0308-307 (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 r:'�. +r• s�Y 7�
Date Signature of `Ownef 7 • ^r•.e +- - fwa
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).
(4, I certify that in the performance of the work for which this permit is issued,
Gall 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: r. ` Applicant r. -, •� . (. ! 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 11810" -days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that.l 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) x <�� �_� ^''� Date 11
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 307 TRACT
JOB SITE�p�•�•7 p
ADDRESS 55x_999 AvEx ¢dl„fARF�9.. - •
APN
'. .. ..
OWNER
CONTRACTOR/DESIGNER/ENGINEER
; ONME BRADY .
O/B
51.89 9 AVE.M. ),F?t, VT1J_Sk
LA.QUMUA CA .92253
i C11I1ff
USE OF PERMIT
SPECIAL IAIS,PRCTION. FJ FCTRJCITY OF? OVER a YEAR.1V1NSP:f:C.T1014
' REQUIREM BY Ilia PRIOR TO VhLT?,GTZ f!0X
ESTn"INED COST OF CO1TTrH.UC1Vn0,N,
00)
SPECLAL INSPECTION ION 101:-000.423.000 $I01100
r
4i3 U'I•A)(. CJ1•g'.S`i I a A� YiJ�7Tt?,��IC.�.Agqi�T��yyC��HE&Z
$;7 b�0.00
�+{ [ �'q
' • J.rY:+IJ 3"1:4i:*.FAID 8°.I:ela S
MOO
TOfAL, PFA.1VU'1.': 't'v-1:','S DVE NOW
$14M.00
! •1
RECEIPT'
DATE G �' BY
lej--__ .
DAT INALEDo
i
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
Party Wall Insulation
Condensate Lines
Party Wall 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 Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping z
Plumbing Final .
Plumbing Top Out
Equipment Enclosure
Shower Pans a
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:
�;
t
.
78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 (619) 564-2246
December 31, 1987.
Mr. Curtis Sadler,
.c/o -Darlene Sadler
11087 Cholla-Avenue
Morongo Valley, CA 92256
NOTICE AND ORDER
The structure located at 51-899 Avenida Villa APN #773-182-01841
Block 119 Lot 6 -has been determined to be dangerous in ccordance
with Section 30216 of the Uniform Code for the Abatement' of Dangerous
Buildings. The building must.be vacated -..,and remain vacated until the
following conditions have been repaired' -or removed.
1. Electrical wiring serving the spa.light as -well as pumps and
motors including conduit to;the service panel'.
f - .
2. Electrical connections under the.kitchen cabinets serving the -
dryer.
3. Wiring at.,light fixture in laundry area is short circuiting. "
4. Isolate and,repair short circuit near refrigerator and kitchen -
sink.
5. Washing machine must be-removed.or'proper plumbing installed for
machine discharge.
6. Vent dryer to outside.
Any.person having.any record title or legal interest in the building.
may appeal from:this Notice and Order or any action of the'Building'
`'Official.to'the.Board of Appeals provided the appeal is made in'
writing :and filed with the Building Official within 10 days -of the
service of this Notice and Order
ltrth.124
MAILING ADDRESS P.O. BOX 1504 LA QUINTA, CALIFORNIA.92253
The aforementioned property has been posted-as unsafe'to occupy,until
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