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LICENSED CONTRACTOR DECLARATION
I here i y 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
Zae
5213'319 11i "Gi20i(
1I,�� Signature of Contractor �
Ile)
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 S11V1.0ft. Policy No. ,vin n.. A"Ior e
�.)115,A I.i I'•..i ASL/ __.Z• yJ_VU LoW11
(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 with those provisions
LDate: �� -Applicant f�
Warning: Failure to secure Workers'lCompensation 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 property, ffoor�inspection iurposes...
,/Signature (Owner/Agent) /•' ' " Date
PERMIT #
BUILDING PERMIT
0001406
DATE VALUATION S,,(1f1•00 LOT TRACT
ADDRESS 79-195 CAN �P+:RI k CIRCLE
APN
604-263-{1 i
OWNER
CONTRACTOR/DESIGNER/ENGINEER
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iy.iS)5 CANINERRijk C.JR
260 P1114 MN CREST
L.AQU191- C,A 92^5{
iIN401JNTA N CTIS 1`I;R.;
:'A
92_ J
USE OF PERMIT
RES JDRE AL JUMODET,
CO NOER 1 ?TIURD LAY Or 11,T 0 WORKSUOP tROOM WOT t1i'PRIDIVIM
Folk SLr:4P114u !'UR10t W-5).
VALUATION ZOO.G� J,S
i;�S?'i'YAA'A'M`!i`71 tl'�h6!'�` Il'C;� 8'Y9T:rp'F•1tESC�Ir°'SI'4yV
A:MSY p11.lf11 tJi:iY✓d•�:iFT.0. r✓A �,.1/A'•11,y ,tl .h'.T}r.J i,. 6.G.V11
'1iA1! A(t
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PLAN CMCK YFE 101-000-439-:318
CONST t T rr, 10 f4 I -7- I S gnt)t1(i i 5 00
.. y
1_
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ibfi�C"eAiaiCAI, F.`!"13 $19.311
-
:i'f'ta.C: NU .MOTI(:NN FEE - 12,ENID 101 -OW -2,41-t100
r•
V3.
Si.,Tl3 T(YrAk, C0N19MV7i10N ANIl PI AN f; WCK
LESS fsWJPjVD FIEIIES
Xw
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
r.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
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
Temp. Power Pole
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.1,
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
A REINSPECTION PEE Of =SO
VALL BE CHARGED IF THE APPROVED
FM- AND JOB CARD ARE NOR ON
'I M SITE FOA A SCNr UV16% 1
INSPECiIOM.
I �oo�PR�
Mr. & Mrs. Delaney
79-195 'Canterra
La Quinta, CA.; 92253
RE: Un -permitted Workshop_ remodel @ third car garage.
Dear Mr. & Mrs . Delaney,
rc��l�.v
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE �3� 8Y
I have made the required corrections and notes. on the plans provided to approve and issue a
permit for the un -permitted workshop remodel that has been completed in your third car garage.
This letter has been prepared to document the condition and corrections required for inspection
and final approval of the existing remodel.
1. Please note that this remodel is not approved for a sleeping room and approved use is limited
to a workshop. There are life safety and light & ventilation requirements that restrict the room
usage as a habitable.and/or sleeping room.
2. Provide a FUSIBLE LINK DAMPER at all garage/workshop firewall A/C penetrations. This
is required to maintain the firewall occupancy separation between your dwelling (R) and the
garage (U).
3. Provide a tempered window within 24" of garage door.
1
4. GFI protection is required at all 120 volt outlets in workshop.
Field inspection coordination is required for verification of (PTDF) pressure treated mud sill
plate at interior framed walls.
Please contact your building inspector for all inspection coordination required. This letter will be
entered into the permanent house file for reference with plans provided. Please call 777-7027 for
you may have regarding the required corrections above. Thank you.
Building Inspector H
':n. auc«:: �! s ,r+,'F . -tT- w�v ��a �. - .-t- ^:•E'' {– r. ,�.,. ct`..i C'�-- r. +>= �'_,A _. O-
1 \
U I N T E R R A BUILDING & SAFETY DEPT.
