ !' 136TH SlD5F Cf WALL$ , 16'' II o. C c � ► ! ,I ;j 1-4x6 H1=ADDER F6R Doo R_ I ANCHOR 804 syll, GL L Z S T 4" X 1-1/2" OUTLET BOX a4" X 1-1/2" OUTLET BOX W/MOTOR RATED SWITCH ®MAGNETIC STARTER W/OL M ® 4" X 1-1/2" OUTLET BOX W/DUPLEX RECEPTACLE Fs -sl 2 GANG WEATHER PROOF BOX WP W/2 MOTOR RATED SWITCHES DISCONNECT SWITCH a7 A< /—/—/--- HOME RUN TO PANEL. "A" 1,3,5 NO. OF CONDUCTORS INDICATED BY—/—/—/—(ie.3) CIRCUIT NO.'S AT ARROW