0007-042 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9,(for mencing with Section 7000) of Division 3 of the Business and
Prc`essiordNCode, and my License is in full force and effect.
License '# Lic. Class Exp. Date
J4�_
C-61 XV 3 G31 1 {2E
Date iiSignature of Contractor'! `UX -P
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).
sm axPmpt 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.
(4)Tave 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 . 3TA 1 E FUND Policy No. 0460-DI41T 0774949
(This section heed 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 thejworkers' compensation provisions of Section 3700 of the Labor
Code, I shall orthith comply with those pry to S.
Date: IV / 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
the above mentioned pro arty fdrnspection purpo es.
Signature (Owner/Agent)�A �r Date +
BUILDING PERMIT PERMIT",
00�37 `0
DATE VALUATION LOT TRACT
/l n?,421,40
In
JOB SITE
APN
ADDRESS 14-364 CAU.s.Lr WSLsiA VMZUF
r
OWNER
CONTRACTOR / DESIGNER / EN (NEER
MM PANAM81I
AILAS AW]r1:i G COMPANY
74364 CAIAd]E: VWA VME
754 "6 ILLWAS ROAD
JL A QIMTA CA 32253
PAiM EWR1hiCS
CA
512264
.
(760)327-8466 I
g
I K5
USE OF PERMIT
];jJjI1tJ /
55$3.F. AI.i- MAWOOD LATTICE P.A,T10 COVER(ICSO 4 2621P)
PORCWP.ATIO 558:00 8F
F.YrD"1 COST OF CC►N9112TTM10N
7,421.40
r)LAN CHECK FEE 101 a000.439�31 S 164.35
CONST.RUCTIOW FLEE 101-000-418-000 $�3Si,00
STRONG MOT1.011 FEu - RE ID 101.000.241-000 t74
r R
C7
L
ULM- COTTA. L CONS RU( ION AND PLA14 C'I-MCFC
$164.09
93 )YRE-VAM FFTS
$0.00
•1'MAL PTEIa.�' FUS ]Y(T NOW
$ 64:09
RECEIPT
DATE
BY
FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
SIBacks
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
Tempa 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:
Srlirnui r LYIr) Amr•I tCll I A1'IIrLhA11n c lol lr 11 triC in rtcr .1— n . .gnu
jxbtWO [OLUIJTIS 1111111411V REQUIRED.
�� . �. "1" 11-1 Un MMOX tAKIII MILrtutt ALtINUAILS.
V - for 000c1A5 rm - IMCH 12 CRADE WOOD IIrADER tAAY OI SUBSTITUTED FOR J r 8' ALUIJ. JX 8' ALUM. OOX OUAI OR
HEADER USE COLUMN SPACRIC FROM :r x 8" t .011 ALUM. IIEAOER. J'X 8'X 12 CA. STEEL 'C' REAM IIEADER
X6 !It OR Sxsr FUU'TERS
ALTER."A" SMALL CONSIST OF 18" opr. ALIERHArE *IrIB' ROOF PA
SEE U``IE 117R VMS ROOF PANELS, PLACED PARAMI TO FOP';. ALIERNAIT
�� ALTERIIAIE 2-416 1/1` STRUCTURE ATTACHED W/2 11O (18 ROOF PANED
11 DER 91 PLACE Or
SIDEPSMS TO RAFTERS. AL OVCRIINIG 16 FOR
7X8' HEADER NTiFI POST
ANO IATES "" ALT BSHALL CONSIST OF 18" ROOF
PAIIEL PLACED PERIVIDICULAR 10 1 1/2" X 1/7" on 18" FOR
T X J POST ;TRUCTURF. MID AFIACIIFD W/7- #10 SMS 1* X"
TO BLOCKING.
\\ ALTERIUUE 2-2' X 6 1/2' HEADERS. IAIIICE: .010 X 1 1/2 Y. 1 1/2' 0 :1 1/2"
OR 1T O.C. OR 2 X 4 0 G 071 8 O.r,.
AY5E 1 ppb C� + NOTES:
RIOt1QNY M111T15 UU41ICSIOOR1165S W/9' 1170 10' 1. 11115 SIRIICILINIi MAY 1101 INI:If);III WIIII \
ora srLtcE REcn0J 1 + 01 coil li�ofS Z. OR10ENLRAL NOTES SEE DWG #35003 SIFT. I
Or 16 NID 7 Or 16.
J. FOR ALTERIIAIE [AVE ATTACIIMENI OF RAFTERS
SEE DETAIL ' OF DWG. t1O. J5003 SIN. J OF 16. t�
4. FOR SAFETY STAKE AND AnfSCO NICIIOR DUAIL
fORD10 0 1 J 17 PR CROI s SEE nWG. 110.
OFT
W. HEADER OVLRIUVIG = 4n f
r iii.
