0007-166 (BLDG)U)
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LICENSED CONTRACTOR DECLARATION
I her �?ffirm under penalty'of perjury that I am licensed under provisions of
Chalk (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
4 OW3 3:l(
L;)a 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 underSectionSection B&P,C,for this reason 1
Date { ?• �j �� .fi Signature of Ownery j,.I i : I Ll y `
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 Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
(`)fl 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. ,
Pate: Appl1can!
r -
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) -_ �• ` Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT L�{.I Ifs' TRACT
JOB SITE
APN
AD s OAK IR RE:
OWNER
CONTRACTOR/DESIGNER/ENGINEER
Y0I*X 1460
1.P►[,llbrrA CSA 921.53
A �;2(17S
�:7l3I.J# iF3�
USE OF PERMIT
Mi0O Ra -MA nAl, W1 DMI -.►. FYS
PfiAk. K I • U TP UC'T A UUMEN TATION & MING ARCI i1'f�'•i"lZ1RA3� l l!PA 1�:;
10 • sw. 4, 0* 06$, 0915; 002, 164. 116,129; 171;
184, 146, 7178; 2A 2414.. 756, 269; 2Rk :l00, 312, 321
VAIAIATION %AD",00 fX
%iTdMA`ilm COST OF C 019 FM II(MON
t3U,owty
PX1Zh91' FXK SUMMARY
CUN8TI,UC T)(41 FEE 1(it..000-41 8-000 S+4 -SD
S'TRO140 MC.ti'fION M0 • MID I JI-000.241-00ki 48 t1U
a llb-1'rYIXA r'ONKrP.tXn'1014 AND PJ AN (11R(�X
$557.50.
I1M FRF'•PAII) ITEM'
- 34.00
TOTAL RICRWr FEFS I)ITY .NOW
M- 57 M
RECEIPT
DATE i- 6Y{ 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
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
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping J
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. -
loke Detectors
1 emp Use of Power
Final
Utility Notice (Perm)
COMMENTS:
JA 9
*
Inspection Report for
PGA West
Oak Tree Structural & Architectural Repairs
9/26/2000 Lower Prelim - 55-324,312,300,288 Oak Tree
9/27/2000 Roof Nail & Wrap - 55-234,312,200,288 Oak Tree
10/2/2000 Upper Prelim - 55-288, 324, 312 Oak Tree
10/3/2000 Upper Prelim - 55-300 Oak Tree
Partial Lower Prelim - 55-268,256 Oak Tree
Frame - 55-288,312 Oak Tree
10/4/2000 Lower Prelim - 55-268, 256 Oak Tree
Frame - 55-300,288 Oak Tree
10/6/2000 Wrap/Lower Prelim - 55-256,244 Oak Tree
Wrap - 55-268,232 Oak Tree
Lower Prelim - (Partial only) 55-208,196,184,172 Oak Tree
10/9/2000 Lower Prelim - 55-172,184,196,208 Oak Tree
Frame - 55-268,256,232 Partial 244 Oak Tree
Lath - 55-324,312,300,288 Oak Tree
10/11/2000 Wrap - 55-208,196,184,172 Oak Tree
Upper Prelim - 55-268,244 Oak Tree
10/13/2000 Upper Prelim - 55-208,196,184,172 Oak Tree
Lower Prelim - 55-128,116,108,092 Oak Tree
10/17/2000 Frame - 55-208,296,172,184 Oak Tree (Steve Traxel inspected)
10/18/2000 Wrap - 55-128,116,104,092 Oak Tree **330pm inspection, no personnel on site
and no plans provided for inspection. Wrap observed only. Prelims not observed
as scheduled on roof.
10/19/2000 Upper Prelim - 55-128,116,104,092 Oak Tree
10/20/2000 Frame - 55-128,116,104,092 Oak Tree
Lath - 55-268,256,244,232 Oak Tree
Lower Prelim - 55-080,068,056,044 Oak Tree
10/25/2000 Wrap - 55-044,056.068,080 Oak Tree
Upper Prelim - 55-044,056 Oak Tree
10/26/2000 Frame - 55-044,056 Oak Tree
Upper Prelim - 55-068,080 Oak Tree
Lath - 55-172,184,196,208 Oak Tree
10/27/2000 Frame - 55-080,068 Oak Tree, No inspection performed, job not open ready for
inspection.
10/30/2000 Frame - 55-080,068 Oak Tree
11/1/2000 Lath - 55-128,116,104,092 Oak Tree
11/2/2000 Upper & Lower Prelim - 54-588,576,564,552 Oak Tree
11/3/2000 Frame - 54-588,576,564,552 Oak Tree
Wrap - 54-588, Partial 576,564,552 Oak Tree
11/6/2000 Wrap - 54-588,576,564,552 Oak Tree
11/9/2000 Wrap - 55-080,068,056,044 Oak Tree
11/16/2000 Lath - 54-588,576,564,552 Oak Tree
12/22/2000 Final all above permit's 0010-284 & 0007-166. Project complete.
55 - /q� OA An -rR-EF—
DAVE STEA VEN S
Inspection Services
PROJECT,214AMP/OJ /a4 -MSE l
ADDRESS QAk' 7Rt c
BLDG. PERMIT #
ENGINEER :� vO Q) c Q G.
INSPECTION TYPE
Page of
PROJECT # c2 0 oU - o 3
CLIENT P (al, t,Qt--� �-(O N
DATE I k (0 a,-> g,>
ARCHITECT r12`)�.-�,P, G�Czce� t� trt� v �E
CONTRACTOR 0 C -L MV\j?-
INSPECTION REPORT
'SMcf1Q ,JA It_tniG A—, 4 -r -Ti C_
KcDOI— r-1 NtL-% G AT
f- iZflivlit,�1 ����,.1Rit� i C.�L ► vZ4litag(e
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CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted,
I Lubstantially complies with approved plans, specifications and applicable sections of the building codes. This report covers
e locations of the work inspected only and does not constitute engineering opinion or project control.
CERT. NO. S - C INSPECTOR NAME _�fi J t►J
tt e�+lY1
DATE I 1 a<:- f Y o� Q Q0 INSPECTOR SIGNATIIR