SFD (0011-297)79185 Mandarina
0011-297
LICENSED CONTRACTOR DECLARATION.
I hereby affirm under penalty of perjury that l 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.
License # Lic. Class Exp. Date
690645, OQUIV
1 , V"" Signature of Contractors ° t
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 theirsole
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).
O
'I a_ m exempt under Section B&P.0 for'this reason
Date ;-Signature of Owner
WORKER'S'COMPENSATION DECLARATION.
I hereby affirm under penalty of perjury`one.of'the followingdeclarations:
O 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 regwred-by
Section 3700 of the Labor Code, for theperformance of the:work for, which this
permit is issued. My' workers' compensation insurance carrier & policy no` are:
Carrier ' ` ' Policy No.
STATE 17CSSTika Y s. J 9 34t1 t10
(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 per°son 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
C de, I shall forthwith comply with thosg provlslons.
te: . , 'Applicant =Yel ,11 ;
Warning: Failure to secure Workers' Compens tion 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...
IMPORTANTApplication 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 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 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) . j ,1 (_ ' I / Date /Q I -•
BUILDING PERMIT PERMIT"
DATE VALUATION LOT { 11.-2111? TRACT..
$22". 0/48,50 l 29447, ,
JOB SITE
ADDRESS 79M5 MANJRA
APN
772-NO—W4
OWNER
CONTRACTOR/DESIGNER/ENGINEER
.RI fA.V.iVJ.CkI.A.. X, :.
1rn "y '.( -0
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t t!1 r}..S T • T tYgy.ty jr4Yf q :,.y' • t
J aY,Er✓ :1,: . 4.'.4`i.1 Y T:J,l .f +l rY S'1,1.1' S: .
i. QUW.A CA,, 92253'
PHOEWi-C ' T 950'44
t
(1502)} 57.1656 CRLO... 4 JU . ...
USE OF PERMIT {
KING 1Y, r?AMLY DWY.U.ING,
LOT 31, PL.A.A(aN.R0, S1 I:Y.3 YidtA4I1 2}Ci)1 ?dC2f 2tJCL(11,)2 iSa 9C:
1 L `QIP'fit:►i. lJI3. ' 't ' d': .°s".F> P;1p.C) kd, '
CUSTOM C0NOTRUCT1014 2833.00 ;SF
M.Fti:a•?.I a tr.e30.a
4Aa Ar f 1 t.s2s fla
PEiMN F7 O'CIN:AR
e
CONSMUCTION F172? 101 4N.70-41 8 00G $1,1198,50
PLAN CHECK1411L 4►9 tit/U- 34I-a2£ $s0t.®a
MECHAACAL FEE = $4U5,.o0
M1? TRIC:AL1, FLi? . H.p .. Li-t42C4- U: fan
►taua a TNQF E,' A0'4,000z419-000
..STKONO f4Qi9•rIUN PRE -'RP-310 ..1 0 a -000
cif t7lRa(3 FER
i Y?dif l.4ak'fld! IMPACT FEE . • $19Q7. 00
ART IN PUBLIC PLACK'S - R Mr 01.O Z.,SSAtl00 ~SS9• 7
S —To -arra=Aa„ CONSTRITC 1fM AIM PLAN CMM .*
IMS
r. pp yy p.p, •. q t I,3 I prilb • krys''.yAp1%9G ,iJ(?
_ .. ..- .JL ✓ 14:G JFM° a.lr, T- A'o.R'esou-G'+. .1`1\ tl! . r
.- A•a r.,3 7
RECEIPT
DAT 1
BY T
DATE FINALED
INSPECTOR
r
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
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
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
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
08/28/2001 12:19 7607713025 RJT ROB
5 CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777.7153
Owner RJT HOMES LLC
(0 s_97 u1
Contractor
LA UU%N
Permit Number 0011-297 'IT r yr
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-185 MANDAMA
LOT 31 PLAN 3ARG SFD PERMIT DOES NOT
INCLUDE BLOCK, WALLS/POOL/DRIVEWAY
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
JOLSTS.&-GIRDERS
ELECTRICAL GROUND WORK
DvNOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGW PLUMBING
ROOF
BOND BEAM
O.K. TO WRAP d/
GROUT 0 a' 08 -
FRAMING 0-61
INSULATION 7 —O
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL -INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
FENCE & GATE
SEW R SEPTIC TANK ; • „ / ; p , ;
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST - O
l NG - A/C
Iri7USE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
PAGE 01
Certificate of Occupancy
City of La Quints
Building'and Safety Department.,.pro,
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 fallowing.-
BUILDING
ollowing:BUILDING ADDRESS: 79-185 MANDARINA
Use Classification: SFD Bldg. Permit No.: 0011-297
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: RJT INVESTMENTS INC
Address: ' 1425 E UNIVERSITY DRIVE
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 8-28-01
Building Official
I POST IN A CONSPICUOUS PLACE