S. OF COLUMN
SPACING FOR UP TO 16' PROJF.CIION NIU JJ% OF
COLUMN SPACING FOR 17'-70' PROJECTION.
10' 1110. 12' PRQjSDQjjS I 6. DESIGN PER U.O.C. 1991 [;IRON. pf+1, 3 I/2 COTI .
tl.
1R- SEE NO EOILS 1• FOR RAFTER IWIC(R, HEADER TO SIDF.PLAIE OR S ON DWG. j3500SPLICE IDCAlI0N5 FOR OPEN LATTICE AWNUIGS FOOUTIGCOLUIIII.'Or? SIA; AllCIL SEE UK. 110.n35017LUUN TSITTS. 6, 1, AWT) 8 Of . 2 OF 16 F IFj
oFaOTE11j1_ DAIL 17LVISIordS
NO. IJ7s57
m Exp �.DI•B2t�- i
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�
/A/N.F•�l/k,to E01%
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RAFTER
MAXIMUM COLUMN SPACING AND FOOTING SIR FOR TX 9"_ ALUM. _U ON - 1FA- At)
1
COLUIItI SrACIFIC Ar FIG. SIZE
PIIOI-
NO
(EN
U'FAAt
RIM
A1V IR 9PACOIC
_M_IIL_FR
2- TX 6 1/2'X .019• IIFMER fx ix .ojfr IRAD_ER--Tx R"X n.n.w irrAmp. �) - TX s'x On+Y IIEM_ER �)
n[N!<.R 10
SUB'IAIL
Jr 8 x t) CA SIl C a[AM
tx trL°�
"'•., E ctIAL
O.C.
COLUMII SPACItIc FOOOtIc COLII1111 SrAOHG FOOIIIIG r•OLUIIII SVWIIG FOUR" COtUIJII SI'N.tllf. FOOOHG
-- -
EE
1 or 6
_ _ _-_
7C
FOsilt
__-
-
ON SLAB p- 01'6 SIZE H-im 1 p {001'6 S17E 1711 SI An I N 1001'x. .117, ON SIA; 1 N LUP
OE S17E
R[OO ISMS
N SImII pA1001'C
- - -
rx6- TY.02f
--�-J----
--
10'
S'
---
l0'-5 10'-S• d•21' 6..11; 4---11* d-70' in, 9' 10' 9' A 71'.. 1v.r 1)'-1 d -).r
- _...-
.L! -� -9 -6-- e'L�•.-... B --Y.._... F.. r... a:_71Y '!_:.!R_.... �.' i� '�'?2 ll it.- = d-7/'
a I
6 1
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d -t9
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11
T
rxlrx.oJU
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---
_0=10 --O-IT d_2.r_ 7'-r 7'-Y a=2V 9'-I' 9•-•1• cw 9i-9' 10•-Y
— — -- — - --- ----
- _ _
8 f't
_
9=9• JO' -0'
_
d=JJ
1,'
JkfY..OJf
•--—........_ "' - --- - --- •--•---- -" -
6'-J - 0'-J d=2J 6•- f 6'• 1" d )Y A' -.r 8•• 6" a -2t 8,"5 9 -111` d-71`
----_.
6 1 1
.---- '--7
6'-K 28•_5
—
d=Jf
j4-
_
t _ 9-?7� d=75
6'-t0 T-! d -2J S --G -- 9;-ir d+jF _6:-iUA•2( 6-IIY a-IdLt a -i6
-- —"---_--_--- __----_ .. ——
---
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_7•-r_ _
6 10 LS' -I
d=J6'
20'10'
. •m1`
a.v
JXfX.O,r
uen .
jxbtWO [OLUIJTIS 1111111411V REQUIRED.
�� . �. "1" 11-1 Un MMOX tAKIII MILrtutt ALtINUAILS.
V - for 000c1A5 rm - IMCH 12 CRADE WOOD IIrADER tAAY OI SUBSTITUTED FOR J r 8' ALUIJ. JX 8' ALUM. OOX OUAI OR
HEADER USE COLUMN SPACRIC FROM :r x 8" t .011 ALUM. IIEAOER. J'X 8'X 12 CA. STEEL 'C' REAM IIEADER
X6 !It OR Sxsr FUU'TERS
ALTER."A" SMALL CONSIST OF 18" opr. ALIERHArE *IrIB' ROOF PA
SEE U``IE 117R VMS ROOF PANELS, PLACED PARAMI TO FOP';. ALIERNAIT
�� ALTERIIAIE 2-416 1/1` STRUCTURE ATTACHED W/2 11O (18 ROOF PANED
11 DER 91 PLACE Or
SIDEPSMS TO RAFTERS. AL OVCRIINIG 16 FOR
7X8' HEADER NTiFI POST
ANO IATES "" ALT BSHALL CONSIST OF 18" ROOF
PAIIEL PLACED PERIVIDICULAR 10 1 1/2" X 1/7" on 18" FOR
T X J POST ;TRUCTURF. MID AFIACIIFD W/7- #10 SMS 1* X"
TO BLOCKING.
