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0304-310, 0305-201, 0312-035 (BLCK)H N (1) W O U) W ti o Z r— m 0. c LULUa rn z. 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 599069 C13 MCC 07PI1/2( 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 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 MUNICIPAL INS CO Policy NO...' WC MIO -00 (This section need not be completed if the peimit valuation is for $100.00 or less): O I certify that in the performance ofrt6e work for which this permit is issued; I shall not employ any person in anyjmanner so as to become subject to the workers' compensation laws of Calffornia,� and agree that if I should become subjlpcf to the workers' compensati" 6' provisions of Section 3700 of the Labor Code, comply with,those• provisions. /bate: °teha?^pplica. f i Warning: Failure to secure Workers'Compensation coverage is unlawful and shall subject an employer t9 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;-agehts and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days fiom 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 th above-mentioned property for'inspedoi n purposes. Signature (Owner/Agent) , 'fDater BUILDING PERMIT PERMIT# DATE i.� %� .J;l 'VALUATION LOT �' ��� TRACT vs rypp A JOB SITEAPN ADDRESS 45,-97!5 ,r rUAk.' VA -1 -MS ROAD .•. "- OWNER CONTRACTOR / DESIGNER / EN (NEER C7.! R Y 1-1C01.1kD45 O1'UR113's ITINCE X35.975 DVINF MW RD 436121? JACKSON UT. LA, c iTWTA CA, 92253 11-M10 CA 92201 ?60)3. X4,2.2400 CEL4 594 USE OF PERMIT Gy-kWi A11 Bl"fDID,113t'# 335 LF ,' 0RX.AMUUTA,1.IRON i7F.T.iCE. r 5 Fr. WOOD PYNCR 20.001117 7Ei:ty'.G:1.I� A'.MD F'ON'T" OF CON91RUC.'.'T'.EON" PF:RP LT FRT?' RUACK RY CONS;T:RUCTI0114 F1 E 101-000418-000 MECHA'HIC-A.L FE D a Q • APR 2 8 1003 CF NOF L4 QUfN-r,q. NC Pr DEPT. Mff3-TOTAL CO14STR.T)O-'1'1OI'T TAND i"LAN' CI -C1: $54,00 IMS FRE-PAX)4 0 $0,00 10rA1; > T -R )RIk"Es DUR NOW t". 110 RECEIPT DATE/ f`i - BY - DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 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 BLOC@CWALL 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 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: U2! Ay IM: I., r . bt-r-�&A CoPY CITY OF LA QUANTA -BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION qs-?J5 :bUr-_' PA -441-5 ZEN -zssc. AIf S'Fjs4tr- i -j l OF%q#w" 7eace 43-612 1414, 64 92201 760)342--2400 fox 760134? -6331 BFCOrnaMental iron HEA�xro�Coat PICKET POSITION SPACING CAN BE ® 4' ACTUAL or -13 31M ACTUAL • 1 112" Square Top.B Bottom Rail, 14 ga. • 3/0 Square Plckats, 18 ga. • 4" or 51/4° Spacing between Pickets • Power Washed for Paint Preparation • One Shop Prime Coat • One Top Coat Black Enamel ACTUAL TYPICAL Na° PANEL NOMINAL HEIGHT V CLEARANCE HEAVY REGAL, Two Coat For black polyurethane top cost add 10% to these prkes j For pnPlelvanised rail & pkkets sdd JS%, to these prices 0�q 'foss" 2' e4,,JCP0rE 1_ rilp P N U) W o d W) r` W,� o Z r` coo 0r F- CID W nom. rJ7 Z 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 579W9 CI3 HIC 013111V Date Signature of Contractor OWNER -BUILDER DECLARATION 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 ex mpt in�er Section , B&P.C. for this reaso [�dte f"- 7 1 :r fes, 2Signature of Owner _ -+��T_ 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: Cartier MUNICIPALL rNS 00 Policy No. WN0 9489-84 (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 370.0 of the Labor Code, I shalt forthyvith comply with those provision .