SFD (0006-262)79305 Mandarina
0006-262
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.
License # Li7c. Class Exp. Date
6X164.5 13 SIC: A / O&I-30i 2C
Date' , i 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 bontracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O ' 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:
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.
( )1 1 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:
CarrierINP, COMPANY OFT Policy No. ' DU.17t 041940
(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: t -= Applicant' a/ r
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.
a;;•
Signature (Owner/Agent) Viz• Date AF,1.+' -.•2
r--"' BUILDING PERMIT PERMIT#
0006-262
DATE VALUATION LOT
r > _ S-214.&WAG 19
TRACT
2W7.2
JOB SITE
ADDRESS Ze ,s
APN
OWNER -
CONTRACTOR / DESIGNER / EN (NEER
R3T "V' F..E1:iW LN IZ, INC.
RJT INV"FUSlivLMM,19C.
1425 Li CMIVER.1 DR"E
1425 F VN1VXRW_T'Y DRIVE
PHC)F. nx AZ 85034
144O:E1' DC
AZ
85034
l
(602)257.1650
CBL#
4990.
USE OF PERMIT
4)L1. TANGLY DWT91MGr
SFD• LOT 19 PLAN 2A. PFR:MIT DOPS NOT INCLUDE BLfail: `WAf.IZ OR
POOL 75 % PLAN C H&C'K M REDUCTIOW FOR ISSUANCE OF SAME
PLAN TYPE'
CUSTOM CONSTRUCTION 2,677,04 sty
1_'i1RC:IHIPA` IO 203.00 S9'
OARACII lc.AiiPORT (SF) 11,407.20
WfffdAaRD C09f OF CONiiTWICNION
^214, 5. O
PEIZWJ? 1t``EE SilllDJ Ry
CONSTRUCFIU-4 FF% 101.0€0 418.000 315942.40
`" f
PLAN CHECK FU, 101.000-429-318 $214.47
MECHANICAL D7 -i 101.000.421.000
ELW.TRIC.ALME 101-00.0-420-000
PF,LZt!4BT. Q1 FRE 101.004.419.000 3120.50
STROINO MOTION FEE - RMID 101.000-241-000 $21.49
t t ADFRO FRF. 101-000423.000 Saw
? C,
DEVELS PF,R IMPACT FEE $I,907,00
yG
ART IN PUBLAC PLA CBS - R.ESIE 701.000.255-000 $37,14
c ;
SUB -T0`1AL CC►23S'1RUCA-1014 AI1D PI" CM -,CK
$3,60.44
LESS PRE-PALDFM
$0.,00
!("-AL F1MM-If FIX -4 IM NOW
&303M
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR,,., ,
INSPECTION RECORD
i
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
. APPROVALS-
MECHANICAL APPROVALS
Set Backs
-
Underground Ducts
Forms & Footings
itDucts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
_
F.A.U.
Framing
Compressor r
Insulation
lCi
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
— 7312- Od
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
_ /
D L -
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)
,t
. FAX NO. 7605642238 Dec. 06 2001 11:47AM P1
c, FRC7('! .....
8* 0,7
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
v- 777-7012
INSPECTION REQUEST LINE
7.77-7153
JUN 2 7 2000
RJT INVESTMENTS, INC
.Owner
' 'RJESTMENTS INC
Contractor
permit Number
0006-262
POST ON J08 IN ONSPIP UO AB ELSPACES
INSPECTOR MUSTSIGN
JOB ADDRESS 79-305 MANDARINA
SFD- LOT 19 PLAN 2A PERMIT DOES NOT
INCLUDE BLOCK WALLS OR POOL.
TYPE OF INSPECTION DATE -NSP.
FOUNDATION & SETBACK T7 7 -
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEE SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
U, NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST zzl
HEATING & VENT- A/C
FIREPLACE
ROOF [)
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 08'
FRAMING )
....l.NSULATION - (J
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED.
DRYWALL INTERIOR -
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK <- W
FINALS
ELECTRICAL G .
PLUMBING
\L GAS TEST
JTI NG -A/C
ROUSE NUMBERS
JOB COMPLETED
TEMP POWER