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0002-010 (RER)LICENSED CONTRACTOR DECLARATION l "rareby 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 _3777 70 i 09/ 1GiNX fDate r r' 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). ( ) 1, 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. ( X)- 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. a','ATE, 01114L) Policy (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 subjecf to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. vDate: 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 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 thZeature above-mentioned property for inspection purposes r (Owner/Agent) PERMIT # BUILDING PERMIT E91b�ioz-,Il DATE VALUATION ir3,t1�` LOT TRACT !, JOB SIT� ADDRESS 77-144 Fitt! RUJURTA APN OWNER CONTRACTOR/DESIGNER/ENGINEER ur.M.3""'hr. TWI Co. 77-144 VIA HUERTA 39725 GARAND WE' a ail, Q1. I NI A CA 92253 PALM lei, SEIR'1' CA 92211 �7CO3 G9R-4711 C't�[n 790 USE OF PERMIT fN8fALi,Aii0'iv' OF (1)t'.�Cr i 9n��i WTN00 AND (A) 5'X4! SLI1,ANU tiLAISS L )R j 3. v •rti%uFi: ssvo� :s,4ii'{i.�1u �a %i l l.';.A'TE K/ CO3v, OF Cb1 t 3`11 RK`T J`N' .i�. if V.1719 Nx,A1V C"E4 FVh F L6 I.d)1 4U©-439- lis 340,9S C'tita'r3"3'�"sfC"i"t�1c� T'1,�, i(1!-'61i)fj-tlif2-(j#lfi Qfi�i llto cr91'gi�01SUV • 1� A. ION ���'�*1`� ,rwv :� f h/i ^►n'r ItRR a zt: .J.l.?lL�y1d.��a�ai'4d9it r. W7 "1.1.6%J/.4A Rffk"1-7.01-At.t"'41WITPRiil'"i10NANnPT.A-4t- iPf- 3f0445 110111A9. VIVIlCMI FE, 1!118 3 Dal, NOW +104.45 RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE I 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 Insulation Compressor 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: C� Y 4, November 17,1999 Barbara Sima. 20 East 74t` Street New York, New York 10021 Re: 77-144 Via T-luerta Dear Ms. Sirna; Your architectural variance dated October 26 regarding the installation of windows, the removal of one sec of french doors, removing the roof above the closet to create an atrium._ cover the roof area of the existing atrium to. create a. bedroom, install screen doors on the courtyard doors anc- back patio doors as well as,the placement of the potted Ficus trees on your b9ck patios has been aR0riwed under'"the following stipulation(s): t Actual modification must conform to the plans and specifications submitted and approved-. w The new roof is to be'installed by Western Pacific Roofing. Thecolor of .the new screen doors and its hardwar•.must match the color of the exis+nng,door. Competent aid licensed professionals hall do all work in a workmanlike manner. All'uork is to be m compliance with local building codes and ordinances. �1] electrical 1�irrng, if applicable, must be contained within approved conduit painted to match the surfa'ce,it contacts, I'my,damage to .the common area rzsultine from this, modification and its construction shall be +'epairedr at the 0wrier's expense. a constructionbin is'rentect through Waste Management it must be beige in, c)lor and stored, if . ,ipossible, in the, garage, All construction debris is to be remov-ed•from'the site by the close of each day to maintain order and retain the aesthetics of the Sana Rosa C we. t, 'The maintenance and care for the Ficus shrubs as well as the pots is; the Owner's responsibility. f " Prior to the commencement of am' �pork -vou -are required 4oh4y a M0 refundable deposit for the roorn addrhon;"(change). {, ' ` m Pvror'ta'the commencement of any work you are required:to pry a one-time fee of $5 per square foot .or the new roof area;,as well as provide a five-year written guarantee covering the new roof area. Prior to the commencement of any'work the contractor and their.subcontractor(s, must provide the Association proof of worker's, comp.; 'liability_ and. auto insurance; naming !Ae Association as additionally insured.. Prior to the commencement of any .work you or, your contractor must provide the names- of the. scheduled workmen. to the°security guards at Mazatlan gate; (5.64-5414). g Prior to the commencement . of any work- your contractor, must read and sign the .� seciation's Contractor Rules, which has been mailed directly to their office, !� C/. JON TANDY 3� r� 1 37630 Medjool Ave. leCikollvQ msgn Palm Desert, CA 92211. Office (760) 772-7192 • (7601,772-7193 REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY X ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTAER t ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION , , � + +•�-+ 10. ec—� L.o, a W, REPORT SEQUENCE NO. TYPE OF STRUCTURE ` PERMIT NO. SN we OOOZ-- O1� OAT j - 3 oO 'DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT R A MK q. INSPECTOR 9- "D, HRS. CHARGED ENGINEER ASSISTANTS HRS.'CHARGEO INSPECTION GENERAL 1rA'°�� ., r SUB"' DATE CONTRACTOR r.�W . CONTRACTOR '. �-. +-• - - -- -- •. -&131 QO o5s Cy� E:L,&, Ils'' h�lf�iQ-e 15 1. 1 rw�Dec�y2a.�t IAS i til 5 o SOc� �x —Z �IS ® &Ls� Ali Obi I0 VID lSiN COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE 1 OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. 0 &�) I 'P 0 -t4 C)l� OF REGISTERED SPECTOR 3�,IGNATURE 0 rcRo / 1113 �y9,� TE OF REPORT REGISTER NUMBER