0102-087 (CONR)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 1 i / � I Signature of Contractor
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.
(,„)- 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.
STATE C0403P.'82r1'f'1' 'd'13DIVC
(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-provisionts•of Section 3700 of the Labor
Code, I shall forthwith comply with{hose provlslo s.
Date:''] Applicant r0,� 1 ��l x25-' -'`"
t t� E tori •"/�'..•. }
^Warning: Failuretorsecure.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 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 prop erfy for`ihspection purp s s.
Signature (Owner/Agent) •� / "?� Dated h j/1
BUILDING PERMITPERMIT#
DATE VALUATION LOTI�MF�2_67 TRACT
7/11 M21 28603-1
JOB SITE
APN
ADDRESS
43
"HXPI 4'�i%MIGE
761-07541=
/DESIIGNER/EN
INEEROWNERCONTRACTOR
8 WH HaZWrA y:yLC
ULVEN WALKER H01103 3
7119114DYW. AVENIM
7119 M141A AVE
1k1 i'RME, CA. 92544.
RPIEUTDF CA 92504
(909)784-0£100
USE OF PERMIT
POOL W.iI,X,6xR OAS PFA APPROVED PL.AWS
Xe &.SYA'.Rh�.P.}'0a0.11' . OF CONSI 6.ETMON
;v13+.rV`AID
f -LAN CHECK 101-000.439.3)8 $ifl$,Z.?
CONSTRUCTION FRE, 101 -000.416 -OW $90.00
M&f:'HAIUCAL ME $28.00
ELECTRICAL .F2.A&<AL FZZ 101 _0001420-010
IsLUMD1110101.000-419-000 1 6.it0
AU IN kSUklUC t°J.ACM-RiF,eP)A;'102-WO-215-'000
fx"YF!OANOrym((��/n''prfel-Td PRE - Ct:�MM
91(ry*1Lgq1-E��H��3``0-24ry+1��-/0-FAIT
QAADINC; li.�'.E 101^000'423 ` 00
�CYrA
SU8 ,, ` R.7FC".1xC?1�i.1�ND P A 01-VICK
�. 6
_,, l LESS YRF-PA1D%fig'. fes'"
$0100
I J U L 1 0 2001 '1' •, FMMU Mims DIM NOW
X4.26,70
CITY QF.LA QUifvTA
H-4,NCE DEPT
RECEIPT
DATE
BY
F
INSPE
r. / �A
�t t
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
_
�Q/(/ ��
Return Air
Steel
Roof Deck
_
_ _ _
�l/3jJ� 3
Combustion Air
Exhaust Fans
O.K. to Wrap
>'3 3
F.A.U.
Framing
8 - ,
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail 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 Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
_
tv • �r p 3 ��_
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:
Y
j
• j.
I
.iii
T
IM
Eo CHARLES Fa
ARCHITECTS, INC.
Jan 3, 2001
Dan Beal
Steven Walker Homes
7161 Indiana Ave.
Riverside, CA 92504
Re: Village I & II at Hermitage
Dear Dan,
The original design intent was to use the same Pool
Cabana at two different sites within the Hermitage
Project. You can, with my knowledge, 'utilize the set of
plans already on record with the City of La Quinta to
construct a.second Pool Cabana building on Lot F of Tract
28603-1.
Sincerely,
Edward C. Nov__. Architect
C.
tio.
9
G2���
f1`
17932 SKYPARK CIRCLE#A' IRVINE, CA 92614 (714) 851-8434' FAX (714) 851-8435
CityLa o uinta
Developers Project Approval Form
Prior to the issuance of Building Permits for the project listed below, the following Departmental
clearances must be obtained. Please return this form to Nickie Gormley, Building and Safety
Department only after approval. Contact applicant for resolution of conditions preventing or
delaying approval.
Project: Pool Building located at 80-980 Hermitage.
Tract 28603 Lot F
Applicant Contact: Steven Walker Homes. 909 784 0840
Application / Circulation Date: 02/01/01
Date
Community Development Department
Christine Di Iorio, Planning Manager Date
Public Works Department
Speer, Senior Engi eer l4ate
Building and Safety Department
Greg Butler, Building and Safety Department Manager
Date
Ci of La Quinta
Developers Project Approval Form
Prior to the issuance of Building Permits for the project listed below, the following Departmental
clearances must be obtained. Please return this form to Nickie Gormley, Building and Safety
Department only after approval. Contact applicant for resolution of conditions preventing or
delaying approval.
Project: Pool Building located at 80-980 Hermitage.
Tract 28603 Lot F
Applicant Contact: . Steven Walker Homes. 909 784 0840
Application / Circulation Date:
Community velopment Department
Christine DI Iorio, Planning Manager
Public Works Department
Steve Speer, Senior Engineer
Building and Safety Department
Greg Butler, Building and Safety Department Manager
02/01/01
Date
�05A/
Date
Date
Date
M