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SFD (0006-257)79355 Mandarina 0006-257 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 F 59{36 s D I: C A. 116/30/2( DateO' %"i'= {_ { Signature of Contractor h1 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 t6 property, am exclusively contracting with licensed contractors to constructOthe project (Sec. 7044, Business & Professionals Code). () I am exempt under Section B&P.C. for this reason Date signature of Owner F WORKER'S COMPENSATION DECLARATION ' I hereby affirm under, penalty of, perjury one of the following declarations: () I have and will maintaln,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. ,(J)' 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: Carrier 1149, COMP I'Y OF T Policy No. WD917A041900 (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', .1/shall forthwith comply with those provisions. Date: 2-11.--&" .Applicant -„-T., 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) l - 7 • +` Date v A 11Z: BUILDING PERMIT PERMIT# t+ DATE VALUATION LOT '115; TRACT ` ' A! 14 JOB SITE ADDRESS q9 APN ( j! ' l =i i A 772_0W ­00d OWNER CONTRACTOR/DESIGNER/EN INEER R T WMr%vffiM,,11. C. iY`a mWim -f-d, rNe. 1425t, 'C.INTVEAWY D `.M 1425 E.'Cf1 lVL?FM*Y DME PHOMM AZ 85034 PWORiiTfK AZ 85034 4 (602)257.1656 C.B F 4990 USE OF PERMIT °. L. NGIT!, FAWLY DWJIZ I,31hi G S'V'D- LOT 14 PLAN 2A PERMIT DOMNOT INCLUDE BLOCK WALL -5 OR POOL 73 % PLAN t HFCK ME RRDUCTION FOR. ISSUANCE OF SAME PLAN TYPE CUSTOM CONSTRUCTION zrn.00 9i,?; PORCHIPATIO 2x33.00 sY GARAGEICARPORT (3F) t 1,407, 20 '.itt+ ` 1 COST ® 2 7C'"a'):()N .,t. 8I p ,{ 7 y.,v ; y s`” l3' LC E7b'vw2 . IKRW I E 490KMARA .k1;5.+5AO q CONSTRUCTION TTE 101.000-418.000- $1,042,00 PLAN CH9CX FEE 101-000-439-318 $214.47 MECHANICAL M 101.000-4-214400 6111.60 9LECTIUCALFEE 101-000420-000 $139.:34 PLUMBINO EPEE 1014000-419.000 '1:530.50 -4 t, A_J STRO140MOTION IPFI,4RESID 101-000-241-000 $71.49 CRADINO FFF, 101,,000-429-000 $20,00 DEVELOPER IMPACT 7,Z $1,1407.00 ART IN .PUBLICS PLA.CIME - RPMr. 701.000.253'000 13714 SUE -101AL. CONSTR!.TC.M014 A&11'! PLAWT $3,693,44 7 5 Pr PArn S $0.00 "£O i'AIJ FMI ., FM ME NOW $3;693; A4 RECEIPT DATE 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 !oU Exhaust Fans O.K. to Wrap F.A.U. Framing j cc/ 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 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 z 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 Util'rty_Jotice (Perm) COMMENTS: FROM RJT_HOMES . FAX NO. 7605646505 Jun; 21 2001 11:58AM P2 O.K. TO WRAP -er`lT OF LA.OUINTA g J DING & SAI`ETY.DEPARTMENT C" 7 LUUU 777-7012 - INSPECTION REQUEST LINE I1 • i k__ E Pr 777'-7153 PRE -ROOF RJT INVESTMENTS, INC Owner DRYWALL INTERIOR RJT INVESTMENTS, INC ( Contractor l 0006-257 POOL PRE PLASTER Permit Number er POST ON JOB IN CONSPICUOUS PI -ACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES 79-355 MANDARINA EWER SEPTIC TANK J08 ADDRESS -. ! i ! `f SFD- LOT I4 PLAN 2A PERMIT 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 ELECTRICAL GROUND WORK Ibu-NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT- A/C FIREPLACE BOND BEAM O.K. TO WRAP GROUT ❑ 4' 0 8' FRAMING INSULATION I1 • • / CSG l PRE -ROOF "'DOVER NO -WORK UNTIL ABOVE HAS VEN SIGNED " DRYWALL INTERIOR ( EXTERIOR LATH l -wz POOL PRE PLASTER L FENCE & GATE EWER SEPTIC TANK ; _ -. ! i ! `f FINALS ELECTRICAL PLUMBING 1L GAS TEST .,Tl NG - A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER ABOVE APPROVAL$ PO NOT INCLUDE RIGHT TO TURN ON UTILITIES 08 OCCUPY BUILDING Certificate Of0c,cupancy City of La Quinta \-/ I.-KOM TW w4 Building and.Safety Department r 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- comp/lance with .the various ordinances of the City regulating bud/ding construction or use. For the following: c BUILDING ADDRESS: 79-355 MANDARINA Use Classification:_ SFD Bldg.. Permit No.: 0006-257 Occupancy Group: R1 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 F Date: 6-21-01 Building Official POST IN A -CONSPICUOUS PLACE