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0104-237 (BLDG)LICENSED CONTRACTOR DECLARATION I her ffirm under penalty of perjury that I am licensed under provisions of ChapW (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 73,30$2 '8 03 ixr Date .Y',/ . - 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 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: r Applicant 1<< <' 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) ' f "' -;- - - _ Date., L BUILDING PERMIT PERMT# DATE • VALUATION LOT 01"2371 TRACT* ����nr�Ai�rtee d{��PP��tt�� �riy��v Y0.�`L7ygP6Prv.00 JOB SITE APN ADDRESS OAK TO 80 - 6 OWNER CONTRACTOR/DESIGNER/EN (NEER F0 BCrX 1060 462 IMMi ME! AVE -0302 LA k', TJIWTTA CA, 92253 ►S, OLANA BRACCIT Geo, 92075 (858)7924150 CIBLO 5823 J��, ►( ff����@@ //�.pp77 ��,,yy�yr�ti� pp���� l:�'rr �riJ\ AL VX'M'1 K INFORtk148'k JON LM USE OF PERMIT �5?i�e�'' ,f .hA.��'}�!,C��D'n�9 '.�3•Al�'� �3�1'. G�3�k�'��S �if 8l�6d V,; 6th, �-Pi�S � �liYb�l {':�,A� `Y • Ett]fT�T3i�if:6 .a,r, "d'Y. dot; VALUATION L9 EII�"IIf,.4.'�d�Fu)i0�'IC1i�.�`�rrv.E��::afi1� 2�1-�U�""��•(iCP�3 ��.0� IMS PRErPAID 111 + S 0.00 �Vlmwl 1W.6 ME ROW F[APR 2 0 2001 i„•..r 1Ij ,JI I I R ` BY DATE FINALED INSPECTOR 1 -3,3- 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 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath _ Drywall - Int. Lattj Final I /d/Ld__ ._— d Final POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test al 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 erior Receptacles T .I. .,oke Detectors i emp. Use of Power Final Utility Notice (Perm) . �:,tx-.rj:r. :: 7'.' issue"!-' �; :+�7i:a, ::,'-�... at.�a.•. .n.r.). .s h Page .2- of Z DAVE STEAVENS Inspection- Services PROJECTA L.�, L tg - _4�tAS,.SE - I A PROJECT # a Qo t - 0 3 ADDRESS {i5 �.tST�� CLIENT BLDG. PERMIT # ENGINEER J , Lit 1 INSPECTION TYPE DATE Q Aug C� ao 1 ARCHITECT Go,3A 'AiLC*4 CONTRACTOR�L ;)Ac -t F% INSPECTION REPORT 3.��S�3� n,ArcTZ�� C.� L��1 \..'1Al.L.t S�ici�2 P.��1 STiZtA� KAAA L J 0,1 - � '�( , C • �TAtI..S . � . 3' t �} IS - � - � L c�C►L �a�� �+ �� w�A\t..t�.►Cs- �m �t_E i c. � � Lt_ A L'S L -r-5 - Z%_oc P,/ A"b--jHeAz 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 ofthe building codes. This reportcovers ,_,)he locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO.02523 U-Sy INSPECTOR T NAME v e DATE -g,2 G QQ/ INSPECTOR SIGNATU �L L to t_t._ �,:,gy=�G-7, rwa►13 . X19 (a85 ©AK"re.