0202-244 (PAT)--q� w:. a.�.i u.. ,. ,.. _--.r...Aa�.w7 %V'.etl4'.3+w:Y. :w '•�' Y+�, .n'�i-s��'',�Fe Tom..
?, LICENSED CONTRACTOR DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of
HChapter 9 (commencing with Section 7000) of Division 3 of the Business and
r�C%J W Professionals Code, and my License is in full force and effect.
w� 5 License # Lic. Class Exp. Date
' (Y L
h I W
6903 /
3• (i 1� / M y 3 f
.o ZO r /Date Date �- �' - Signature of Contractor 11/1 i/, y"� -
•q CD0 I
J U C) OWNER -BUILDER DECLARATION
WLU I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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).
co () I am exempt under Section , B&P.C. for this reason
L
N Date Signature of Owner
O- rn
CL Q WORKER'S COMPENSATION DECLARATION
p cr I hereby affirm under penalty of perjury one of the following declarations:
Lo O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W �= compensation, as provided for by Section 3700 of the Labor Code, for the
m� Q performance of the work for which this permit is issued.
Q. U () 1 have and will maintain workers' compensation insurance, as required by
O UQ Section 3700 of the Labor Code, for the performance of the work for which this
Cl rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
?• Z Carrier Policy No.
ob a LE010N RSUR INC9 WCA 0q22
J(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
3 Code, I shall forthwith comply with those provisions. -
. d+ Date:. Applicant V12 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 hull 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.
,,O -Signature (Owner/Agent) :�P -y Datd--As
--�--gUILDING PERMIT---`' PERMIT#
DATE - !':- VALUATION LOT =2, 244 TRACT
JOB SITE
ADDRESS
APN
48-732 CALTZ 1 I:ORIVA
OWNER
CONTRACTOR/DESIGNER/EN (NEER
?AiD1UMC.
BOSSCCdTxIJCON
4-731,
45M5 p1fvLM)D DIL
LA Q''•uik .k "'moi 922'S 3
PAIS. DEV, 7' a& 92261
(165)349-.33.78 M1.9 2246
USE OF PERMIT
MIT)
ON K 140 SY, &: OTS Z 115 SA.t1:t+tJMa9 W000 LATTICE RA T f O OOV M
HOA APPROVAL COXI111p-MED,
POR°,.t:i•1!1'M"10 :5.Df3 S
PLAN Ci'9T:.�1� FEE 101.000.439.318
C'ONSTR XIC i10N 1 I +1 �Gi.3d�- 1 f3=i?ird'e &�i1.f10
$TROIKO MOTION FF, RIMM 101 k= -Ml i,000 i"
F tb ' 2 5
city®FLAQUINTr-.
T
SUB -TOTAL CONWIRUM-1.WN .ANI' YNR Cp1�.;C`X
$11414
PAW. WYEI-SIRT9 NOW
RECEIPT
DATE/
%. !� )1 Com✓
BY ` r w
DATEFINALED
INSPECTOR -
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
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:
//
` osev
07
'Ili( OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
ul
M
ASHTON, VANCE & ASSOCIA'T'ES, INC.
consulting engineers � l�] structural engineering
1182 N. MO.NTE VISI'm _AV .. #10 PHONE. (909) 920-+1185
LtPLAND, CALIFORNIA. 91.786 FAX: (909.) 920-'1786
December 19, 2001
Metals USA/Texas Aluminum Industries
2900 Patio Drive
Houston, Texas 770.17
To Whom It May c=oncern:
Please be advised that as of December 10, 2001, my certificate of Authority to practice Civil
Engineering in the State of California was renewed until December 31, 2005.
:A.s.you are well aware, there are many thousands of prints in existence showing a license expiration
of December 31, 2001. In an effort to salvage these prints and comply with State of California
Wasteful Paper Act, please change this date to December. 31, 2005.
If you have any further questions regarding this matter, do not hesitate to call.
Since
Michael M. Vance, P.E.
QH�Fess/0y,�
`jr,� C 25758
1=xp• 2312001
Licensed Professional Engineer
Arizo�na California Colorado Connecticut ,Florida ;Idaho Illinois Keinsas XfIni-wi-ola
Missouri Nevada NewMexfco NewYork Oregon Utah Virginia Washfri'�,Ion
el
�Or.g
ARCHITECTURAL COMkITTEt CERTIFICATE
(Exhibit "A" to the Architectural
Improvement Application and Agreement)
Architectural Improvement Application and Agreement was
Z"u'Viewed by the Architectural Committee on and has
_n:
F_ roved Conditionally Approved.
subject to the following
conditions set.forth below
'%.._urned for Further Information
Revuired Modifications
C, -.=ments
Y:.._ No
Rejected
Recording to be sent by owner to County Recorder's
office for roof and/or exterior wall modifications.
Deposit Required
n
Da, ' Xe`7V.
A.` :-hitectural Committe
Deposit Amount Required $
Architectural Committee
Architectural Committee
,-.�hitectural Committee Architectural Committee
THIS APPROVAL IS VALID FOR 90 DAYS FROM APPROVAL DATE