9711-033 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Ch %(=ear 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
\!Date
Signature of Contractor/. '
OWNER -BUILDER DEC.ItARATION
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 . Policy No.
izxr, t`y .
(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 w,jth-& se provisions.
Date: "` ' Applicanttff �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 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 representativeso f this City to enter upon
the above-mentioned Property for --in ction- •urpo�ses. g
Xi nature (Owner/A ent) A_�% li�Date/
BUILDINGPERMIT PERMIT# ' CONTROL#
G
41,4111
DATE VALUATION LOT TRACT .
JOB SITE
ADDRESS 79435 Vii4ii(."i T COU Kf'
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
`y�`�%jL b�S '
.+I�y�aE1�tt��..�'rt �v�
7'S ,235 Y 10LET 0.
YL�p�i'�, f3,�{i���S, MA
t�
3916n�' K1',�V134.M.ryry�`' AEL i��IlC%
LA QUI Nr 1A CA 1)225A
PALKI
CRI,* 4.515
USE OF PERMIT
KA -41
POOL AND 4TA
t 0,0000) LIS
KAN CWr.'K, FFX
CY-INSIMUC1,11014 rPH 101._ A)0.411840 "ni±
\%l;�i�t�rii'((�i�i ^- 1}Lii� ic-:iv1:-flt ail�4.ifit
PLUMBING, 041C., . 11, X 41.().14JIWA19-000
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N O V 13 1997
R yyy 'NOW
rff r r kyy q gq gg py ��rrDUE
' .•FOI L ,d'1~�:9 A4.1 4` A!�1� U.S t�UE 791 JYY
RECEIPT
DATE
By `
DATE FINALED
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
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
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 s/ 7
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
F'rdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
'fTemp. Use of Power
;Final
;:Utility Notice (Perm)
.,CITY DF LA-_QUINTA
SUB -LIST
CONTRACTOR �.�/ a, ADDRESS 6AA-k 'C
OWNER— JAMr� :. JOB ADDRESS'2-:2
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous Dace.
It is the responsibility of the General Contractor or the Owner/Builder to mon for the sub -contractors that
are on this list are the same persons performing the work. Any changes to this list must be approved the
City of La Quinta Department of Building & Safety pjLQr to work being performed by a changed sub-
contractor. Failure to comply will result in a stoppage of work and/or the voidance of building permit.
GRACE <><>>
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I
Tonniges
79-235 Violet Court
La Quinta, CA., 92253
RE: Pool & Spa Permit 9711-033
Dear Mr. Tonniges,
The purpose of this letter is to inform you that your Pool & Spa Permit 9711-033,'for the
project at 79-235 Violet Court, has expired. In accordance'with 1994 UBC section 106.4.4,' no
further work may be performed until a new permit has been issued.
Please contact Daniel P. Crawford Jr., Building Inspector I, at (760)777-7012 to obtain any
information. you need regarding a new permit and/or any required inspections.," Should you
choose not to complete the project, we would then have to'pursue any or all c•f the following
actions:
1) Abatement of the project through the City Attorney's Office and Code Gompliance Division.
2) Notice of non -conforming structure placed upon property profile.
3) Action filed with Contractor State License Board. Optional if Owner/Builder.
Please contact us at your earliest convenience prior to.10 working days to resolve this issue, and
for any questions you may have.
Sincerely,
Mark Harold
Building & Safety Manager
aniel P. Cra rd J
Building Inspector I
cc: file
dpc
CITY OFLA QUINTA
13UILDING & SAEE?� DEPARTMENT
CONDMONALLY
ACCEPTED P0Ps
CONSTRUCTION
;SUBJECT To INSTALLA T e�� AS PER
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AND ALL APFLiCA CpCiEs _-.n .
►� ►3 a BY
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39-685.SI•Mtichael P14ce
Palm Desert, CA 92211 • Li -...#61777.3
447.6316 • Hrm..e: ;519' 16-0-1403
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APPROVED BY: 1 3
SCALE DRAWN BY
DATE::. REVISED -
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1619) 360 140
DRAWING NUMBER,