SFD (0011-300)79155 Mandarina
0011-300
LICENSED CONTRACTOR DECLARATION
I hereby•affirm under penalty of perjury,that I'am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
'Li cense
e# Licc. Class Exp. Date
6 Ji3 j f'
644 . i3 x' 'aTC 4 ' 1C iOM
fL / f y
Date Signature of Contractor
OWNER -BUILDER DECLARATION a
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 fhe property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O I am exempt under Section B&PC'. 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
p rformance 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:
:r
Cartier Policy. Nod : • - . .. .r
(This section need not be completed if the'pennit valuation. is for $100.00 or less);
() I certify that in the performance of the work for which this permit7is16suedi
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. J '-
bate: l 1 '` % Ap 'licant r,l A!
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an 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 persom 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 applicator 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 applicatiori 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'sfate'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 r inspection purposes.
Suture (Owner/Agent) ' c I tft✓ Date
BUILDING PERMIT PERMT#..
jjj
DATED f VALUATION LOT TRACT
34 28447
JOB SITEtom.
APN
ADDRESS 79- .e5Ja5 I•frt 8'DARI.`t ..
- .' 772
OWNER
CONTRACTOR/DESIGNER/ENGINEER
R U9
WT114WESTMEN .ATC
PC) BOXX 810 .
142.5 Z 'UHM-, KCl'1i' IM
LA, QUINT i (, ; 922SS
1✓ROnWIX - V 85034
002A51.1656. !'?:EL .49-90
j
USE OF PERMIT
LOT -9, PLAN IAQ SK''S PERMIT f9OXS' NOT IIf."LU-0F, L;I 3t:K
FOP, Mt3i:' 1PLY.13SU.ltNO9 OP&WE PLAN "F Y'.P A F.
0i3STOM C"OTRfkC:8? '
aCa };Qf>tj !a'"it' -
/ I•ap►'rt I g :Lp°t3,yd&'A 1i',iA'C yG9p / .,» q r f a
7 AFYfl'4fA 7''.1<<;-,P1.l FK.• s i' i 1R Ivpf..6V
. d61 %.Ei.IC'P.e.1790 COST0 ,8 i.cM vA 'n7,13VU .'d.A0x9
.d9E igVJ5.:✓. O
CONNTRUCTION'ftt 101 aM-4111.000 $1,042,00
PLAN Ff211 $214.+47
i1y 1 ,,><aLC. T. z s1.O w uej0o s YT.sa
ELECTRIC,i t FEE,, 101-0q0 ;ao-0iis2
1'L'li1~rTP111dG MM 101.-600-419-00 $1$0.50
STRUNIIMOTION FEE,, SID- W-000-241-000 $21,49
GRADING YEE . 101-000423-000 il2neit
DWE-1,0PY.R. IMPACT ME
ART 1Fi PUBIAC PLACES -1 . (E:.701 $37,14
AND S•',Lei'.11V 0.rCIP.,+.aA .
$3,60-3.44
t.
RECEIPT
DATE lhi
BY /
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Hacks
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Sh=qr Pans
O.K for Finish Plaster
Sews Lateral
Pool Cover
S r Connection
✓`-/
Encapsulation
s Piping
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.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
FROM
BOND BEAM
FAX NO. 7605642238 Aug.
O.K. TO WRAP
67
GROUT 0 4' 0 8'
FRAMING
Ol
INSULATION
CITY OF LA QUINTA
PRE -ROOF
BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-1153
1p
Owner RJT HOMES LLC
ContrWor RZE INVESIM
Permit Number 0011-300 LA
POST ON JOB INCONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-155 ALANDARINA
LOT 34 PLAN 2AG, SFA PEEt.NUT DOES NOT INCLUDE
jgLocKwALL"oOLS/DRrVRWAY APPV-OACH
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
PLUMBING 5-
—GROUND
PRErGUNITE
00 NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
L,, AOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROU'GH'GAS & GAS TEST
HEATING & VENT - A/C
FIREPLACE
,77 775-7
BOND BEAM
O.K. TO WRAP
67
GROUT 0 4' 0 8'
FRAMING
Ol
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOYI, M4S BEEN SIGNED,
POOL PRE PLASTER
PQqI, PENCE & GATE
WVQRSEPTIC TANK
FI
ABOVE APPROVALS 00 NOT INCLUDE RIGHT TO
.n ippi OKr I ITIl ITIFA OR OCCUPY BUILDING -
15 2001 08:46AM Pl
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in_ compliance with the various ordinances
of the- City -regulating building construction or use. For the following:
BUILDING ADDRESS: 79-155 MANDARINA
Use Classification:. SFD Bldg. Permit No.: 0011-300
Occupancy Group:' R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: RJT INVESTMENTS INC Address: 1425 E UNIVERSITY DR
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 8-15-01
Building Official
a
POST IN A CONSPICUOUS PLACE