SFD (0006-258)79345 Mandarina
0006-258
LICENSED CONTRACTOR DECLARATION
;1 hereby affirm under penalty of perjury that l am,licensed under provisions of
Chapin 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
r=' License# Lic. Class Exp. Date
690645 13 BIC A 06/30/2(
,r r
Date A- Signature of Contractor .A a , s :.•,.o
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, 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).
( ) 1, 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.
Sec( ) I have and will maintain workers' compensation insurance, as required by
tion 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:
Carrier . 1142. COA IPA1` Y Oil T Policy No. WUEI7004.1900
(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: 1Applicant 1- " I V;"
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.
P S
Signature (Owner/Agent)` •' • - Date
BUILDING PERMIT PERMIT#
0006-2m
DATE / VALUATION LOT TRACT
92-33,748.501 S
247.2
JOB SITE
ADDRESS 79-34* AIANDAIMA
APN
772-",0i 003
OWNER
CONTRACTOR / DESIGNER / ENGINEER
R1`T lTi' EMW- 977, INC:. ''
I .i` i" II i V'ESTMEIT11s, n4c.
142U lI1i R 3I17Y lar.
51.
1425 E.17N1N FR0r1T DRM
PHOLPkax AZ 95034
PHOENIX
.AZ
950:4
602)251.16564
CHO
4990
USE OF PERMIT
SINCOX PANf.1LY DWM, , G
SFJD? WT 15 P.LA14 3;,'A PERMIT DOES NOT INCLUDE BLOCK b«iAlAA OR
IP004 75 %P AN c;HECX KEREDUCTION FOR. ISSUAACTIOFSAMS
PLAN TYI1
CUSTOM CONSTRUCTION 2,033,00 21F
PORICH/FA TIO 00.00 SF'
_..
0ARACIUCARPORT (N) 11,329.311
C
ESMIATM COST air C:ONST=CTIO111
748M
PERMIT FEF: WhItbiARY
=-
CON+3TRUCTIONPEI, 101.000.416.000 $1,108.50
PLAN CH'E& eft 101-000-439-318
MECHANICA1.FFE 101-000.421.0003 5105.00
ELZICTRICAL IME 101-000-420••00I0 $168.22
PL.UMR10 YFIE 101? -000-419-000 8180150
ST1 ONO MOTION TRE? a MSiD 101.000.241-000 $23:37
GRADING V29 101-000-423-000 II 0,b9
DEVELOPE,i IMPACT "M $1,407.00
ARM PUBLIC PhACE9 - R&'!L 701.000.235.000 S84.!.r/
SM-1Ci'I'AL COROTR 3•Cc`i7Oly AND PLANCIMCIC
$3,823.46
Ir..S11 PREI%PA1D$.MES
$0,07
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
- 6d
Underground Ducts
Forms 8 Footings
ezb
Ducts
Slab Grade
=2(_. Cjv
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
(} -F.A.U.
Framing
Compressor
Insulation
Q .
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
O - -. 60
Drywall - Int. Lath
QQ
Final zzl�
Final o,Z_21- o r f�G�
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
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
_�� -OZj
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
G.F.I.
Smoke Detectors
Temp. Use of Power
Final a
Utility Notice (Perm) Z -� _ p,
COMMENTS:
FAX. N0. :. 7605642238
Feb. .21 2001 11:23AM P1
0
a s CITVF LA QUINTA
BUI.LIAN6 SAFETY DEPARTMENT
c o► 777-7012.
JUN 2 7 2("PECTION REQUEST LINE
777-7153
` RJTMENTS, INC
,Owner
Contractor RJT INVESTMENTS, INC
0006-258
permit Number
POST ON J08 IN CONSPICUOUS PACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS "19-345 MANDARINA
SFD- LOT 15 PLAN 3RA PERMIT DOES NOT
INCLUDE BLOCK 'WALLS OR POOL.,
TYPE OF INSPECTION DATE INSP.
FOUNDATION 8 SETBACK
FOOTING STEEL Ci4
MAIN GROUND SYSTEM
PRE-GUNITE
DO NOT POUR CONCRETE, UNTIL ALL ABOVE HAS BEE SIGNED
CONCRETE SLAB -4wj
JOISTS & GIRDERS
ELECTRICAL GROUND WORK.
Dv NOT POUR CONCRETE UNTIL ALL ABOVE HAS SEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS 8 GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' O 8'
FRAMING J 40
INSULATION
PRE -ROOF
1 /'.rc itl / /.Cf
COVER NO WORK U T ABOVE HAS BEEN SIGN D
DRYWALL INTERIOR - CiOj
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE 8 GATE
EW R SEPTIC TANK
FINALS
ELECTRICAL C
_PLUMBING
L GAS TEST
.._ATING • A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
i,
Q
SI
t
I
Certificate. ®f occupancy
CityQuinta®f La
_
Building and Safety Department F'fQf C,
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=345 MANDARINA
Use Classification: SFD Bldg. Permit No.:. 0006-258
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: 2-21-01
Building Official
POST IN A CONSPICUOUS PLACE