Loading...
RPL (0008-433)79445 Mandarina 0008-433 LICENSED CONTRACTOR DECLARATION 1 hereht,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 ^#Qhs^ C {9Lic y.pClass Exp. Date/t1 /y 9tlb4S 13 TVC A !01/2( w Date Signature of Contractor - OWNER -BUILDER DECLA ATION 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 Sianature 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. L,)A-1" fiave 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 INS, COMPANY OF T Policy No. WD9170041900 (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 Se Pion 3700 of the Labor Code, I sallforthyvith comply with those provisions. Date: -d Applicant WarninFailure to secure Workers' Compensation cov r e 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 inspectio purpo es. % Signature (Owner/Agent) y I. Date -fT UILDING PERMIT PERMIT# DATEf! ¢`'4VAL'iIATION LOT d t1+f -433 TRACT 410,000.vX) JOB SITEl f ADDRESS &445-ATMA1 i 1'11 APN OWNER CONTRACTOR / DESIGNER / EN (NEER ,R THOMESLTC IWT1NV.IF,SiuFNTS, Lim 110 BOA', 810 1425 E. UNJV.l+'42S7."i'3C:CJRIVE LA, T1N'TA CA 92253 IMOEM ,tom 85034 (602)257-1656 CB141 4990 USE OF PERMIT POOL ANDIOR SPA POOL &-SPA OJLY•ALhI.'MSi,SARRIERS SFLW BV 124 PLACE.AT PRE PL"TER, WSPECTION, 001, PIQUIPMENT D4CLA'1SURR IS NOT MCLUDEU IN THIS PERMIT POOL ANDIOP 9PA 10,000.00 LO 99]i Al JW €;`OST a -V CO NSTROC170H 10,000.{!() PkVb f'f FEE SUMIKARY PW4 CHECK FEE 101.000*439.318 $76.05 CONSTRUCTION ITE 101=000-418-100 $11'7.00 MECHANICAL FEE .- POOL, 101x000-421-000 $24.00 ELECTRICM, VVE -• POOL. 101-000-420-0010 $45.00 PLtilitMBINO FE -- POOL 101.WO-419-000 527.00 ` MTB -TOTAL C'aMY1TLUC' ION AI&L PAR a11 CK '$12.89.05 Ims PRE -PAID Y=,S $0.00 TO'fA '1 .0 V S DUE NOW $Mks RECEIPT DATE BY DATF^EIVALM INSPECTOR I 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 OX 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 POOLS - SPAS Steel - . -cord 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 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 Utility Notice (Perm) COMMENTS: FROM : RJT_HOMES 6.56' 5.0 F 0 FAX NO. 7605646505 Aug. 30 2000 03:38PM Pll SEE MODEL INDEX ON SH* 1 FOR COURTYARD' DRAINAGE 79 ` ys3R qvI F-40.1 j PAD=39*6 .. " 42.77 TW ' • . '••• , • = 38. 10 TF GpN`' C 05/01/2002 08:44 7605646505 RJT HOMES PAGE 04 g - CW OF LA OUINTA orn� BUILDING & SAFETY DEPARTMENT 777-7012 Ownfi_ Contractor NSPECTION REQUEST LINE -t' r _ 777-7153 RJT HOMES LLC RJT INVESTMENTS INC Permit Number 0008-433 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES 79445 MANDARINA JOB ADDRESS POOL & SPA ONLY-ALARMSBA,RRIL' RS SHALL BE IN PLACE AT PRE PLASTER INSPECTION. POOL EQUIPMENT ENCLOSURE IS NOT INCLUDED IN THIS PERMIT TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK MAIN GROUND SYSTEM GROUND PLUMBING DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB JOISTS & GIRDERS ELECTRICAL GROUND WORK 6_ NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING CJ -2 L.' ' W ROUGH GAS & GAS TEST HEATING & VENT -A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP GROUT 0 4 ❑ 8' PRE -ROOF COVER NO WORK UNTIL d&hlAffdEEN SIGNED DRYWALL INTERIOR EXTERIOR LATH POOL PRE PLASTER / ✓" POOL FENCE & GATE SEWER SEPTIC TANK FINALS ELECTRICAL PLUMBING FINAL GAS TEST . TING - A/C HufJSE NUMBEI DMPLETED 7' - POWER PMC Ist LACED A- AI.L I.UIVIiKt It: t'LA l VVu MINIMUM OF 2" BELOW WEEP SCREEDS.