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0104-213 (BLDG)LICENSED CONTRACTOR DECLARATION, T d hergh&ffirm under penalty of perjury that I am licensed under provisions of Cha(commencing with Section 7000) of Division 3 of the Business and Profes nals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 73,3152 D 0311 lin Date r Signature of Contractor 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 r 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. (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. Date: Applicant " Warning: Failure to secure Workers' Compensatibn 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 for inspection purposes. Signature (Owner/Agent) Date f < r -SUILDING PERMIT PERMIT# DATE VALUATION LOT 0104-21.3 TRACT 0=00 JOB SITE ADDRESS 54 -moo APN .... OWNER CONTRACTOR/ DESIGNER / EN (NEER FGA W199f ILESTDENITAL ; OM.1.70H DEL MMPAMIC GEt.A3IMM, Lr.°014I3,.AM014 PC) A0X 1060 46%NU AVZ 0362,, LAQ�W,I'A CA 92253 301"ABRACS C% 92075 (856Y19,24300 CB.0 5033' OI�i+�+r�'�y�9['�VQO*i�3i+ft.4�TiON USE OF PERMIT ��jj��yy.ffjj YYY �'Q���**..hh''..,, ��rr!!� .iii.Y.it 1 -ME , VS Ilj4gti>`:[1�L f� 460 $7. CHARI.57�MA PL M•Wk, 44•=,, 5&= &5i-96il'OAK Teta • BUILI INOXis ` iPR VALUATION LI ES—MATED C09f OF %OMITRK,11011 20MW CONSTRUCTION Ilt '101...000-418.x000 5207.00 I' SY13�I ,flglf :t >I?;� I 1 101-000-241,000 V.fY+3 lr"J s4.;t°i3l.a.. i mmuoka Am 1mmf m�.m :'Jog-oo .I,r' 3 PR'WPAM FEES $0,00 APR 2 0 2001 D FALF"WIT r., PSE DUN NOW =9.00 CITY OF LA OUINTA FINANCE DEPT RECEIPT DATEBY DATE FINALED INSPECTOR i try , INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR IFBUILDING APPROVALS MECHANICAL APPROVALS Backs Underground Ducts ms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap S /$ U! F.A.U. Framing S(! S a ( 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 41 7�1�6L— Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric r!—Fial Underground Plbg. Test 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 COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles Q F.I. oke Detectors rnp. Use of Power Final Utility Notice (Perm) r,� f Page t of DAVE STEAVENS Inspection Services. PROJECT:�;,k U)Z5-7 /PV 4A',C I PROJECT4. cZy o A D 3 ADDRESS CLIENT:P GA BLDG. PERMIT # ENGINEER�I �, SA Jvt iJ L INSPECTION TYPE DATE 1 `7 M A y � v© I ARCHITECT Gvc.d A CONTRACTORIeC IMA a t3e c-, =tc INSPECTION REPORT ,R ►.J �1 fJ LL- '**t 1E S T P -A? P, 0 0 rA i r N%%- ��-'"�A �AKTz4c��� a� ETN U— 2-15-2k - c=,z�,,> — t�lc�►C (.� r� tet- A- 3 ,s �or� �i cT � *BETA k L_ L.�+-9 Is -9 - Q��z tltt,c—4?�ocxt►�c� A-35� l.r'i-ti - �ow���<rE t , k �-t4 IS -9 - �toc.tC��C� :�-' A -35r1 - Cow• CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, , substantially complies with approved plans, specifications and applicable sections of the building codes. This report covers ,the locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. ©859 3 T Rte' S o INSPECTOR NAME J C ire n v �►� S '^+ (Print Clearly) DATE r] I'VE A ~ Q INSPECTOR SIGNATU E� Page. of DAVE STEAVENS Inspection- Services PROJECT�C-, yj A 5C A PROJECT # I uy 1 - 01% 3 ADDRESS ,A 5 L/ S / CL) BLDG. PERMIT # ENGINEER�u,-,,� Sfl-JetE 40c,, INSPECTION TYPE .5V A(oQ OAKTZe% - CLIENT 36,A t,JGS i NoA DATE MA `t/ Q Uo 1 ARCHITECT (SOL8A ARct4tac.i uz_' CONTRACTORS C L tOAR INSPECTION REPORT 1 5, 14 15 —I - tS Lo C -K K) A t L -t LJ C_ tet- t -J l., N A t L ► ,� 6, (,LO ry. �►JGaIt)t2 lVu�T� TiGr1TE�J�� .