SFD (0006-260)79325 Mandarina
0006-260
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 # Lic. Class Exp. Date
690«5 D 1310 A/ 06/30/x(
iJ, t. F L.•"y
Date /! w y,_. ,. Signature of Contractor
OWNER -BUILDER DECLARATION J
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:
Carver Policy No.
. FINS. COMPANY 0>7T WDE170041900
(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:.. -+ !: 'Applicant
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) ,'} r• • Date
BUILDING PERMIT PERMIT#
"7.2.60
DATE VALUATION LOT TRACT
'?) $206,1 Z 20 17
28447.2
JOB SITE -
ADDRESS . "_3.7 511 a4.N13A'EtAM
APN
771-M-EK).3
OWNER
CONTRACTOR DESIGNER ENGINEER
P,JT 1'1`7'i% kngmrs, INC,
R 1 t IN Yasp liY. L-`N i`3, INC.
14.25 F, AMIVEK.ITrY DRIVE
1425V M41VERRSfTT IDR VE'
PHOENIX AZ 85034
PHC rOMC
AZ
85034
(602)7.57-I6S6
CBT,#,!
4990
USE OF PERMIT
SF0- LOT .i7PLAN IRD PERlv1IT'DOES NOT ItdCLUL)N BLOCK WALLS OR
POOL, 75'ib P% 5;i liHEC1; IjEF £rDU(:7'Tt??1 AFL J, Si3Atd(:1 t)N liA1VII+'
PLAN TYPE
CIJS'FQkh CONSTRUCTION 2,470.00 9F
PORCH/PAT10
0ARACIEiC.ARPORT (%F) 12,20-60
{ "
1.%TftdA A COST OF C:OMMUC'I'I.ON
,, '
266111_7i.20
PERMT k'EER RUADAMY
C'•ONErFRUC:TION FBE 10118000-418.000 f.1014,A0
fir,
PLAN CHECK FEE 101-000-439-318 $209.88
MECHMICA L F'EE 101.000.4421-000 S I O,SA
H..iXXTRICRL}EKE 101-000-420-000 ' $156,47
P1,UMBINO FU 107.-000.419-000 5180.50
S'fFf.i3NO MOTION PRE - RESID 101-000-24.1-004 $20.62
C4I3.ADINO I;•IiE' 101-000.423-000` $20.80
D9VF4IDPVX!MP,,A.C`I' IER $1,907.00
ARX 1AI PUBLIC PLACM - RESIr 701-000.255-000 SISA
SLTB-7!`OIM, CtiM- i1MOR AND PLAN ¢ Y -MCR
$-3,627.00
LE 33 PRE -PPM FFM
$0,00
'1'4D7AL YMMIT 1'' E5 VUE NOW
$31627.90
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Slab Grade
27 (::*J !
Ducts
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
_
t Cl9
F.A.U. 4,20 ez
Framing
_� l p� _ (,
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
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
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
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles a
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) •-
COMMENTS:
AN 2 7 2000 INSPECTION REQUEST LINE
777-7153
HOwner CMEIE Zfi RiqWSTNTS, INC
Contractor RJT INVESTMENTS, INC
Permit Number 0006-260
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-325 MANDARINA
SFD- LOT 1.7 PLAN 1RB PERMIT DOES NOT
INCLUDE BLOCK WALLS OR POOL.
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL 2_2
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB 2_2_is
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
7*
bu-NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING& VENT -A/C
FIREPLACE
ROOF 0
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 0 8'
FRAMING
INSULATION
PRE -ROOF
CO ER NO WORK UWTIL
ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
CG
EXTERIOR LATH
POOL PRE PLASTER
eQPL FENCE & GATE
SR SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
:\L GAS TEST
_NC
_777,1)- 0(
STING -
7
HOUSE NUMBERS
f -
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES
OR OCCUPY BUILDING
P TT_HC IES
FAX N0. : 7605646505 Mar. 21 2001 10:51AM P3
8
OF LA QUINTA
DEPARTMENT
;> 1:�
�•= WILE &SAFETY
Y, 777-7012
`JUN 2 7 2000 INSPECTION REQUEST LINE
777.7153
Towner I; ` - ,VESTMENTS, INC
RJT INVESTMENTS,'INC
Contractor
0006-260
Permit Number NSPICUQUS PLACE
POST ON JOB IN CO
MUST SIGN ALL APPLICABLE SPACES
INSPECTOR
79-325 MANDARINA
JOB ADDRESS
.t
SFD- LOT 17 PLAN IRB PERNIiT DOES NOT
INCLUDE BLOCK WALLS OR POOL.
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
i.. -.
ELECTRICAL' GROUND WORK
'
Vil POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST /
HEATING&VENT- A1C
FIREPLACE
'
ROOF
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 0 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UPMC ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
e0pL FENCE & GATE
(H "R SEPTIC TANK . U()
"
FINALS
ELECTRICAL
PLUMBING
T '\L CTAS TEST 0
5„m:lTl NG - A!C
' ^
HOUSE NUMBERS
JOBCOMPLETED
:i
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TI IDN nu I M1 ITIM nD nrr.110V pl 111 r11A!/2'
8
Certificate of Occupancy
City of La Quin-ta
Building and Safety Department `FMofmE°`'v
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:
Use Classification: SFD
Occupancy Group: R3
79-325 MANDARINA
Bldg. Permit No.: 0006-260
Type of Construction: VN Land Use Zone: RL
Owner of Building: RJT INVESTMENTS INC
/"7
Building Official
Address: 1425 E UNIVERSITY DR
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 3-21-01
POST IN A CONSPICUOUS PLACE