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0112-090 (RC)LICENSED, CONTRACTOR DECLARATION I hereby affirm. under penalty of perjury,that;l.Iam 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.'ulass Exp. Date -Date ' ^ Signature of Contractor—,+ 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: ( ) I, as owner of the property, or my employees with wages as their sole compensation, willydo 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). 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 Sk $ :f a FOOD, Policy No. IMM -00 (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. I ,/ Date: ;, Applicant .�.. �_ l 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. :r 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/Agent). ` `• Date BUILDING PERMIT PERMIT# DATE VALUATION LOT \ (H 1,2.4ft TRACT JOB SITE APN ADDRESS AAVE N -MA MIA a°0'�.�- $102 _ OWNER CONTRACTOR / DESIGNER / ENGINEER Imo,quorrA CA 92253 :iAQt:.I%NTA, CA 9225:3 x:9131 226 USE OF PERMIT TPANT .1MPRCNEMia4 d' "3*UZTZ 101 (11 P714AL FXND 0 SHEA. t;;E?25'J':tZACT AMOUNT. 4000,001° C<.d&.p.'f3:it:+' COWE°�!o:4;Pf;,;YI1'- ON r3�•fyta'�'�.IXR.tTM'O Sy7C7.4,'�"�Yp ,tV��S�. iP Ol.WA77df.W.PT:. S� PLAW CHEM W., 101„000_4391.318 $46.80 CLIMS'd RUCT1ON FEE, 101-00.0.419.000 $71.60 El LEt,:i`AICAL FEIR. 1014)00,420-0001i 5 C` Xa DEC 1 Wtl OFLA'bYi✓IRTA 9' . ffU.8_T(Y7A L:ORMOC:`:9 OM N"D'PLAXTC REW $1?2.65 -xr& lmafflT _mm mr Now RECEIPT DATE /rr BY DATE FINALED INSPECTOR rr 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 ��, �2� Insulation Compressor Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall ' Exterior Lath Drywall - Int. Lath Final FinaJ 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 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 Te p. Power Pole Und'srground 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) �l� , j•OZ COMMENTS: -. •t• .r• - t h^A., ir« + + t t « • a ..xr., „P, �•ts» fh•r _�a Y-t,'1Fr, #, �t,� •t .. f - .1r y.: } - • •S 1 ., r V • {. a •- .. 'k;, i . ].. f '4y "' tet., t,�*. ` , .:r r • f+ Y`, r •'a. )• � , • • ,- ; _ ♦ � . a, JT., 1�"' .T _ . ., + 1'' �., 1 1. - T. •` :r i, .. f •{ , •./? * • « ty pP ,;i�• •* a •. �. ' - 1-� 4. y ♦ • 4. ii _ S `►',+'.- • to 1 ; . . - . _ 'c i . t ..� . .t .. r - r •. e.'' r. + ^ M e L , s r ! - `,p•♦+ - 1. r r e p i :', _ v` -'Y !` : * `L. - ` i,. 2110'. ` - 'tet. �� a'f - '.tom.{• `" • • A '" : •z - ! .-.....`._"k ,r' .t, y:• ,-a ..5'iY ` �. • •`'� ., � -.. .�/'. L � { *i r j.t I. 1s •, • r ,r `'.i, 'Y, ^� . • , R� • - - Y- a+. . /i,F• ` r , `• - 'g .. y• I .. - • �;. # .. � r . } •. 4 +r p• 9 f r r', J .m w •f+� ' - .- J� - 1 i3 _ + . f % M EXIST.DOOR - I •, .t � I 1t T .. .:}i•�. F ' '' .r f t ,,. - � ` M � r _ , , -_ �' 3 ' .., ♦ - � N- Y i` `t'] J.• , i ^ .. + -�., a • t`. f • • c �,. . *: _ O - •' x' w• a t° 3068 DOOR � DOOR _— 13068 DOOR.. ..c ' • ' r t4 t f- 0 + _ I '�. a• M' •..; rte• �, ', J 4 �f'T.��L'_I ,R , ' OFi �� r / x • - � . .a.'i ` .r . w. , •4 w� w �---��_•.�-�--� ` �,. " w r ., •1 14 , ,t t .© f - a` , PROPOSED WINDOW EXIST.WINDOWS \fir 'WINDOW DELETED EXIST:WINDOWS' ♦ s 1 10'0' "-----=-- 9'0' ; —fit 12'0 •' NOTES r r • 2X4 'FRAMED .INT' WALLS �: _ REINSPECTION FEE OF -$30 CITY OF LA-QUINTA - - { •Will BE CHARGED 1F THE APPROVED BUILDING;& SAFETY DEPT. r f'1/2;' INTERIOR DRYWALL- R PLANS-AND JOB CARD.ARE' NOT ON 4 i :�TENANT(IMPROVEMENT SUITE 10.1 . $ a • ". - � THE N • SITE 'FOR A SCHEDULED .� - ' + �^ - •. c SCALE:, 4 ;APPROVED BY: , ~' - DRAWN BY 2 COAT SYSTEM TAPE SRRAY,ORANGE PEEL INSPECTION.' - OR`CO STRUCTIO I r - . .NOEXCEPTIONSI, ` - " - DATE: .�•. - REVISED • a. r i'<. '"` t ' • ,'�. - ..`., ~ ; - •` ,. '-' n� i DATE Z BY E; • _- 1 F' . :� Via, . r ♦• jt.. .R « 4 - ;: :1 CORONEL'CONST.'564-4604 + . 4� / t" - R _y �• , ..T l f'•43{ OW �..`%�- T/y�'r//,t1V t��bd J�^•I_ .� r:,. _ .�.: �•- I��•Q,J {/� rR � � a• �, �'�t apr to _Z A err" r�r.° :t t ,t _ �r �* t• r '�•t`-s + �/ • ^.� a- .. _ -- r :• rFr .. .. r - _- lip )jj::� #a • .•Fr r � i ,' ,. 1 .' '' �,t < <.. '4 1;� � ... c ^/` - ' 7 • }'y • L � { t4 F' '� �. ♦ t�. • .. , � � . ► t r • +dt�,�Ce l t r' DRAWING NUMBER '' — _ "'• - - f r e 1 "' i ` r f 7nevS e���' %� QAC % -11 ' ..4 • _a1 "•' ' t F r{ F• « a• ,�.� ,;rS ( "� - -;- .i .e' - i .I,. . ar - , r � R � L- -ia Fir cti.W D��V'i.i /� W� J . - a•_'4 r't` :. .- .'�:�' +[.. '°• `� .. h F s