RPL (0008-431)79465 Mandarina
0008-431
LICENSED CONTRACTOR DECLARATION
Thereby 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
Ev9 S 13131C 03/01 /2(
Date i Signature of Contra r fdl`
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
performance 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:
Carrier nos COMPANY OF T Policy No. WD8170041400
(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 SDY
' of the Labor
Code, I sh )I fortith comply wit, ,t os provisi fSs. Date: ApplicanA
Warning: Failure to secure Workers' Com pen satio 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 be 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 V*
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.
6
I certify that I have read this application and state that the above information" s_
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 fog„} spection p rposes.
Signature (Owner/Age Date 6er-
BUILDING PERMIT PERMIT*
/I
DATLOT 0008431 TRACT
JOB SITE
APN
ADDRESS '19-465 MANDARRU
-
OWNER
CONTRACTOR/DESIGNER/ENGINEER
WTITOMOUC
R3 r INVEM..WWI.1, INC.
Po in- X 810
1425 Yr Ulgf MERMN DRIVE
LA QrJIRI'.A CA 92253
PRO'ENA, AZ S 34
(f,02)257m1656 MEN .4990
USE OF PERMIT
POOL . WDIC9R 0A
POOL. &SPA til+ LYkAL.ARMS/BARRJ),RS SHALL HE fN PI AC1V, AT PRE
PLASTER INSPEC TICi' POOL ISQL1IPMENT ENCLOSI' M IS NOT INCLUD.W
11'1' HIS PERMIT
POOL ANI3/OR SPA 10,000,00 LS
I"ir7, 1KAM COSH' OF C:OT49 UC CION
PLAN CHECK YEE )01-000.439-318 $76,03
CONSTRUCTION FEE 101-000.418-000 $117.00
MECHANICAL FEE -- POOL 101.000.421-000 $24,00
ELECTRICAL FFZ - POOL 101-000-420-000 $45.00
PLUMBINO FEE, -- POOL 101.OM419-000 $27,00
LUPI. OTAT Co1491-I UC`TI-I iii' AWD PLA r CI3ECK
$289.05
7UESS PRS: -PAM :EKES
$0.00
f
• WIAl:, PERMTMEWSDUE 14OW
$269.05
tf'-
[
RECELPVVTI
DATE
BY
DAT&FI ALD
INSPECTOR
P .
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 8 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
2 5";_66
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
FROM : RJT_HOMES FAX NO
r
FF
PA
7605646505Aug. 30 2000 03:36PM P7
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0
IDHO1 FOR
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A RE-INSPECTI
FEE OF $30
WILL BE CHARGED
THE APPROVED
3R
PLANS AND JOB
RD ARE NOT ON
THE SITE FOR
SCHEDULED
INSPECTION.
am&40,65
CITY OF LA
INTA
Df4Q O
BUILDING DING & SAF
Y DEPT.
A P
ED
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FOR CO. STR CTION
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RJT HOMES PAGE 03
-.1
ll k
_ 6TY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
777-7012
-- L` Q04 INSPECTION REQUEST LINE
- 777-7153
rner RJ`'I' HOMES LLC
Contractor RJT INVESTMENTS INC
Permit Number 0008-431
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-465 MA"ARINA
POOL & SPA ONLY-ALARMSIBARRJER3 SHALL BE IN
PLACE AT PRE PLASTER .INSPECTION. POOL
EQUIPMENT ENCLOSURE IS NOT INCLUDED IN THIS
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
JOISTS & GIRDERS
iiELECTRICAL GROUND WORK
L •WOT POUR CONCRETE UNTIL. ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING -
ROUGH GAS & GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP CYI_Q
GROUT 0 o' ❑ 8' WILL BE
INSULATION
PRE -ROOF
COVER NO WORK UNTIL _ _ REN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER _
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
DING
:TING -
JOB COMPLETED ^
TEMP POWER
ALC7CUICRETE FLAT WORK SHALL BE PLACED A
.MINIMUM OF 2" BELOW WEEP SCREEDS.