•At..L. �CJS�t_r.� toy � � � T'L�tGE ZC-t t_S t 15.9 tM 0C.Q 4- Q4 rJ A t t-, � c� - C. cD 1_yT Z 1 C-V4Q\Z 'fit X L l+ P LA c -E 5NCaR%-',Lo C - ���t� NA�� �� V p >�T f!o'�' I /5.9 Zr-Al2 1-/fp� 7/5 T -ffS1{ OAOI-p-E�. S14eAt t' iJLOC.K( 0 A t Lk0Cp Ar A - Tt c,, I E--rN tt- W S- 90C,KaZ -"rt (at t C' c'. L A t_t M-rJ Su -i A`r c o Q IN -1 �LA c -g e7 4f.S. t L_ .4 1-1'41 - BLOCK/ * f�.l y IIIA) t_(tJ e� - (!�Orv\ _Inc e_ -r -t •N t t_S 3 , `� ��' 1 �oc r `t %'� f' 4 AJA i L. W C= COM A LZ--f- SHO Li :) C (ZA 1 e, LQ H o2L e►� tA-Lu, � � tJ To -BE P4 -A cc - d - L t�TN �1tr=� �'o ?L T/ E l� O.rJ �e�t e. V r hj �, SS_�t� `ff `3 2g� 9,40 $ TZ_ CERTIFICATION OF COMPLIANCE: To the best of our knowledge., all of the reported work, unless otherwise noted, jubstantially complies with approved plans, specifications and applicable sections of the building codes. This report covers We locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. O �":�,l t,I - SV INSPECTOR NAME t �J�1q J G a S ' DATE f,S M -AV ;)-001 t Gear ) INSPECTOR SIGNATUR����-. e ,..- �.,,�,yr,yfM7i'MPd+sI.�'W"31F�a"'k.swHR"��ru,�wum.+-Jr.-r� 1`+ ��_�i���`�i{'iS�a.:.r��cR!SZT'�1��e-f "'r'iy' �:�('�-w�" ��:MvrtNi*'�? +fir 'Sx �'.R",�'b:, iuY�ar'�•r..rn'cnnai"^� 514 - 8(oaEtE Page of .DAVE STEAVENS Inspection Services 1. _0 PROJECT�?�A PROJECT # c5! vp ADDRESS BLDG. PERMIT # ENGINEER, u/c%W_SAod1C //IC~ INSPECTION TYPE ePoky CLIENT :P(..A (..J E5 i too a DATE // AA -1 a o o/ ARCHITECT 6,o _9A 4?04 / Tt C_7 -L12 t: CONTRACTOR, t G IOA(,7 C! FJ G INSPECTION REPORT Fay maw, w3e,!3. C=e2c.A- c u oas r--rtoo,c q 5ETF t' X r� / - o 3 rLl0 Lee. �n2c1f�►-1�31 )(,N D,4K—rg E c 4/4) CD*Z' M f k S A0 - �+oc-e.S- �� �� ► D1L 20 -os c.EOGTH 1-1 `moo ►_t t1 t,J � - � LoLS - ./ Z �c Prv� 3��' �I11 ' lZo��- (� C.�►J(,,TH 'fid � rfi: 5:4 8 r.'t' L /_a A 4 T Q LL l Q E� � - aLvc.� - k4oc e 1 Z i�EP irl 1 k, A ROD S It If LetiJ(1TN Il8 bIA Q„• rax 0.,.n'c.Q -rl 6, iR LU - UX,,� - a�t5 - �:, l�C.t��� 3A 1� cn RoDS , 11"LlwV-rq s/K ►'} 94 la 'LiMn-11� ALd ~ c� i••DG�'s - '") VI..iS " , 2, l� Gt? i1 -i (�{ 7 3 " ` S 2z�Q S�..T►� ,,;1.�,_ _ c �s-�1���� -t �,�+rt' N /� la 2o�s - (s ct�G REO"Z - a (_oC_S - 9QLr_ n rA ''RODS l `7 /_ JU7P �/5a bI A� CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work; unless otherwise noted, iubstantially complies with approved plans, specifications and applicable sections of the building codes. This report covers 'Whe locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. D Sg ,3'y J D INSPECTOR.NAME 1 C_�j4 Lo >` ,� S (e!f' ). earty)- DATE l%� %�� V jj/ INSPECTOR SIGNATURE Q.c_t