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0104-227 (BLDG)
LICENSED CONTRACTOR DECLARATION I here Irm under penalty of perjury that I am licensed under provisions of Cha (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 733 132 B Date - 4. 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 11 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/9� Policy No. L M]MATY f42174 s (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: r Applicant 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 - i BUILDING PERMIT PERMIT# • DATE VALUATION LOT TRACT S204MM JOB SITE ADDRESS APN OWNER CONTRACTOR/DESIGNER/EN (NEER PGA S�1°. F1 r =YN* iA3« AN10CUTION DEL MML W.MIC" C,�XNE`i X CG,i< INLACIOP P© . 1 f3�s{1 462 s�'1'&�VM43 .&VZ 4802 LfA IQUW A CA 92253 SOLA :R.k EACS CA. 92075 5$23 IJtJ 'Al OFFICE NMPMA.'d'ION USE OF PERMIT 15.165 ST. C^HARL-10 PL itiE3. . 90.327, W-333 & M.U# OAK. `fHe rz - flur.r1.iF673Ci l i, rypp. V Li)ATION ZA6Cf3B4,Gi3 La 11W81.1H,1ATim COST OF C' ONSPIR'.iTC,''1ION 20,01IM g g�1�gvq, p;1 �t�7 101.0 W-418-000 $207.00 MC 4:i 4�iI Sd3^cic c� ?d;i>f,Sd�i 101 -000 -iib? -000 S�d.Etf) M -� �i 09,00 D �� P , 3r ATIM;M isoxw ,Vu RAW 1-7;01S DTWI now $209,00 APR .2 0 '2001 CITY OF LA OUINTA FINANCE DEPT REC fBY DATE FINALED INSPECTOR 6r•� •1 I� 8,3 INSPECTION RECORD ` OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING !F APPROVALS MECHANICAL APPROVALS acks FOErms Underground Ducts & 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 v�� Final' POOLS - SPAS BLOCKWALL APPROV LS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test anal 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 Panels FSub Exterior Receptacles G. F.I. e Detectors Net- . Use of Powei Final Utility Notice (Perm) ' rr'4�-�.,�,,,�, -. � l.':.—.,sf�•r+rk",�.'F.-,�3"e.�+ir+^r1r.'+�.ir�j�^✓;^1�.....'1w..r°rv'tlv+'+yikrrt'n.--.✓WL:s.vrJ':r`^r DAVE STEAVENS Page _� of Inspection Services PROJECT4-A, QCS`iPROJECT # :;200 / - 01 ADDRESS CLIENT�#a BLDG. PERMIT # ENGINEER,15R30i '�J c... INSPECTION INSPECTION TYPE DATE a r90 l ARCHITECT Go 4 - dA AKC14TCC14ee CONTRACTOR N64 M6tt ;)4G1F1 e -- INSPECTION REPORT C. S - t l.A ST ►'Z�At� -A t- t �:Z �fr'Et:�. 2.. o -37S 3� l . 343'l . 3q � o�•►.c`r•�2c� 3�Jy4W t1_ W JC1"t L5 - SI�E�AR `F�-R..�t `* nkl 'I ►2e-ACZ.. k43*w t -S - EXAw,%'.3(.. HAfUvaAP C- Coll, -C' ' �i C�x=i 1 iti` •�5�> T�t`1BIZ S144F--o . t�flNJ -i, 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 he locations of the work inspected only and does not -constitute engineering opinion or project control. CERT. NO. INSPECTOR NAME . 1r���-•�" (PrintClearly) PATO� -S xU _1J '4. u'G I INSPECTOR SIGNATURES ..r p Page _ -of _ DAVE STEAVENS Inspection, Services PROJECT{ Ic`_S - HP S E I R PROJECT # ADDRESS BLDG. PERMIT # ENGINEER�I)u-a&) SAjole 1a INSPECTION TYPE -L-Pa u CLIENT_�(=f! : DATE 0 TL _t. -J ZI ARCHITECT 6o L_4 A ¢I Qe►4 1-1 L L�'k,z c CONTRACTOR % CL, e"Ag efts, r, r INSPECTION REPORT t_A 0 3 'P,'R-Ai2 LASS LTJ. ItoCOLE Z014431ItIIP +3 (.;-"A S�r3 ��1� -i. a 3 - o� koCS - 4oLE4, ! Z�Te-1 (JkA Z)brZ - I ALe:.►.�ea�-1 190-361 C>AK-,-ZCZ t?�i�r� a �PIEAR OeS7 c...I J.. t Lac$ - POLL^(Z� 1�t t3Cr� �'tL+ t1. �o l� ' ! 71, t_E►JC�� ?���r A aA& ��z Lacs - AOLES- I zz-;�-rVA /4 1�K • 1 Oz1--1 to LC -IQ '�8 l�A• 1'7 L c_Q C� , 43" ,'-A. 8a-381 ofIviltTZtt �� 3 E EA S"T LI J - I L.0 L - 1-} 0 L - (� DEa7tr1 /�+ A . o L� - I C� Lc�J �.�'►-1 �8 , a 1r,JTC►Z - LucS - N oc.�S - 11-� 8�.� �-� 3/t �1J, A . I��LDS- Ito L.Cu) C —4 S46 � 0, R ! 1Er►-t. l ��ta�A. �0�5- I'7��L.r.►.�c,T� ,�S��D�r� 94 -393 Q AK T e �Lrl �l 3 �2 LJts,- L� J - I c.vc- !