9704-083 (RER)LICENSED CONTRACTOR DECLARATION
I hereby 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
/Date ! Signature of Contractor—
OWNER-BUILDER
ontractorOWNER-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 (Scc. 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 Sianature 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:
Gamer- Policy No.
FUND .229 ."W110014" I I
(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 Sect 3700 of the Labor
tode, I shall fort with comply with those provlslons. ��
ate:• 7Applicant ~�i"a.►/ - �-.-•
Warniqg: Far ure to secure Workers` Compensation goverage 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
the14above-mentioned property for inspection purposes. f {%
/ignature (Owner/Agent). � .� x,- -.-Date(
BUILDING PERMIT PERMITk
°°NTR°`#
9704-11:3
R ® Q 8
DATE VALUATION ,4,760.60 LOT TRACT
JOB SITE
ADDRESS 499 V`IST,% iiONI—TA
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APN
OWNER
CONTRACTOR /DESIGNER /ENGINEER
K:c:,UR
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e�A[�lo"Ll"4 CO.
49.'129 aISM 8014TVA
77�350 C;,At, L1 ARROSA
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LA l:1L.11N1 A
CA.
9:17.53
I ISF OF PERMIT
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RECEIPT
DATEBY
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
OX 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 A OVALS
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:
r --.i t--\/r:m6KI
January 16;)1997
;Dale Kessel
49-329 Avenida Vista Bonita "
La Quinta, California 92253 -
Re: 49-329 Avenida'Vista Bonita
.Dear Dr. & Mrs.. Kessel:
Your Architectural Variance dated January 8, 1997 has been approved under. the following ,
stipulation(s); -
• Al1work shall be done in'a workmanlike manner by competent and licensed professionals.
• Actual modification must conform to the plans and specifications submitted and approved..
• All work is to be in compliance with local building codes and ordinances.
:. Any damage to the common areas resulting from this modification and its construction will be
repaired at the Owner's expense.
Contractor must provide the Association proof of worker's comp., liability and auto insurance prior to
the commencement of any work :
`;• ' You or your contractor -are to provide a list of names of the scheduled workmen to the security guards ;
at the Mazatlan Gate prior to the; commencement of any work.
!; • All construction debris is to be removed from the site by the.close.of each day to maintain order and
retain the. aesthetics of the Santa•Rosa`Cove:
' . • 'All electrical wiring, if applicable,' must be'contained within approved.conduit painted to match the `
surface it contacts.
Any alterations to the commori:area landscaping must be presented. to the Association's landscape
contractor, Omar Garza of Shadow Palms Gardening.
• All hardware must match in style and.color with.the existing hardware'.
A'copy of the approved.variance will be mailed to you ,after.the•final inspection.' Please contact,
the Association Office when your modifications are complete. If you have any questions, please: call me.
• jVe ours, - .
{ Pamela S. Salinas
' Association Manager on behalf of ;
' THE ARCHITECTURAL COMMITTEE
cc:. GregScrivens; G. L. Scrivens Construction .
.49-991 Eisenhower.
La•Qu_inta, California
(619) 777-7621
Faxr(619) 777-7622
Mailing Address:,
Post Office Box 12910.,
SANTA ROSA'COVE ASSOCIATION • , . Palm Desert; California 92255
. � L
FIREPLACEER sr.n
TOOSMART
HOUSE
Mops[
DIRECT VENT MODEL SL -2000 (21,000 BTU)
SIDE VIEW FRONT VIEW SIDE VIEW TOP VIEW '
1u
--V �- /ventcollar
1—C 29'�/au
13°
22%11 12n
`I ,UIQ
10%11c— 2
LE
,u15 -�1
26" SCALE '/." 0 1 FOOT
SPEC 1. F I C A T 1 O N S'
Height Front Width' Back Width Depth
Model Actual Framing Actual Framing tua! Framing Actual Framin 9
Front
Glass
Door
BTU
Input
2000 SL 29'A 30 26 26'A 26 26'A . 10'/. 11'/.
18'/.
k mvQ, cc N MINIMUM Ur 7z- AUOVE UOTTOM OF THE BRASS HOOD.