APPROVED
PLAN O N FOR CONSTRUCTION
OXY • ,
gar /" '�*/x
Enwy
n«igna[es ailing
f prewirc
WINDOW 10 x 4'1,D
0
goo' 1 � 11V �W�14
1,968 square feet a Two bedrooms plus a den and two baths,
- or roomsandwo ,bathsi + rhrmal -dining- room• a Cozy morning room
+ hiterior laund area a 3 -car garage
F05A a >✓ Lt N►L -DA int P
Roger Snellenber and Associate eserves th 'ght to change product design, price, density and location without notice. Any designated project area is subject to change without
All m re oorplan other project materials are preliminary and subject to change without notice. Ask sales counselor for details.
3
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CITY OF LA QUINTA
BUILDING &SAFETY DEPT.-
__-
APPROV
FOR CONSTRUCTIO
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3
Oda 2a6ta
PLAN CHECK CORRECTIONS
------------------------
DATE 12/27/99 PERMIT #. TBD
JOB ADDRESS: 79-195 Canterra Circle
CONTRACTOR: ' Owner/Builder
PLAN CHECKED BY.- Daniel P. Crawford Jr.
RE: Un permitted garage/workshop remodel.
Dear Mr. & Mrs. Delaney,
The following corrections are requested to permit the remodeled garage. Please provide 2 sets of
corrected plans with the following corrections, thank you. /
1. Provide dimensioned plan. Provide verification that a minimum 20' by'20' two car garage ✓
exists. '`ti $
2. Provide Electrical. (Note all existing and added outlets, lights and switches)
3. Provide Mechanical (if applicable) Was the workshop space conditioned? If the space was Yes
conditioned, firewall and life safety corrections will need to be addressed at resubmittal. 7
4. Window as shown is required to be tempered (safety glass) within a 24" arc of the door. Verify
dimension to door. 12 r' 0'&V1icko— e9yrfdrA
Please address the above noted corrections and resubmit. Additional information is required to
complete your plan check for permit approval. Please note that upon permit issuance some field
verification of the garage remodel construction may require some areas to be exposed for
inspection, i.e., pressure treated sill plate verification. Field coordination with our field
inspector may be required. Please be prepared for this request. If I may be of any assistance
please feel free to call 777-7027. Thank you.
I i l l f 1 industries Inc. FIRE 6AMPER
MODEL SERIES 0100 WITH INTEGRAL SLEEVE
VERTICAL OR HORIZONTAL MOUNT
12', 14'
OR 16' I
�..
W
MODEL 0114 • 1 1/2 HOUR LISTING
TYPE A DAMPER WITH 22 GA. INTEGRAL SLEEVE
I H Minimum size Vertical - 4" x 4' ° e
Horizontal - 6' x 6"
Maximum size - Vertical - 48' x 30" or
33" x 48' Us L
Horizontal - 33' x 38" or
30' x 45'
H
MODEL 0124 - 1 112 HOUR LISTING
TYPE S DAMPER WITH 22 GA. INTEGRAL SLEEVE
AND BLANK -OFF CHANNELS OF BOTH ENDS
Minimum size - Vertical - 4' x 3'
Horizontal - 6" x 4'
Maximum size - Vertical - 48' x 26" or
33" x 42'
Horizontal - 33" x 33" or
30'x40"
DAMPER HEIGHT (H)
DIM. "A"
5" THRU 17"
2 "
18" THRU 27"
3'
28" THRU 36'
4 "
37" THRU 42"
5'
PATENTED 1982
12', 14' CO) + 2
OR 16' r
MODEL 0134 - 1 1/2 HOUR LISTING
a TYPE C DAMPER WITH 22 GA. INTEGRAL SLEEVE
+ AND TRANSITIONS ON ONE OR BOTH ENDS.
p Minimum size - Vertical - 3" dia.
{ { Horizontal - .4" dia,
I I Maximum size - Vertical = 24" dia.
{ Horizontal 24' dia,
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FOR INSTALLATION INSTRUCTIONS
SEE DRAWINGS 0100-12A AND 0100.128.
R
DATE I A aantaa I supanuots I cumpiO no.
vT01''�
I 7 -au ' OIOO t 11.89 L 9100.15
Nailor Industnes Inc. oursues a policy of continuous product development and we therelote reserve the right to change any in this publication without n000e.