RPL (0008-435)79425 Mandarina
0008-435
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 1`3 RIC ,A. 07 /2C.
Date I" Signature of Contractor`
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 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
perfo ance of the work for which this permit is issued.
(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:
CaPolicy No.
Carder INS,C'OMPANl OFT Policy
(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 Sgetion 3700 of the Labor
Code, I a fort With comply with tho provisions./
Date: Applicant yG
Warni g. Failure to secure Workers' Compensation verage 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 pur oses
Signature (Owner/Agent) - Date /
BUILDING PERMIT PERMIT#
Der f T , VALUATION LOT OWS-4," TRACT
SxiiMom
JOB SITE
ADDRESS .9-425 wmnuaIu
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
RH ITOWS LTX
R3T ftTV0nMFNTS, WC.
P0130X 610
1425 F. MN1VIRR,31TTDRIVE
3 A QUIRrA CA 92253
PIC MIX AZ 61034
(602)2.'Y7-1656 COLO 4990
USE OF PERMIT
POOL AMWOR. SPA
POOL, & SPA ONI.X-ALAI' MSIBARRIERS SHALL BE M PLACE AT PRE
PLASTI*R INSPECTIORPOOL F4UIPMFNT ENCLOGURK IS NOT YNC;LUtaI•+da
114 THIS PZRMIT
POOL A:NDICR SPA 10,000.00 LS
Esrf V.FAm COST 010 Ct..a' N1f7.21`Jcnos
Xt},0t>t3.ifi0
PESMIT FRE SUMX4RY
PI.A14 CHECK FEE 101µ000.439-335 mos
C:ONSTRUi TION FEE 101-0013-418-1300 $117.00
MECHANICAL FFT.-- POOL 101.000.421-000 $24.00
ELECTRICAL. YZE - POOL, 101-000-42("00 $45.00
PLUMBING FEE-- POUT, 101.000.419.000 W.00
SUB TOTAL ICCO1`i t 'lsMTION ABET PLA14 + HFAY,
$019.05
LESS IvRF,- AID .r., %
$0.00
¢, gg {--
1_4 AT
IM9.05
RECEIPT
DATE
BY- J
DATE V
i
INSPECTOR
INSPECTION RECORD
.4 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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Footings
Electric Bond
Main Drain
l0 Ct/
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
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
-(J
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
FJT—HOMES
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FAX NO. : 7605646505
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05/02/2002 08:33 7605646505
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' CITAF' LA OUINTA
BUILDING & SAFETY DEPARTMENT
L IRSPECTION'Ri<4UEST LINE
-7012
7 .
. , r .,777-7153
Owner RJT HOMES LLC
Contractor RJT INVESTMENTS INC
Permit Number 0008435
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-425Ak"AR NA
POOL & SPA ONLY-ALARMSBARRIERS SHALL BE IN
PLACE AT PRE PLASTER INSPECTION. POOL
EQUIPM.IrNT ENCLOSURE IS NOT INCLUDED IN THIS
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE (7
DO NOT POUR CONCRETE UNTIL ALL A OVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
t ---AOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH PLUMBING I JA
ROUGH GAS & GAS TEST
HEATING & VENT - A/C
BOND BEAM
O.K. TO WRAP
GROUT O W O 8'
FRAMING MARD AR TON
PR
COVER NO WORK UNTIL AOMTIX5 VEEN SIGN
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
ELECTRICAL
FINAL GA5 TF -5T
i TING - A/C
JOB COMPLETED - f"
TEMP POWER
ALL L:uNL%Ht It rLA I
MINIMUM OF 2" BELOW WEEP SCREEDS. _
_ r