` NOTE GAS FIREPLACES DO NOT REQUIRE A HEARTH.
D -Series Termination Vent
-Outside
Inside `' Wall Chase
Chase Thickness
` -7'/." MIN.
3011
10" 6" DiaT�
26'/2"
;' •.
Framing *% 11l.n shows:
Dimensions ' Shows: SL-DVK-01
(Flaming is inside opening) SL-DVK-01 S S; u .02SL-DVK-02S
7,14'
ARCHITECT'S
TEMPLATE
:.,DRAWINGS
rHE.A.T.-IN310.
(612) 890-8367 FAX (612) 890-3525
HEAT-N-GLO Fireplace Products, Inc, 6665 W Hwy. 13, Savage, MN 55378
9 0 0 0 • s
Finallyfireplaces that don't
let efficiency go up in smoke.
s • s • 0 4 0 • • • 0 4 • • • • * • • • s 0 • • • • 0 • • • • • • • • • • • • s
EASY AND ECONOMICAL TO INSTALL
With the use of our direct vent technology,
The Slim Line vents directly out the back
of the unit, makirig this fireplace very easy to
install. The air tight firebox takes all combustion
air from the outside and thus is ideally suited for
today's tightly sealed homes. This feature keeps
the warm air in and the cold air out and provides
a thermal efficiency in excess of 65%.
In addition to the ease of installation this
unit provides, it will radiate and convect heat into
a room. And because there is no heat loss as there
would be up *a conventional chimney system, the
heat exchanger of the Slim Line is especially
effective. To further boost heat circulation we
offer an optional fan.
This compact unit measures 26" wide,
291/2" high and 10 3/4" deep. Although the
overall dimensions are compact, the ceramic
glass door allows for a full view of the four
ceramic ftber,lt g yellow flames and buming
embers. Our ceramic fiber logs and burning embers create
the most,realistic look available today.
The zero -clearance feature of the Slim Line allows for a
variety of installation possibilities, including as a built-in
fireplace, in a bookshelf or entertainment center, in starter
homes, multi -family units, bedrooms, sunrooms, bathrooms
and for zone heating applications. No other fireplace product
on the market offers this flexibility of installation possibilities.
S P E C t F I C A T t O N S
Height Front Width I Back Width I Depth I Front
BTU
Input
Model Actual Framing ctual Framing ctual Freming Nal Framing Opening
2000 SLI 291A 1 30 1 28 1 281E 1 28 1 281<. 10% 1 10% 18%x 101/.
21,000
NOTE GAS FIREPLACES DO NOT REQUIRE A HEARTH.
DIRECT VENT MODEL SL-2000MH (21,000 BTU)
SIDE VIEW FRONT VIEW • SIDE VIEW TOP VIEW
t"
/Vent Collar
—/L 1 10
JIL JIG— y
il fes -24
°�"
117
28°A
HEAT N GLO reserves the right to update units periodically.
STANDARD FEATURES
• 21,000 BTU/hr. input
• Combustion efficiency in
excess of 65%
• Four Ceramic Fiber Logs
• Safety: High Temperature Limit
Switch and Glass Doors
• Piezo Ignitor & Safety Pilot
• Air Tight Combustion Chamber
• Burning Embers
• Freestanding or Zero -Clearance
• A.G.A. Design Certified,
CGA Certified
OPTIONS
• RCH-09A Remote Control
• WSK-21 Wall Switch Kit
• GFK-50 Fan Kit'
• RC -STAT Remote Temperature
Control
S+
rut: n. liar beim, q'« uwwi iire rrrlb A, a arNttb. e/%ic erx r rnul
r,:u:•,u a'v :r ;«.a. Neat -V -Iiia is lbe'Sntrtrt Choice'
FIREPLACE SUPPLIER FOR SMART HOUSE H0 lSE
HEAT -N=
HFAT-`-GIA Fireplace Products, Inc. 6665 W. H11-• 13, Savage. %IN 55378
(612) 890-8367 Fax (612) 890-3525
B-SL2 9/94