9709-137 (COMM)r ; LICENSED CONTRACTOR DECLARATION
iiereby affirm under penalty of perjury that I am licensed under.,provisions of
Chapter 9 (commencing with Section 70D0) of Division 3 of the Business ;and
C%4. Professionals Code, and my License is in full force and effect
M
. License # Lic. Class Exp. DateLLJ
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o Z � ' .4Date 7 � �' Signature of Contractor ti, : � � `�-'t°•
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J U.co OWNER -BUILDER DECLARATION ,.
H.d I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z ( ) 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
r 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
� ,
N 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.
Se( ) .I have and will maintain workers' compensation insurance, as required by
ction 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:
Carver Policy No.
(This section need'not be completed if the permit valuation is for $100.00 or less).
O 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 3706 bf the Labor
ode I.shall forthwith comply with those provisions. t R
D �, 2. /! S Its
>f Date• . 'Applicant ;: ' . �_� a'.
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Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subjectan.employer to criminal penalties and civil fines up to $100,006, 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, f
Signature (Owner/Agent) ✓ f�/�i'��Date-
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PERMIT# CONTROL#
?""BUILDING PERMIT ,
7091:
DATE VALUATION ti TRACT .. Z 8 U
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CG Nam/.LOT
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JOB SITE <
ADDRESS <L .O]R1)j,_VY3
APN`
OWNER >
CONTRACTOR/DESIGNER/ENGINEER
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4:,9499 EUEIKHOW141
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I,.:t1 373�6` CA, 922 53:
LA QUIUNTA CA 9.r, 3
taiC(15it �a�Y4 . .t3S'�EF'
USE OF PERMIT§
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S'17K NG Nt.C)^1':iON FEE - C ONZ 1000 3tiQ-24110, 00
t)0' �5:51i31C1 $6.8-0.17
PLAN CHECK
$116;356,99
LESS 3IRL-PAID I FIZ.
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RECEIPT
DATE,
BY '
DATE FINALED
INSPECTOR
INSPECTION RECORD
g
OPERATION DATE INSPECTOR
BUILDING APPROVALS
Set Backs
Forms & Footings
Slab Grade
Steel
Roof Deck
O.K. to Wrap
Framing
Insulation
Fireplace P.L.
Fireplace T.O.
Party Wall Insulation
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
BLOCKWALL APPROVALS
Set Backs
Footings
Bond Beam
Final
PLUMBING APPROVALS
Waste Lines
Water Piping
Plumbing Top Out
Shower Pans
Sewer Lateral
Sewer Connection
Gas Pioino
Utility Notice (Gas)
ELECTRICAL APPROVALS
Low Voltage Wiring
Fixtures
Main Service
Sub'.Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
c
Final
Utility Notice (Perm)
OPERATION I DATE I INSPECTOR
MECHANICAL APPROVALS
Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
Fans & Controls
Condensate Lines
Final
POOLS - SPAS
Steel
Electric Bond
Main Drain
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Gas Piping
Gas Test
Electric Final
Heater Final
Plumbing Final
Equipment Enclosure
O.K. for Finish Plaster
Final
COMMENTS:
j
LA F LA QUINTA
X'SAFETY
a2ffiDEPARTMENT
777-7012
FEB U 5 19918SPECTION REQUEST LINE
777-7153
FINANC TMQUINTA HOTEL
Owner
Contractor RICHARD DODSON CONSTRUCTION
Permit Number 9709-137
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 49-499 EISENHOWER DRIVE
HEALTH SPA
TYPE OF INSPECTION
DATE
INSP.
FOUNDATION & SETBACK
-
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN
SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN
SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT -A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT a 4' 0 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
FINAL GAS TEST
H EATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
r ION nN i ITu ITIES OR OCCUPY BUILDING
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Certificate. ofOcc,upan
cy -�
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CityLa Quinta
of
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B'uildingand'Safet.D'�� yapartment .•. �oF�
This Certificate 'issued pursuant to the. requirements of Section 109 of the Uniform Bu
ilding Code,
certifying that, at the time of issuance, this structure was in comp/lance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: �y
49-499 EISENHOWER DRIVE 1O,
Use Classification: COMMERCIAL •
Bldg. Permit No.: 9709-137 - '
Occupancy Group: B Type of Construction: VN Land Use Zone:. COMM
Owner of Building: KSL LA QUINTA HOTEL
Address: 49-499 EISENHOWER DRIVE
City: LA QUINTA CA 92256
By: KIRK KIRKLAND
Date: 9-18-98
Building Official
POST IN A CONSPICUOUS PLACE
f." L,: .f ..^,iy. •.i�•..::�r,r. �.r»:r..—..�.-ynnrf+�+. ^v�"ti tV•*1h,�"+.oaaitWYr!`�r,�`!^•e'..._... „�k...K.,r. .w '1: a����r r. , .`./" ,i .;,�� �'Y. � V'/� !'Y "��.,
CALIFORNIA DEPARTMENT,OF FORESTRY
-,RIVERSIDE COUNTY FIRE DEPARTMENT
'210• WEST SAN JACINTO''
. PERRIS; .CA. 92370
(714) 657-3183
(619) 347-2480
INSPECTION" LOG
COMPLIANCE ORDER Page of i
ff Notice N11 o:,
FACILITY NAME, LA Qui✓�-� Date: 9TE
ADDRESS 'qi ` ;- O 'q-,i City 4 Quite Phone:
The items listed below are in violation of one of the following,:
UNIFORM FIRE CODE /9y UNIFORM BUILDING CODE:
RIVERSIDE COUNTY FIRE ORDINANCE CALIF. HEALTH & SAFETY CODE (TITLE )
OTHER
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�av� Orom2a' i ► i'A e� .�t�saF? roll % :tr; . P� � o-Dr—..
o f 1l►�a'1 i9 1'ni C' �'orr ` G�CCRSS 1� rD 1, �i I� 'C't7 o i� .
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Measures'shall be tak n to correct listed violations. A reinspection will be conducted
on or about 19 .FAILURE TO COMPLY MAY RESULT IN LEGAL ACTION.
Receiv-4 Bhp �— Title
c' rg� ,es SS ,
Fire Inspec"tor "
FOR FURTHER INFORMATION PLEASE CALL
Phone �7( � sG 3 -3NP
RCo 26.11 (Rev. 1-87)