-��L.r: - �Z �.-� I �� �� ion- (� ��L.�►�c. �18�� �, A aeb 3 - o? Loc -.5 - H.L.As ' j I Z)E:Pi-H'( Z IA ?'Pys - /7 LCQ G; --W _'14', , �a SO - 32I cAK-rzeC IgA2 LJc.S-r- oZ LaG'S P oLeS /�t,l�C t�TN 3�`F' b I A . J 0&s- �� LC�J (� +�/ „I)I A 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 section's 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. _53717'- � C� INSPECTOR NAME DATE (;?19 %TW L -T e2C V INSPECTOR SIGNATUFi�`�--J��►.Q DAVE STEAVENS Page .3 of -3 Inspection -Services PROJEC4; GQA GAJ eS P144S E- 4 PROJECT # ADDRESS 74.5 i-ts rteCLIENT 1,I.ILS7 11011' s' DATE e;ZD J a L.-1 c�2y o BLDG. PERMIT # ENGINEERIL, JAI _4Sf4t1oiE 9 t/C_ INSPECTION TYPE -321 A!)-1 33 ARCHITECT C;,eL_JA 4&4 /TC cTu'C CONTRACTOR J)eL IMV2 AU F' 1 G INSPECTION REPORT *,a 3 t I LL, A-r-rlC Sr..r9A2 KJA1c_(iJGo - (?..oml) t.t= i t- -1.2 -1.2 L (LJO� - COMPL6—I C p�.�i _+I5 -g 3L�c,L � PLq JAS _/-��(_prte" 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 he locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. INSPECTOR NAME �V ��`� ayU 1infElear DATE v INSPECTOR SIGNATUR�;E' (.1 Q\ o41-\r.T-4t£ . 7� L:DG'a� �c�►.l A LL AT \ \ L. "'5�4z-k%t KiA%L.l A](., C_0M.1lL.CC T— p�.�i _+I5 -g 3L�c,L � PLq JAS _/-��(_prte" 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 he locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO. INSPECTOR NAME �V ��`� ayU 1infElear DATE v INSPECTOR SIGNATUR�;E' t-"7..:.+..-..t.�,,,.;-�t.'�;;,,rn.:�y4w�•..��!-.�w'.ri�ay. �.�r�iit„t-.'+`i..:r-'.'r'ti--^"+... 4-�v �,r.�.,YTti,��.: Vvl•+....�Y1_.y�,n,.�,,:,:.l:f-'..,.,-ni.-+4+r'ri:r..-.,.-�.:. -_ . -, Page-4—of A -- DAVE STEAVENS Inspection Services PROJECT A .1;k V- 's: T -+7 ASS. { A PROJECT # vo ! - 0 3 ADDRESS As L_i S i E.t�) CLIENT g --A i J E ST e4 u l} BLDG. PERMIT # ENGINEERIX� J,. �JO(lz -1. ►-1 INSPECTION TYPE DATE 1A . rU L y a oo/ ARCHITECT 6oL,d A A e 04 rt C CONTRACTOR— INSPECTION M A (c �Atr F ►c. INSPECTION REPORT LQ A\ L)mA L L S - t R'4 •� J Ca �%A 2� w E1 rL ?�.rlS(,c L,471 o�J -. C � rr • r v S5 -4S Sc.e e;Los g J.b o k..4vt nI Ate- 3-15"3,9 39-1 39 3 oA K-rizet Jt; L L) aa' P LA J � 0 i r • -t F -r -APA it . A-31�' ts. LPT-4,S Ls, - �ca.►, Jc�T� �L0,- -I C_, xt6 L 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 We locations of the work inspected only and does not constitute engineering opinion or project control. , CERT. NO. �_ ti 4fi ” 5 D INSPECTOR NAME 1 JE- �� 1� cIC��S r ,(0iintt C ea, DATE—/8,.—Tlt_ G .`f �irh� ! t INSPECTOR SIGNATURE DAVE S.TEAVENS Inspection. Services PROJECT-� It:�ZS i ADDRESS BLDG. PERMIT # "ENGINEER INSPECTION TYPE 4!� twx Page -_ of 2— PROJECT # 6700 / - 0 3 CLIENT / WEST -,1.1,04 DATE l3 J"c cL.`f ;2 yo 1 ARCHITECTC'-�C Z �P_CX i7 i .testi CONTRACTOR�)EL. /'1>~1i2 t7AcaF'� L. INSPECTION REPORT • L..oGATt 0#J g . E P0*_Y t:sl m psy 3 F,- EXP; d�r1 AZ.a 0'*a r V -r \ _r 2LO6LI-C1 ►_l —L n J..1 ., 1:• 7, AS - r � ff ... 'i +• t+ �, .T h �r_D e2`_R�-�c�->}-►JL�S^Ia-�iL��a t l��r\. r?t�t��- 1�1 Lir�r�TN� �a 1�� "� 8D 3 Z`"j f3AtGT IZ �t �V41 eJ �. 1• N �i '1) u I l t.� - Vc5 �o S- 1 _il ►��c 1 J,A. D S-1-1 l C_-3 .3 'i)%;\, �Q cel - a• Lvc_5 41 cc - 5 '--I 2 bt P111`4 X4 i)%;\ , - � � t�.►JG %H �'s3 � i,� , 0 AK-T►it;` .I, n - Lu US - N Ot-LS - 1 ;Z b. Pt,4 1 D Itk. L c �1G, >+ �g , A I R- A2 Cl.0.7-C I�L Loc -'s - �-kL� gz 1 Dr-P-43�4� b i0% , jZpDS - 1(�' �d: 33q o�.-��-�=� .: t� VAS � .`�- �• :;�!'Z >tq i ,.ALL Loc I7.bC s'� 1 t i w : Tbb- I i "LLQ6; 44 .T�g 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' project control.- CERT. ontrol:CERT N0.09:5-13 INSPECTORNAME,��•. ' DATE ANSPECTORSIGNATUJ