RPL (0008-432)79455 Mandarina
0008-432
LICENSED CONTRACTOR DECLARATION
:.I hereby affirm under penalty of perjury that I am licensed under provisions of
Q-aapte0 (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 B IZC lir 07/01/2(
Date Signature of Contractor ✓.//
OWNER -BUILDER DECLARATIO '1
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
performance of the work for which this permit is issued.
( & -1 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 RIS, COMPANY OF T Policy No. WDE170041900
(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 fo hwith comply with those provisionj,,.,
Date: Applicant
Warning: Failure to secure Workers' Compe tion 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 inspe to urposes.
Signature (Owner/Agent. Date
BUILDING PERMIT PERMIT##
DAVE J VA xca,o€$1(1,0W.00LUATION LOT TRACT
JOB SITE f
APN
ADDRESS ". 455 plA."Ai AMA,
OWNER
CONTRACT6R/ DESIGNER /EN 1NEEEFI
R3T 17yOKM 7
LlU IGv%, 114C .
PO BOX $i 0
1425 X UNIVM- .WrY DRIVE
T,A Qvkrm CA 32253
PROEM AL 85034
(602)357-1656 CAV) 4990
USE OF PERMIT
POOL ANDIOR SPA
POOL. &SPA ONLY-ALARMSMARFtiFILS SHALL HE IN PLACE PRov,
PLASTER INSPECT1ON,P00i, FQ01PMENT ENOLOSURLr 15 NOT 1NCLIMED
YN THIS PF"IT
POOL AND1011 SPA 10,000,001..x#
ES11MATED COST OF ICO. STR'UCITION
I%W.00
PEMMT`T" FET SUMMARY.
PLAN CHECK ". ,E 101 -ON -439.318 $76,0
CONST[dIXTION FEE, 101.000-418-000 $117.00
MECRAMCAL FEE -- POOL 101.000421.000 $24,00
Ia;I..l+CTRICAL FFX1 -- POOL 101-000-420-000 $45.00
PLUMBING ME -- POOL 101.ON-413-000 $27,00
SIM -TOTAL C0NB'I12iiC 17:OX AND PLAN'CHECK
$289.05
LEM PRE -PATO F.SS
$11100
TOTAL ' b pJT— Irk: -6 DVEF
V 69
RECEIPT
DATE
B
DATE FI q.L D
INSPECTOR
5 !/
INSPECTION RECORD
Y
y 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
POOLS - SPAS
BLOCKWALL APPROVALS
steel
gzi
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
rjv
Gas Piping
Gas Test
Appliances
Final
152_
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)
FAX N0. 7605646505 Aug. 30 2000 03:37PM P9
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FAX N0. 7605646505 Aug. 30 2000 03:37PM P9
•
••
•
SEE MODEL
INDEX ON
A
SHs 1 FOR
COURTYARD
DRAINAGE
FF 30
, =4 vp1
ARE-1NS 0 ZNE A ON
.,, ,.•, PNESSEFpR AS.
, iwN• St
Moll 40 TW
• • . 38.40 TF
®m \ON1+ { yrs' '1
ON
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05/01/2002 08:44 7605646505
. ..fes I AK _4..
at
1
s ITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
`
777-7012
t QOa INSPECTION REQUEST LINE
S 777-7153
ner
RTP,14IVIES LLC
Contractor RJT INVESTMENTS INC
Permit Number 0008-432
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79.455 MANDARINA.
POOL & SPA ONLY-A.LARMSIBARRIERS SHALL BE IN
PLACE AT PRE PLASTER INSPECTION, POOL
EQUIPMENT ENCLOSURE IS NOT INCLUDED IN TFT$
PERMIT
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
MAIN
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK.
MOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST /
HEATING & VENT- A/C
BOND BEAM
O.K. TO WRAP A RE-INSP CF 10
GROUT O 4' ❑ 8'WI gn IF
FRAMING99 GARD-ME
INSULATION
PRE -ROOF ,
COVER NO WORK uNTIOUMUMMUEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER d
POOL FENCE & GATE
SEWER SEPTIC TANK
LS
JOB COMPLETED
TEMP POWER
J ALL -CON FLAT WORK SHALL. BE PLACED A
MINIMUM OF 2" BELOW ,WEEP SCREEDS. —