\\ ALTERIUUE 2-2' X 6 1/2' HEADERS. IAIIICE: .010 X 1 1/2 Y. 1 1/2' 0 :1 1/2"
OR 1T O.C. OR 2 X 4 0 G 071 8 O.r,.
AY5E 1 ppb C� + NOTES:
RIOt1QNY M111T15 UU41ICSIOOR1165S W/9' 1170 10' 1. 11115 SIRIICILINIi MAY 1101 INI:If);III WIIII \
ora srLtcE REcn0J 1 + 01 coil li�ofS Z. OR10ENLRAL NOTES SEE DWG #35003 SIFT. I
Or 16 NID 7 Or 16.
J. FOR ALTERIIAIE [AVE ATTACIIMENI OF RAFTERS
SEE DETAIL ' OF DWG. t1O. J5003 SIN. J OF 16. t�
4. FOR SAFETY STAKE AND AnfSCO NICIIOR DUAIL
fORD10 0 1 J 17 PR CROI s SEE nWG. 110.
OFT
W. HEADER OVLRIUVIG = 4n f
r iii.
S. OF COLUMN
SPACING FOR UP TO 16' PROJF.CIION NIU JJ% OF
COLUMN SPACING FOR 17'-70' PROJECTION.
10' 1110. 12' PRQjSDQjjS I 6. DESIGN PER U.O.C. 1991 [;IRON. pf+1, 3 I/2 COTI .
tl.
1R- SEE NO EOILS 1• FOR RAFTER IWIC(R, HEADER TO SIDF.PLAIE OR S ON DWG. j3500SPLICE IDCAlI0N5 FOR OPEN LATTICE AWNUIGS FOOUTIGCOLUIIII.'Or? SIA; AllCIL SEE UK. 110.n35017LUUN TSITTS. 6, 1, AWT) 8 Of . 2 OF 16 F IFj
oFaOTE11j1_ DAIL 17LVISIordS
NO. IJ7s57
m Exp �.DI•B2t�- i
��Tui�• v,rr;_
�
/A/N.F•�l/k,to E01%
i1`q C1VIl .;:-
l`07 CAILE�� �
0.piES5/p
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01-1.1.
LACUNA—TYPE OPEN
'
7 X Jr N.pM, COLUMNf46
ALIERNAtE i
z
OtALLMAN9
clyn
; i � .
:6267:
1\1
1`T/l
BUILDING PRODUCTS INC.
0-0111.
tx trL°�
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2t PSF, 6 ,O Wq VW VM
ALUM. RArIER_-F QIFRNA,1E Ui IR'
SEE SC[OlR1 FOR SIZE
HEADER OR X 1`X li C
LACUNA—TYPE OPEN
'r BUW ,
7 X Jr N.pM, COLUMNf46
ALIERNAtE i
1/r ALUM. Star-
PIAI(-
X 4 O.r.
MOOD POST
gtri;naIE
2 X 6 O.F. SIDE PLATE
)Pi. J I/Y CONC. SLAB
BUILDING PRODUCTS INC.
SAF(TY STAKE OR AOESCO�.-r
A6 LC.8.0. ES, EVALUATION REPORT NO. 2621P
u+clk)R RIRI CONCRpE
2t PSF, 6 ,O Wq VW VM
1`001111; np. OR FOOMIC
EE
1 or 6
11rRp111 u+cL s.
VIEW
—SIDE
24' MAX.
0111WC-C'
MIN. 011ANC
%5
8*—J MAX.
COLUMN M.
4I IIu�TIV'WA ' „ •
�.-,N
M
LACUNA—TYPE OPEN
cG�`
LATTICE STRUCTURE
IIIl'01ALUMAX
I ma. .1 &" If idw ho&% h
BUILDING PRODUCTS INC.
I/651 DoBot Pe"t.e2 Suite JSO
D•"e1`. ,x. 1324"W78
A6 LC.8.0. ES, EVALUATION REPORT NO. 2621P
KO STo
NONE VAYEPAR, AI10. 1 30
2t PSF, 6 ,O Wq VW VM
S -JI -91 od ' 't J3017
J�eE�
EE
1 or 6
L08qC0S ` Pe tZr,__L. to
T"S
C-ACIVC o 2rlx- L;tTV L
�A I' I SERVING THE
COACHELLA VALLF_W
'SINCE 1972
and SCREEN a r _ LIC. NO. 6782 s
bJ
tj
1 7
>1z
a 3 I
j >1 E a aQ '
= 754 Williams Road / Palm Springs / California 92264 (760) 327-8466 Fax: (760) 327-8467