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9809-043 (SFD)LICENSED CONTRACTOR DECLARATION | hereby affirm under penalty ofperjury that | am |kmnood under provisions ox Chapter (commencing with Section 7000) of Division uofthe Business and, Professionals Code, and myLicense ioinfull force anuo#o�. License u oenoo�� v.o/osu Exp. Date '147866 B ^ /ate Signature of Contractor��Lso. OWNER -BUILDER DECLARATION | hereby affirm �unda,penalty ofperjury that |amexempt from the Contractor's License Law for the following reason: ( 1, as owner ofthe property, mmyemployees with, wages as their sole compensation, will mvthe work, and the structure isnot intended moffered hx 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 (.) I am exempt under SectionB&P.C. for this reason ������� --- Signature -w_- SectionWORKER'S COMPENSATION�btdLARATION 1. hereby aff irm 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 V00 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation� ' C��hx�� which this permit is issued. *My workers' compensation insurance carrier & policy no'. are: Come ` po|�9mo� ' ^. T se dn4196' i1not be. mNplekd if the permit valuation Wis 6' 08 ()/ certify that the performance'of the work for which this permit is issuecl� 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 1. should become -subje�t to the workers' compensation provisions of Section 3700 of the Labor CAB; I shall forthwith comply wil.Ethose pi�.ovisions. Warning: Failure to secure Vy"girkers' Compebsa ion-tro'verage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to -the cost of compensation, damageg as -provided for in Section 3706 of the Labor Code,, interest 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 applicatiom 1. �ach person upon whose behalf this appl ication is made & each person at whose request and for whose benefit work is performed under or. pursuant to �i4 any permit issued as a result of this applicaton agrees to, & shall, inclemnify' ~ .~~ harmless~.the `.' of ^. ~~ ..~ its officers, .x~~'~~~.~~,.~, o. Any permit issued aoaresult ofthis application becomes null and void if work is not commenced within 1e0 days from date of issuance of such permit, o,000mmon�ofwork for 1VVdays will subject permit mcancellation. ' | certify that | have read t his application and state that the above information io ` correct. | agree mcomply with and State laws relating mthe building construction,and hereby authorize td of this City to tupon the,/above-mbntioned property for inspection purposes./ ^/ ner/Anen PERMIT # BUILDING PERMIT DATE VALUATION LOT JOB SITE APN ADDRESS hll-ito'VISTA FLORA kSL bE'S4EkT RESORTS, WC. KSL LAND If CORPORATION 56440.P4GA BLVD 55-9M PGA.81,VD LA QUIWA CA 922-53 LAQUINTA. CA 922 53- (760)5&1-7166 CIBU 5323 USE OF PERMIT DAM 'A46 NGLE FAMIP -,P 611; ,LOT 1, PH 2. 'PLAN 2A - SFID - JP a -MIT DOES NOT INCLUDE BLOCK WALL OR POOL. CUSTOM CONIX(RUC 11014 1,674.00 8F PORCWPATIO 157M 9F rXf MAT ED COST Or, CONSTRUMON .In,492Y.70 CONSYRUCTION FEE-, 10.1-000-419-000 SM.00 PLAIN CHECKFEE 101-000-�39-318 $W.85 NIECHANIMFEE 101-000-421-00.0 137LECMUCAL FEE 101-000420-000 PLUMBING FLIF 101-000419-000 $174.50 +GRADINQ FM 101-000-423-000 $20,00 225-.0002,44.1.342 $2,9A4,10 L WNSTRUCTIONAND PLAN CHECK, ;10T.A 48,52 PAID FE ES LESS, PRE $0.60 Nov 0.,2. 1998. TOTAL PERh Mh FEE'S DUE NOW' S4,848M DATE DATE FINALED INSPECTOR "—°--r- �_-_�----�--� "—°--r- �_-_�----�--� INSPECTION RECORD OPERATION j 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 I 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: ------- V-00 I I III I I I `� / ��� • / � , 9.5011 HALL TIE 5TOR. 1 i i r 0 4 I I - . T�LEicPr. m � I I I ( f '-e" 11_x(T" 1TI 1 I I i EN�y i I i I i TILE I I- I i I f 1 a �v J L---- -� PORCH ®, _ _, l 6F1 )TltOE CLOCK r.) ski REVI t 5'-8" b'-1 3/4" ~ I'-4' 6'-1 3/4"'-8°-:.:: ^ J., .. ELEG 1 L / REFER TO MAIN F ON SHEET '6-2.I' FOR TYPICAL NOTES d INFORMATION NOT SHOWN HERE. FIRST FLOOR PLAN I I I I 1 I I 01 0 1 ©I I I I 1 I . I ; VG 1/A c�. AM IT It ► �1:l��b l�a� WWI tali algal �(«<Awl i �s II��II�I�II�I