©ate; ?,%. .. _pplicant' a ._ f 41 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 180 days from date of issuance of such permit, or cessation of work for 1.80 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). J . Date.- G' BUILDING PERMIT PERMIT# DATE VALUATION LOTd TRACT � i2 tJ�d1t S.00 JOB SITE APN ADDRESS 45-975 DUNF PALMS ROAD OWNER CONTRACTOR/DESIGNER/EN (NEER CtZR't' HOF'fCI1d GRTFIMTH9 FIOXT, 45.975 DUNE PAL S RD 436) 2 Al MONSON ST, LA QUINTA CA 92.253 4T+10 CA 92201 (7WJ342-2400 CBT.4 594 USE OF PERMIT ��?L� EC1J,i.J31�1'f3 SUPPLEMI?NTA), TO PF—P MIT # 03001.31% fsDDINO 4 COLUMNS TO P,P.EVIOU 0(PF,RMIT-rF.D FisKE I r#.T91WXr= COS'.0 OF CIQPaMi7MON 0.00 1PF.,�Mff "OWE stwv5RRY SlIPPI.EMENTAL•Pl?HMIT h'iE 101-000-423.000 Wri jJ MAY 2 2 2003 CITV OF l P ZittTA FINANCE DEPT. t� SUB -TOTAL (20%3TROMOON AND PLAN CIMClY $4.50 LESS .PRE-PAU) PLft?-;1 $0.00 TOT Al )E.':i»~F:irr rr M S DUE NCaW RECEIPT DATEBY DATE RNALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Duds Forms 8 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 Pibg. 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: - U JU ' If 044#d4 7CN" 4F"I,? /% (7404W & ,07 /�, C/f 9z2o1 fi6a/3�� a400 far �760)34fZ-6331 BFC Ornamental Iron "E"°REGAL PICKET POSITION SPArAN G CAN K ® S'1/ ACTUAL ® M6rOMr • 1 Iff Square. Top .& Bottom Rail, 14 ga. TYPICAL • 3140 Square Pickets, 18 ga. k PAA MELNWNAL • 4" or 5114° Spadng between Pickets Power Waahed tor'Paint Preparation • One Shop Prime Coat • Oro Top Coat Black Enamel V CLEARANCE HEAVY REGAL, Two Cost For black polyurethane top cast &W 10% to these prices For preValvanised rail & plakets add 36% to dreae pries (�tq„ I 2V H N_ LU W O 5 M W oZr� �0 LL l w I— a a) Z 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 4 Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 59°9069 C 13 'BIC CYIr31 /2( 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 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 permitis 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: MlTHI IPA►I. INS co Policy No. 1MIC fl0it9.00 (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: Date: 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 permitsubject 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. (Owner/Agent) Date BUILDING. PERMIT PERMIT DATE VALUATION LOT TRACT TRACT JOB:SITE APN ADDRESS 45.9-7-5 D1UNJ1i PAT,NTS R..0AP - OWNER I CONTRACTOR / DESIGNER / ENGINEER GARRY HOPKI.AIS 4!i-975 DMIZPALMle, RD I.A.(Z'47IN A CA 92253 USE OF PERMIT C'rW.(±RAIf BU 11,1311,10 140 LF V0 RN"HNTAL, 11RON F ENCI?. 3 N'i'. Vit>OD F°PMOr" Cr.KJMITS FEWLY 4 l2.N JACK;ION' S1'.t', INDIO (-)60)34--a W(IDUN 594 !44.00 LF Ja,Kl'MAII N D con (W CO±VS"STr`Iltr110H CON'S"rRu"I"�10N ME 101 -OW-41 8-11,00 V191DO %WB-ZXrTAL, t;C)M37Ri:iC'Tir.}N AND Pi„i4N (:;F102,':tC "i'O"I"!3>F:':N IKIRMIT YKES DITEr J40W! CA 92201 RECEIPT I DATE_ [ i'� I BY* I DATE FINALED I INSPECTOR 29.00 $1), 001 ; 29.(X) 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! POOLS - SPAS BLOCKWALL APPROVALS 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 Wat«it 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 COMMENTS: - 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) SliDewwx CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTIONS, DAA 12- 7,0q � �/ - I- -6� /opir. vAL-Wk� z- /00, z