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05-2424 (AR)P.O: BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number. 05-00002424- Property Address: 52925"LATROBE LN APN: _ 770-340-007- - - Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: _ 30000 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT . I hereby affirm Linder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business essionals Code, and my License is in full force and effect. License Class: 6 License No.: 846226 ,5::�Dati7l Contractor: [� O ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001: (_ 1 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). 1 _ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERIIIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 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 and policy number are: Carrier EXEMPT Policy Number EXEMPT 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 b meject to the workers' compensation provisions of Section O ,.7 7`00 of the Labor Code, shall fort ith comply with those provisions. r'Date: • O '; Applicant: WARNING: FAILURE TO SECU RKERS' COCNSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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 ' ation is correct. I agree to comply with all city and count ordinances and state laws relating to build onstruc on, and here y authorize representatives of this co my o enter upon the above-mentioned property or inspec n purpos Date: Z Signature (Applicant or Agent):. Date: 8/17/05 Owner: LEHMAN BRUCE "--� Contractor: DEVLIN CUSTOM INTERIORS 44410 SILVER CANYON LANE " UINTA PALM DESERT, CA 92260 L��FINA�t4CE PT_ (760)408-9523 Lic. No.: 846226 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 and policy number are: Carrier EXEMPT Policy Number EXEMPT 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 b meject to the workers' compensation provisions of Section O ,.7 7`00 of the Labor Code, shall fort ith comply with those provisions. r'Date: • O '; Applicant: WARNING: FAILURE TO SECU RKERS' COCNSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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 ' ation is correct. I agree to comply with all city and count ordinances and state laws relating to build onstruc on, and here y authorize representatives of this co my o enter upon the above-mentioned property or inspec n purpos Date: Z Signature (Applicant or Agent):. Application Number . . . . . 05-00062424 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 284.50 Plan Check Fee 184.93, Issue Date Valuation 30000 Expiration Date 2/13/06 Qty Unit Charge Per Extension BASE FEE .252.00 5.00 6.5000 THOU BLDG 25,001-50,000 32.50 Permit ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 17.38 Plan Check Fee '. 4.35 Issue Date . . . Valuation . . . . 0 Expiration Date 2/.13/06 Qty Unit Charge Per Extension BASE FEE 15.00 68.00 ---------------------------------------------------------------------------- .0350 ELEC NEW RES - 1 OR 2 FAMILY 2.38 Permit GRADING PERMIT Additional desc . Permit Fee 00 Plan Check Fee .00 Issue Date . . . . 8/17/05 Valuation . . . . 0 Expiration Date 2/13/06 Qty Unit Charge Per Extension ------=-------------------------------- BASE FEE -------------------------------- .00 ----- Permit . . . MECHANICAL Additional desc . Permit Fee 24.00 Plan Check Fee 6.00 Issue Date . . . - Valuation 0 Expiration Date .. 2/13/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 -------------------------------------------------------------- 9.0000 EA MECH APPL REP/ALT/ADD 9.00 -------------- Permit . . . PLUMBING Additional desc . Permit Fee 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation 0 LQPExnfff LQPERMIT Application Number . . 05-00002424 Permit PLUMBING _ Expiration. Date 2,/13/06 Qty Unit Charge Per Extension. BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS' --------------------------- 3.00 --------------------------=------------ Special Notes and Comments . ENLARGE AND REMODEL LAUNDRY ROOM.August 10, 2005 3:40:27 PM JJOHNSON . ------------------------------------------------------- Other Fees. ENERGY REVIEW FEE ------------- 18.49 STRONG MOTION (SMI) - RES 3.00 Fee summary Charged Paid Credited ----------------- Due ---------- ---------- ---------- ,---------- Permit Fee Total 352.88 .00 .00 352.88 Plan, Check Total 202.03 .00 .00 202.03 Other Fee'Total 21.49 .00 .00 21:49 Grand Total 576.