0006-095 (RPL)'LICENSED CONTRACTOR DECLARATION
).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
s74127 0(3/31/2(
Date r/� Signature of Contractor/A'" ��^--
5-
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
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. , A,
�(4...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 STATE MOD Policy No. 046.00-()0OW34
(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 ee/that if I should become
subject to the workers' compensation provisions of,F's-Section 3700•of the Labor*
..ff.,.. `
Code, I,shall,forthwith comply with�t oserovlslons.
Date: G" �' Applicant;
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 applidaton 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-representati es of this City to enter upon
the above-mentioned property for inspection purposes.
110
Signature (Owner/Agent)�� � �y'a" `-- Datety t''U
BUILDING PERMIT PERMIT /t
DATE t RV ) VALUATION LOT � TRACT
4f
alo
' '
JOB SITE
ADDRESS 8"74 HEkt , AQ
APN ,
_ r
OWNER
CONTRACTOR / DESIGNER / EN (NEER
S'TEVIM MALL. 110
STEVE 17ODSON CONSTRUCTION DNC.
7161. %T.DIANAAV:G.
?3011 Ct>UITIRY CLUB DR., SL)TiE F4
XWERSME CA 92504
PALM DFSERT CA 92260
(760)346.4032 C:RL*. 1044
USE OF PERMIT
POOL ANL/Olt UTA
POOL & SPA ONLY - ALAi2flfiUiAItP.(ERS 31JALL BE, IN PLACE ,AT
PRR-PLASTRk INSPFCT102,�iWt-r W/` U, FOR FOOL EQUYPME14T
ENC'L.OSURE, IS NOT F14Ci UDED IN THIS PERMIT
VAWATI014 3Q,000,00 LS
MIAIV ftST OF CONYMUC7710K
30MM00
q��ap� y,'E
J." AUd�.E�'.1.1 A. FFX 9UMM 9 a Y
PLAN r_'HWK FXY 101X000-439-3118 $194,93
;
CONSTRUCTION FEE 101-000.418-000 $284.50
`.
MECHANICAL FEE •- POOL. 101-000-421-000 124,00
,&L)•;t;;:'1 kHCA.L ME — POOL 301-.000-420-000 $45,00
PLS. MBIN`F FRE •- POOL 101.000.419.ON $27,00
1
SUB -TOTAL C0NOT. ETCi10NANJD PLAN CIMCK
$S6S:43
l�23 Iy.•'3 1M
$0.00
�RE��UAID
Y(Yf AL �
RECEIPT
DATE
BY `wafe4
DATE FINALED
INSPECTOR
7 -�
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 Ate/
Set Backs
Electric Bond IP- -7
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
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:
-
tF'
�;� �:-moi: i� ✓ 'ff� 5a�•�.' `•� �`
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Steven Walker Homes
7161 Indiana Ave'
Riverside, CA 92504
September 27, 2002
To Whom it May Concern,
(760) 777-7000
FAX (760) 777-7101
On June 9`h 2000, the City of La Quinta issued a Pool & Spa permit #0006-095, located at
80-574 Hermitage, for Steven Walker Homes with the contractor of record as Steve Dodson
Construction Inc.
Under the administrative provisions of the 1998 California Building Code, "Every permit issued
by the building official under the provisions of this code shall expire by limitation and become
null and void of the... work authorized by such permit is suspended or abandoned at any time
after the work is commenced for a period of 180 days." (CBC section 106.4.4) Consequently,
this building permit is expired. With no provision for further extension, no further work may be
performed until a new permit has been issued.
Please contact me directly at (760) 777-7027 as soon as possible to.coordinate a plan to obtain
information you need regarding new permits and/or any required inspections.
Sincer y,
aniel P. Crawford r.
Building Inspector H
dpc
cc 80-574 Hermitage
N