0002-055 (SFD)LICENSED CONTRACTOR DECLARATION ,
I herb.. ffirm under* penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Pri6ssionals Code, and my License is in full force and effect.
License # Lic. Class Exp." Date
Date Signature of Contracto
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 S-1,.4& : pUic3D Policy No. fl -16-1001113`1
(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 s� 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 37001-f the Labor
Code, shall -forthwith comply with those'provisions.� `
Date:' 1 A� Applicant____ 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, indemnity
& 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/d to horize representatives of this City to enter upon
the above-mentioned property for inspectiQpurpose .
Signature (Owner/Agent) Date
BUILDING PERMIT PERMIT#
-; 04111-41.4;►
DATE VALUATION S2611,917 `, LOT s 4 TRACTJOB
SITE
ADDRESS .5-654 VISTA itALOa�0`.111%
APN 649-9445 006
OWNER
CONTRACTORDESIGNERENGINEER
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J!,A. («1f,11WA CA 92253
LA. l�UINTA CA 9225:;
(70)771-1941y; CRY,,# 794(1
USE OF PERMIT
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1'CAJL1 75% KAN C'111±:t.i<:1•'b6 RhULI( 11' J.N Q'
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i
RECEIPT
DATE
BY/
DATE FINALED
INSPECTOR
/
t /J
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
--2 _ C -v
F.A.U.
Framing
— cTa
Compressor
Insulation
— /p — Vp
_
Vents
Fireplace P.L.
Grills
Fireplace T.Q.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
;- �F-
Exterior Lath
Tr
Drywall - Int. Lath
Final
Final
_
POOLS - S AS
BLOCKWA
/L A PROVALS
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
Water Piping
_
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
s
Encapsulation
Gas Piping�--
Gas Test
Appliances
Final
COMMgNTS:
1iC;.:.� 0 4
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)
GO UVIS :ENGINEERING
�t • C A' L I F O R N I A •
CALIFORNIA E-MAIL TO • SUPPORT@GOUVISGROUP.COM • SALES@GOUVISGROUP.COM
March 22, 2000
T.D. Desert Development c/o
Sparks Construction
79295 Rancho La Quinta Drive
La Quinta, CA 92253
CITV'.OF LA QUINTA .
a
ttn: Nolan Sparks BUILDING R SAFETY DEPT.
- Re:. Montanas , APPROVED
Pad Footing FOR CONSTRUCTION
GEC Job No.: 20914
'Yl_'-aPia. we_
Dear Mr. Sparks:
Pursuant to your request regarding the above captioned project, per our'phone
conversation on 3/21/00, we submit the following:
Since the cantilever`steel column is replaced with a steel -frame, the 31 sq. x 4ft. deep
flag pole,footing called -out at the rear of plan#3 should be replaced with a 3ft. sq. x 12
ft in. deep pad footing with (3) #4 bars each way (P-5 of the pad schedule).
Note: Please verify the above with the building department prior to construction.
If you have any questions, please do not hesitate to contact this office.
Sincerely,.
Q OFESSIO
GOUVIS. ENGINE.
No. C38276
Exp. Z
31-01
Saeed J. Bekam "`� �p �tF ��' Ra mo d Frangie
President Proj ager
SJB:cb
20914
GO UVIS ENGINEERING GROUP OF COMPANIES WITH OFFICES IN: WEB -SITE: WWW. GOUVISGROUP. COM
4400 C.IMPUSDwvE, SuITEA NEWPORTBEACH, CALIFORNIA 92660 (949) 752-1612 FAX (949) 752-5321.
2150 EAST TAHQUI7Z CANYON, SUITE 9 , PALM SPRINGS, CALIFORNIA 92262 " • (760) 323-5090 FAX (760).325-2863
5465 MOREHOUSE DRIVE, SUITE 100 SAN DIEGO, CALIFORNIA 92121
(858)1623-9941 FAX (858) 623-0278
FIELD OFFICES: LAs VEGAS (702) 597-2005 • FAX(702)597-0905 FREMONT (510) 252-9195 FAX(510)2152-9196