-40 .00 :00 576.40 LQPERMIT Tract # Study Area Type Residential Addition No. of Units 1 Lot # No. Street S.F. Unit 1' zf 52925 Latrobe Lane 68 Unit 6 Unit 2 . `� Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Lot # No. Street S.F. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 5 X00 square feet, detached accessory structures (spaces that do not contain facilities for Irving, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 68 S.F. or $0.00 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Exempt - John Devlin Check No. Name on the check Telephone Fording Exempt By Dr. Doris Wilson Superintendent n Fee collected /exempte y r ilv ey Payment Recd O.oO fw ';6.ver/UrCdi - .'!' Z Signature G �f..r j`f1' : • • r: ,r �;r :,� NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy - Accounting YOUNG ENGINEERING SERVICES *Engineering *Architecture -Surveying• Building & Safety Services Letter of Transmittal To: City of La Quinta Attn: Ed Randall Tel No.: (760) 777-7012 We are forwarding: X By Messenger Date: 08/09/05 Project: 52-925 Latrobe Lane PC#: (15` check) Tract No.: 05 � 11442614 By Mail Your Pickup No. of Copies Description: 1 Revised Plans 1 Struct Calcs 1 Redlined Plans Comments: Structural contents are approvable. Thank You. This Material Sent for: Your Files Per Your Request Your Review X Approval Checking At the request of: Other By: N@lin Pochunuri Phone # (760) 360-5770 EXT. 108 77-804 Wildcat Drive, Suite C, Palm Desert, CA 92211 (760) 360-5770 Bronz Young r- si ` ,:M* 91`1117TI-1 A rlrV /-lir, t -it e Pr je tTi t Project Ad( ' JOkr. 'iio60 . r NCE: RESIDENTIAL CIG 4��' 9SZ3 DocutnACtati n.APKA�h�o�r ` � Telephones e; p�'hone Compliance Methoacker Cot�tpu� Climate Zone GENERAL INFORM 1 of')) - Building Permit # Plan Check / Date Field Check / Date 1 nrrPn f x CF -IR ATION Total Conditioned Floor Area ft� Average Ceiling Height: ft Conditioned Slab Floor Area Building Type:Single Family Addition (check one or more) %Multi -Family Existing -Plus -Addition Front Orientation: ' y North / South / East / West / All Orientations (input front orientation in degrees from True North and circle one) Number of Stories r 11 Number of Dwelling'Units:-(-� Floor Construction Type: Slab/ aised Floor (circle one or both) RADIANT BARRIER (required in climate zones 2 4 8-15) Required for this submittal es _no BUILDING ENVELOPE INSULATION Component Type Frame Type wd = wood stl = steel Cavity Sheathing Total R- Assembly Location/Comments Insulation Insulation Value' U -Factor (attic, garage, typical, etc.) R -Value R -Value Wall 29_ WON it^2.1 Wall Roof Roof Floor Floor Slab Edge t r__ • v — --y vias - auv auu r+abcmury L)-racror are not requirea Tor a woos-Iramed wall that meets cavity R value insulation requirements for the Prescriptive Package FENESTRATION Fenestration Orien- Area Fenestration Fenestration=ShadingoAtt. Overhangs/ #/T e/Pos. tation (ft') U -Factor SHGC Fins Front Front Left Left Rear Rear Right Right -Z Skylight skylight � N1�1005 �v Com ,I , ce Forms August 2001 A-2 RTIFICATE .®F COMPLIANCE: RESIDENTIAL: 4pL E tProject CF -1R °....= HVAC SYSTEMS o Note: Input hydronic or combined hydronic data under Water Heating Systems, except Design Heating Load. Distribution Heating Equipment Minimum Type and Duct or Heat Pump Type (furnace, heat Efficiency Location Piping Thermostat Configuration pump. etc.) _ (AFUE or HSPF) (ducts, attic, etc.) R -Value Type (split or package) 171 'Cooling Equipment Minimum Duct Heat Pump Type (air conditioner, Efficiency Location Duct Thermostat Configuration heat pump, evap. cooling) (SEER) (attic.. etc.) R -Value Type (split or package) SEALED DUCTS and TXVs (or Alternative Measures) 53 Sealed Ducts (all climate zones) (Installer testing and certification and HERS rater field verification required) %'TXVs, readily accessible (climate zones 2 and 8-15 only) (installer testing and certification and HERS Rater or field verification required) Iiii Refrigerant Charge/Air Flow (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater or field verification required) Am ❑ Alternative to Sealed Ducts and TXVs (see Package C or D Alternative Package Features for Project Climate Zone) Climate Zone Window SHGC Window U -Factor SEER Heating WATER HEATING SYSTEMS Energy' Rated' Tank Factor or Water Heater Distribution , Number Input (kW Capacity Recovery Type Type in System . or Btu/hr) (gallons) Efficiencv 59 External Tank Standby' Insulation Loss (%) R -Value I. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list rated input and recovery efficiencies. SPECIAL FEATURES (add extra sheets if necessary). Package C and D: TXVs, Sealed Ducts, Radiant Barriers (see installation requirements for radiant barriers in Section 8.13 of the 2001Residential Manual). Package C: thermal mass (thermal mass type, covering, thickness, and description). I Compliance Forms August 2001 A-3 CERTIFICATE OF. COMPLIANCE: RESIDENTIAL(Page.3) of 3) CF=1R (:tAet4tk CS Project Title Date COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to. comply with Title 24, 'Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. The undersigned recognize that compliance using duct sealing and TXVs requires installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business and Professions Code) Name: Title/Firm: Ca W Nb I2 Address: C`5 2- 32-5 La Tko (3 9— Telephone: Lic. #: (signature) (date) Enforcement Agency Name: Agency: _ Telephone: _ (signature / stamp) (date) Documentation Author Name: �� i>t /�(Q A) Title/Firm: C_'O,U N &4L Address: (=62= 325 U 'Rag 9' Telephone: cf52,3 (signatur (date) Uompliance Forms "August 2001 A-4 MANDATORY MEASURES CHECKLIST: RESIDENTIAL (Pae 2 of 2) MF -1R Note: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (') may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. Instructions: Check or initial applicable boxes when completed or enter N/A if not applicable DESCRIPTION DESIGNER ENFORCEMENT Space Conditioning, Water Heating and Plumbing System Measures: (continued) • §150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and insulated to meet the requitement of the 1998 CMC Sections 601, 603, 604, and Standaid 6-3. ducts insulated to a minimum installed level of R4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape, aerosol sealant, or other duct-closum system. that meets the applicable requirements of UL 181, UL 181 A. or UL 181 B: If mastic or tape is cued to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used. Building cavities shall not be used for conveying conditioned air. Joints and scams of duct systems and their• components shall not be sealed with cloth back tubber adhesive duct tapes unless such tape is used in combination with mastic and drawbands. 2. Exhaust fan systems have back draft or automatic dampers. 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. § 114: Pool and Spa Heating Systems and Equipment. 1. System is certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System is installed with: a. At least 36" of pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spas. 3. Pool system has directional inlets and a circulation pump time switch. §115: Gas fired central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously burning pilot light. (Exception: Nonelectrical cooking applianccs with pilot < 150 Btu/hr) Lighting Measures: § 150(k)l.: Luminaires for general lighting in kitchens shall have lamps with an efficacy of 40 lumens/watt or greater for general lighting in kitchens. This general lighting shall be controlled by a switch on a readily accessible lighting control panel at an entrance to the kitchen. § 150(k)2.: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumens/watt or greater switched at the entrance to the room or one of the alternatives to this requirement allowed in $150(k)2.: and recessed ceiline fixtures are IC (insulation cover) approved. January 4, 2001 MANDATORY MEASURES CHECKLIST: RESIDENTIAL (Page 1 of 2) MF -1.R Note: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. Instructions: Check or initial applicable boxes when completed or enter N/A if not applicable. DESCRIPTION DESIGNER ENFORCEMENT Building Envelope Measures: • §150(a): Minimum R-19 ceiling insulation. §150(b): Loose fill insulation manufacturer's labeled R-Valuc. • §I50(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -Factor in metal flame walls does not apply to exterior mass walls). §150(d): Minimum R-13 raised floor insulation in framed floors. § 1500) : Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 ern/inch. § 118: Insulation specified or installed meets insulation quality standards. Indicate type and form. § 116-17: Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. 2. Fenestration products (except field -fabricated) have label with certified U -Factor, certified Solar Heat Gain Coefficient (SHGC), and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. § 150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. § 150(f): Special infiltration barrier installed to comply with .§ 151 meets Commission quality standards. § 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. I. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilot lights allowed. Space Conditioning, Water Heating and Plumbing System Measures: §110-§113: HVAC equipment, water heaters, showerheads and faucets certified by the Commission. § 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE. SMACNA or ACCA. § 150(i): Setback thermostat on all applicable heating and/or cooling systems. § 1500): Pipe and tank insulation 1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. 2. First 5 feet of pipes closest to water heater tank, non -recirculating systems, insulated (R-4 or greater) 3. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or R-16 combined intemal/extemal insulation. 4. All buried or exposed piping insulated in recirculating sections of hot water systems. 5. Cooling system piping below 55° F insulated. 6. Piping insulated between heating source and indirect hot water tank. January 4, 2001 JUN 1 7 2005 Ll Gk I4 59 .ESI/FIVIE,.Inc. STRUCTURAL ENGINEERS CITY OF LA QUINTA BUILDING & SAFM D€fq; APPROV0 FOR CONSTRUfft6ki ne FIELD FIC FOR MISSING DCT IOR HOLDOWN (NON -MONOLITHIC UIV Sheet Date /O' JN. OS6 4x POST MIN. SEE -PLAN FOR HOLDOW COLD JOINT CALL OUT CONC. SLAB pD g THREADED ROD ®a EMBED W/ SIMPSON --------------------- � "SET' EPDXY—TIE* W/ SPECIAL INSPECTION 4" MIN. t INSTALL IN ACCORDANCE WITH-SIMPSON STRONG -TIE FECOMMENDATIONS: SPECIAL INSPECTION REQUIRED; LA RR # 25279: - ICBO # ER -5279, SIMPSON HOLDOWN . I b d DIAMETER OF -'-EMBEDMENT THREADED ROD W/ "SET" EPDXY TIE DEPTH INTO FIRST POUR HOL OWN FASTENERS INTO POST 16 �f 11 26B 5/8 INCHES 5/8 INCHES 101NCHES 10 INCHES. (18) - lad's (24) - 1 ad's S8D tD tlL S1931IHMV 988 2 5/8 INCHES 10 INCHES (32) -16d's 2A 5/8 INCHES 10 INCHES (2)- S/8"dia bolts A 5/8 INCHES �INCHES 10 INCHES (2)= 3/4" dla bolts DGA 7/8 -INCHES (2)- 7/8" d 11 bolts DSA 7/8 INCHES •i4� 40 899 'ON INCHES 3 — 7/80dia bolts S8D tD tlL S1931IHMV 988 N06:1 5006'01 'Nn CITY OF LA QUINT'A SUB -CONTRACTOR IST °I JOB ADDRESS �✓� PERMIT NUMBER OWNER GCucZ-X04, BUILDER -2—C-1 . This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance _.y_.:__ _ .......,a L...1........ .n+ k- n�mnlntnA by n nnlirant" '"fin HIP" is not an acceptable response. of building permit. ror edcn dp{�ncduic udUU, do nnvi111aL1V11 1UgUVO►cu ucwv• III..�� .,� .,.,...r....,...,, ,.rr ........, _....._ .- _--_ --- - ;.: Workers Com ensation.Insurance:: `.;' City. Business License: Trade / ClassificaUon Contractor :.. rac or s License .:. :;. ::::::<::;;:. ;;. ; :.State.:Cont t . Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp► Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C712) . ;. CONCRETE IC -8) . r l�: ) G U ¢75301 S 3/W �+e_ 0 ' 20 FRAMING .(C-5) ' .: .. d ter r' . STRUCT."STEEL (C-51) ` MASONRY (C-29) (C- W?.5C'La 5 e/ t b/44Qb7. 02—lo-7 l Z f 2 d LATH; PLASTER (C-35) DRYWALL (C-9) - HVAC (C -20Y C' Llec' c.' � I � - 0 00071b15ELECTRICAL. SHEET METAL (C-43) FLOORING (C:..15): GLAZING (C-17)` INSULATION `(C-2) . SEWAGE DISP; (C-42) . PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C=27) POOL (C-53) ___