BLDG (9904-040)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
O ch License # Lic. Class Exp. Date
G74LO
��1?G 7/ ilSj9
oZ r-- Date; � Signature of Contracto
co O. !`�_
J U � OWNER -BUILDER DEOL-ARATION
HLU I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z_ ( ) 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).
C () I am exempt under Section , B&P.C. for this reason
O N Date Signature of Owner
Q WORKER'S COMPENSATION DECLARATION
CL
p ZI hereby affirm under penalty of perjury one of the following declarations:
LO ,p O I have and will maintain a certificate of consent to self -insure for workers'
X W.I.L. compensation; as provided for by Section 3700 of the Labor Code, for the
O .j Q performance of the work for which this permit is issued.
m•Q U X, I have and will maintain workers' compensation insurance, as required by
CCQ S ction 3700 of the Labor Code, for the performance of the work for which this
Il a Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Cartier Policy No.
CIS O STNIti (3I�Is� 11tIG !lt;;(►7�;
J
(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 agre).6,6at if l\should become
subject to the workers' compensation provisions. of Section 3700 of the Labor
3 Code, Ishall forthwith comply with those provisions!_. - -
ate: 2 ,' i r ✓ Applicant
Warning: Failure to secure Workers' Com osation 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, indemnity
& 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 purposes.
Signature (Owner/Agent).-f'/f� Date'
BUILDING PERMIT PERMIT#
DATE VALUATION ' U.00 LOT TRACT oat
57• .C(cf n
JOB SITE%
ADDRESS 4ip` .4I>3�A Sli� !.+•ii9i V.�, �
APN 6.49-210-1142
Q
OWNER
CONTRACTOR/DESIGNER/ENGINEER
111). DESS. T 7J1:V.T'.F.(31?.M-r3N,I.,
SPARKS CSO, 91RUCI'f0N
.P.0. Box 1716
7,9-295 RANCHO I.lr. QU1NTA DR.
1AQU IN'iA CA, 92.2.53
LAQUf IWA CA. 9225:'
(760)771.194.9. CY31A 2990
USE OF PERMIT
GENERAL WILi3INC11
_.
CCalVfAION AR11A POOL HOU&F
VALUATION 8,938.W LS
fl.I,l.a:itAIPEII) COJ'�.4�•! O \.�./AVSTIN IiJM.. A•�M:ON
HH yt11��pp�� 6� �+ SUMMARY' NN,,sgRR qq�s��J`
A�F1ZW.k'ra-9. A fr�1� E SUlYidq ARY .
I.'LAN CI FEE— $70.20
t.; n1 STRII T(771(YN l -TY, 101 -(W -4184W $1(K00
EL i C°TIUC.AL FW' 101 -OW -4120-000 $24,12
59't2C)NG ANY110111°EE - R&S) 101-000-241-10100 $,€I9
Cil�!1 t'tT{V�1'�:`� 1 U9.-�}-tb9.Z-91()(? ?.'Za�t,(1(►
S(M-T(YTAL CON6TRUCTION AND PLAN CREC:l{
$280.21
CESS P.r;1�-PAiCf 1'uf 3
$0.00
fry' ... s.
RECEIPT V U
DATE / '1
BY I `1C-
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
i2 _
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 E Controls
Party Wali 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 Pibg. Test
Final 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
SqWVr Lateral
Pool Cover
4TJ Connection
Encapsulation
NZas'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)
June 2, 2000
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Mr. Nolan Sparks
Sparks Construction
79-295 Rancho La Quinta Drive
La Quinta, CA 92253
Dear Nolan: 'CORRECTION - PLEASE NOTE LOT I
(760) 777-7000
(TDD) (760) 777-1227
Please be advised of an address change for the following structure. The structure
formerly addressed as 78-960 Mission Drive West, APN: 649-210-042,; ot I, Tract
28640, the construction for which building permit #9904-040 was issued, will now be
addressed as 79-060 Mission Drive West.
Please note this change and contact me directly at (760) 777-7019 if I may be of further
assistance.
Thank you.
Sincerely,
Diane Aaker
Senior Secretary
Building & Safety Department
I
N9/22/2000 10:49 7607711841 SPARKS CONSTRUCTION
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Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 4/19/99
No. 18586
Owner NameT.D. Desert Development
No. 78-960 Street Mission Drive West
City La Quinta
Tract # 28640
Lot # 1
APN # 649-218-042
Jurisdiction La Quinta
Permit #
Log #
Zip 92253 Study Area
Square Footage 456
Type of Development Commercial No. of Units 1
Comments
Common area pool house
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory. structures or replacement mobilehomes.
It has been determined the above-named owner is exempt from paying school fees at this time due to the following
reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code53080 in the amount of
.31 X 456 or $ 141.36 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By CC/PD National Bank/T.D. Desert Development
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green
Signature
Payment Receive
Check No.
Telephone 771-194`:]_. t `'
r �
Received
$141.36
74766
INOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified I
above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting