SFD (0004-311)79405 Mandarina
0004-311
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
690645 13 MQ' A OGl30/ t
ate Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors
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:
Carrier ic1S. COMPANY OF T Policy No. WDE17M 190.0
(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 thoseN'provisions.
e: _v i-._ a,- Applicant _4-0.{i Vi
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.
r
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). V, V, t'^ c~r DaW2-1') „P_1'J1' f
BUILDING PERMIT PERMIT#
111
DATE VALUATION {/ LOT [ DOW-`. TRACT ry 9q y
t214=5-40 9 2844 7.1
JOB SITE
ADDRESS 79-405 ZiJAVVJnAWWA.
APN
772 -OW -OW
OWNER
CONTRACTOR / DESIGNER / EN (NEER
Rn IAWFZ1?vE@M, WC.
R3'x Itwmw"fs,'IN'C.
1425 Z 'L1N1VKWf.rY' I R1VF..
14231, CJMVl W.rY DRIVE
PHOE 91X !AZ 85034
PHOEADC AZ 83034
(602)Z57-1656 CST 4990
USE OF PERMIT
°WHIaLE F.AI&LY DDW L.YJ iC:r
•
i
N
SFD-LOT 9K2A PEfiMIT DOM NOT INCLUDE BLOCKN.rIALW OR.
POOL.75% PLAN C14FC"K RE REDUCTION n)R ML11s91PL'F', ISSUANCE OF <
SAME PLAI•C1 YPE:'.
GUATOM CONSTRUCTION ?, .00 SF
POJ CHMATIO ST
0A:RA0F7CARPOR.T (3 ) 11.4117. U
ES'.iWATED COS"r 011* CC;tiVSTI; ft7CJ10N
214, . 5,4is
PYAZ rxrr FRE SUAOAARY
CONSTRUCTION Va 101.-000418.000 $1,042,00
PLAN CHECK FEE 101-000-439-318
MF ".RANICALFEE 101-000-421-000 X111,50
ELECTRICAL FEY. 1014000.420-000 $139.34
PLUMD1110 IEE 101.000.419-000 $100150
STP,ONO MOTION FEE - RESID 101-000.241-000 $21.49
GRADINO F'ER 101=000-423.000 SAN
D1 V'P;1..OpPM ]IMPACP"f FEE, $1,9(Y7.00
!AXf IN PUBLIC PLACES - RESIE 701.000.255=000 sh13
«31.7:5-! 4CUL COitTB°.fRUCM 9 AND I' T..AK (,`.I:',1 ::C-K
1'3,693.43
LEBO PRE-PMFERS
80.00
O'M YX' —TT' FIETS DUE NOW
"W93.43
RECEIPT
DATE
B Y//
'
AT
DE FINALED
INSPECTOR
r /7
A
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 W
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
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
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) - - Q
Of
FROM - ........... FAX NO. 760564223e Apr. 24 2001.09:15AM P2
CITY OF LA OUINTA
• BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-7153
RJT YJOMES LLC
Owner
EW
R -Z b
Contractor—
Pwmft Number0004-311— a"ITY Qi LA QU
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-405-MANDARINA
SFA -LOT r' 2A; PERMIT DOES NOT
INCLUDE BLOCK WALL OR POOL.
TYPE OF INSPECTION DATE IN P.
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
6,Co NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUQM-FLfCTf1.!Q
ROUGH PLUMBING
ROUGH GASA GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF
CO -
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 0 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
A W
DRYWALL INTERIOR w
EXTERIOR LATH &1
POO[ IRE PLASTER
FENCE & GATE
AFVJEF4 SEPTIC TANK
FINALS
ELECTRICAL C>'
PLUMBING
%L GAS TEST
HOUSE NUMBERS
708 COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
T. IMLI ^M I MIS mra no nr.ni 10Y RI Ili nING
Certificate of Occupancy
City of La- Quinta
Building and Safety Department OfTME°"
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: 79-405 MANDARINA
Use Classification: SFD Bldg. Permit No.: 0004-311
Occupancy Group: R3 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
Date: 4-24-01
POST IN A CONSPICUOUS PLACE
a..
Building Official
Address: 1425 E UNIVERSITY DR
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 4-24-01
POST IN A CONSPICUOUS PLACE
a..