�E ���� aS ,�c.Aa� f� �TA1L 15-c - �LgGFC ACJ ii }�t�l t,�Ats_ ��t� - C�rr�Jc..E'►�E /4 t. -L_ Li 1V Pt t L_ 1.13 {�'TTt LS ' Cr ��_TA t LS �o' lP t OC -W /4 t.i D 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 ofthe building codes. This reportcovers ,_,)he locations of the work inspected only and does not constitute engineering opinion or project control. CERT. NO.02523 U-Sy INSPECTOR T NAME v e DATE -g,2 G QQ/ INSPECTOR SIGNATU ' " �. - ... >?'a•`r, 1 . .:5y.���:: %'7'yr.. +ty-,�+«n•F: ♦>_ �,�". :4..�tap �; .r ,N' .'-.�.y,.: .:. N• ,. .. Page _� of DAVE STEAVENS , Inspection Services PROJECT \,J E5 i 5 E I A ss 9 S 9a G I G U 7 ADDRESS l 14 L z r. &'3 I BLDG. PERMIT # ENGINEEK_�) L.,,),j S�Jc�E 1.JL INSPECTION TYPE PROJECT # a- 00 ( - 0 3 CLIENTS u3I�S l tk opt DATE 2k k w(= zoo(' ARCHITECT Got AA -Ae0-4�� crud d.. CONTRACTOR.j}54. WQ Ac. Fi c INSPECTION REPORT �t_� (,Uua �JA.w�- ��A��( �A.ZOW�i2i✓Z,�S�un�'tv�-'\j alta='rte. ,S) S Sca w1 A k)> -A wy-" a 2 kjwns -�- / f•l 415ye-cpT AO -61'3 RE- 6A57 1/,JG Revrt Ae-r-A A-* 55 -,T L4:17 �1� L- to , - eor� a�e-TE. 1%4 /S - ck • Z wcg , j C + A - 3 7 ` S C I9�Gzs1(.1) (3Ak-TZeE 3C. ( C S- f-rZjim„) to . HA,ttZwiLNzESTA 3S S fow.rx.['Tt; .bETAIL5— /. 3. N IS -moi , CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported wo k, 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 orproject control. CERT N.O. R - �(� INSPECTOR NA"J � - ;pct_'_-;• , � { DATE ZLCAOI INSPECTORSIGNATuBi --_ • .. � ,.r.r.>.. --,.^. ... . rp. �.Z � f ...yf. .::q-:•_,. ,;M��•'t✓..N._�:w;tt'i.;i�n rY.Rv�. �:r��.nh :'. .�C i='..-. Page l of �- DAVE STEAVENS Inspection Services PROJECT:�J-., U>E s7 - -,p uRs P: A PROJECT # a�/-0 3 ADDRESS 8D- G13, (,tq . [„ 2.5- (113( BLDG. PERMIT # ENGINEERS ,a Q 5+^%) atc INSPECTION TYPE 4 -PO -`j CLIENT _CR, u,�s.T k4o A DATE IG .A u t!, coo f ARCHITECT (SD(.8A Al2CN?gc_7� rtti CONTRACTOR'hE L- MA(2 rc (� c. INSPECTION REPORT �I f!)t"lI7t LOC-4-r,oN*i FtooX`l 1iw.?s0rt ErF Ey? 4 0% 6-joc.c-. x_ Tq OWCO- /E;). Bzu---F+T-b t, ­A 1 Qs -5-2%" nP A P?ucwi c. T L� rJ�� �y sT A r...c_.A-z• � U � A � �+ C,Z Z' C Rn W 9 µ �' ,��?�a.� to o. L i �� - (Lc c - f�Ol a%_ • l ,L � ?�•.)► 314t� �,�. -�ob V. Jc�:►,1 �lS�t�ic� �f � 3• SAS • � acs- u rn.c s - 1 �. �.�t-►-� 1 a �+� . � o S - t -t � v z.� a � �. A 23.A01a'1 %-r L, - I L� �..- �lo - I 1 z 1 tJ A . Rob - (I � ` L c j c- , �4 , r8 0 ( A, b��S - t� 3) ED P"t*4') t a - "N.JS� II.- Le0e:-,--+ '/8 h. P, . . ��1.�T �,L - d �s - r� � `+t s - i �' Dt'�'-1 �4 � P . 1�a� • I L t_e�c�� r -I %g ��, n EPsT �o Lt0 - LC, C_ .) o(-;. to Z�t:?\HI l,iA IZo�- 11 L�Uce'*t g bin �� 1.-,.wc5-�-10�.:�� •1� ,�(a-,-„�. 1 1��� t�.p�S —l� LEN .�� t3 aim '7 n Q .� ; L, I - t 1.0L 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. QAS 9 3 q Pi - S O IN NAM ��- (Pra�Cw�") DATE -16 A ,.t` ( INSPECTOR SIGNATURt- [a.