RPL (0008-438)79395 Mandarina
0008-438
tit LICENSED CONTRACTORICENSED DECLARATION
I hereby affirm,Iunder penalty of perlu y that-1 am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Protessionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
690645 1' T3 HIC A `% /s31l2i
Date Signat'ontractor
OWNER -BUILDER DECLARATION
1 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
compensationAwill 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
contractor? 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
pance of the work for which this permit is issued.
erforVhave 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:
CarrierINS. COMPANY OFT
Policy No. did UB170W119t30
(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 o Section 0 of the Labor
Code, I s al fort with comply wi , those provisio
Date: Applican
Warnin :Failure to secure Workers' Compensation ver ge is unlawful and
shall subject an employer to criminal penalties and civil 'ns up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit' issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above nformation is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for insection purposes
Signature (Owner/Agent) ' Date
BUILDING PERMIT PERMIT#
0 ;4'8
DATq/ VALUATION LOT TRACT
(Jfj ` C 00ko
JOB SITE
APN
ADDRESS m.ANDA .$ A
T
OWNER .
CONTRACTOR/DESIGNER/EN INEER
P,J".f'H0 AS!'L' 110
FJTiNVWM%. -1 -0,INCG.
PO -BOX 810
1425 R UNIVER31'1 Y DRIVE
LA QZ7imm CA 92253
14.10E= AZ 85034
(602)2571656 C$I t 4990
USE OF PERMIT
POOT, AAWOR 8PA.
POOL &SPA CrN1,'Y•A"RMSt19A..I:. UZS SHALL BRAN PJ_kC P AT PRF
PLASTER INSPECTIOpi,POOL WUIPMZHT ENCLOSURE IS NOT I-NCL1 J1'*D
J7 THIS PERMIT
POOL AT701t?R SPA 4400,00 LS
COST OV COI4'SJ:'.[ J't''TJ::OM
10,00.00
y p`' y,, p p. y 9 e } 'rn y ,{'ykJ :y]41%"r1KXr9D
Sd?,.1"G.{Y3.1L.E Sl A E ST AYEaY1.ldJ.C.l
PLAN CHECK 11% $76,05
CONSTRUCTION FEE 101-000-118-000 $I 17.00
MECHANICAL FEE—POOL 101-0t3O-42.1.000 $24.00
Ei;LC, IMICAL FEE — POOH, 101-000-420..000 $e,5.00
PIIUMBII40 FEF -- POOL 101.000.419.000 $27100
SUL, OTAT, CON"ST:RLJ'C.M014 AWD PLAN CHECK: r
$283.05
1.2355 PRE-PA.U1 PE'E.9
0.00
fit
S PE-IMIMMS DUE VOW
RECEIPT
DATEBY
JI
DATE FLED
INSPECTOR
s'
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
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
v
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
Pool Cover
Sewer Connection
Encapsulation
_ 6;J
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
Utility Notice (Perm)
COMMENTS:
RJT_HOMES
F -I
i
b
T
Aug. 30 2000 03:45PM P21
/ t. •. .' p•R :t 1SPEC'if0 • .. VEO
L V O L :• ,j1lL BE ND Oat R
AkL 677 R
SC"EO LED
" 00.9
F
:39tlNItlNO
oavuano
ZION
V'HS
BIO X-30NI
13(30ri 33S
05/02/2002 08:33 7605646505
CITY OF LA QUINTA
ILDING & SAFETY DEPARTMENT
OF YN Z 777-7012
s EQ PECTION REQUEST LINE
777.7153
Omer
RJT HOMES LLC
Contractor RJT INVESTMENTS INC
Permit Number - 0008-438
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
79395 MANDAMA
JOB ADDRESS
POOL & SPA ONLY-ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE PLASTER INSPEC'T'ION. POOL
EQUIPMENT ENCLOSURE IS NOT INCLUDED IN THIS
PERMIT
TYPE OF INSPECrON DATE INSP.
FOUNDATION & SETBACK
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLA13
JOISTS & GIRDERS
e(ELECTRICAL GROUND WORK
L•_ NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING 8 VENT- A/C
BONO BEAM.
O.K. TO WRAP
GROUT O 4' 0 8'
INSULATION
PRE—ROOF
NO WORK UNTIL A HA E'F=N SIGNED
POOL PRE PLA,
POOL FENCE &
SEWER SEPTIC
FINALS
MINIMUM OF 2" BELOW WEEP SCREEDS, _