9906-186 (SFD)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
- W _ Professionals Code, and my License is in full force and effect.
C) ri/ License # Lic. Class Exp. Date
1�_ d U.) t)9i311+�J BLU
_ tkti30'2t�f
oZ Da/te { '/� Signature of Contractor
O O
ip OWNER -BUILDER DECLARATION
W w 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).
co () I am exempt under Section
LO B&P.C. for this reason
N Date Signature of Owner
ON
d Q WORKER'S COMPENSATION DECLARATION
o 2
Cc I hereby affirm under penalty of perjury one of the following declarations:
Lo H O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w compensation, as provided for by Section 3700 of the Labor Code, for the
mJ Q performance of the work for which this permit is issued.
Q () (,F) I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
6 5-•9w•I 2,A)
[1
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�.c6mpensation laws of California, and agree that if I should become
3
subject to the workers' compensation provisions of Jection 3700 of the Labor
s
Code, I shall forthwith comply with those provision
`Date: s" ' }' Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Compensation 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 inspection urposes.
vSignature (Owner/Agent)--�"'�� Date
BUILDING PERMIT PERMIT9904.38/+
DATE JI(jf'ZJ1199VALUATION S16S,fW44,." LOT j1j TRACT 7389.12
ADDRESS 8.820 CASTLE .�aE li)'�NES � RIVE JOB
APN 149-740-018
OWNER
CONTRACTOR / DESIGNER
tt y5
i1 r, 1' i 34 ��1i''..wr yr., t,t,.�
A/ENGINEER f
A� li:irl:. wa ri+2i': i'Yli.l� iTl ..
P.0.11OX 810
.1425 E. UIN i.V E i'S Y DRIVE
IA QUl.NTA CA 92253
P['IC.11~NIX AZ 85034
(64117.)231140% tyl�P,l1 �13��(1
USE OF PERMIT
S.Lt � .L,8 PAMHAV D�,rr;LLWG
3�,�! - i..l.o� I£�, 6?L.�1�' �1.t1?ii. � i�1;';';.E#i�S�� F,i�(..r"�� i.�,a ✓C.a.l�i C.Tl�.l�. }'1.itllti`I'
cul,,)TOM CCirb IiZ.I.'r:,`.',i'I0N 1,9&1.00 ;sT
P1.+.K0-V11eM0 77,00 8E
QAHA.QEi ;AY2Ni. fV1' 483.00 Sty
.a TX es.c�l��13) COST Or' � NSTIstiif,.T101T
s�i`F���-°i 411
CIONST1tl?CTION FPX i01-000-418-000 $870.50
-OM-439-318
11VIECIUANICALI�LF' 1011-000L.421MO 360.00
ELEC°i IUC.NL FQ.; 101-000-4 20-000 -000 5136.60
E'1,OH k_NO r• rX 10) -OW -419-000 Is 7.I�,
S'I RONQs lb (YVIt?N'PEF - RESTV1 1014M-241-000
f',1t.AI:1)I�`O %G:1i Ii?1-1300-4�?-000 S�U.00
1tv'1s1tR,;;!.iil3tlil1l FEE 225-000-443-342i,e:u>4G
ART 11N k+'03LIC PLA.CES - RIUSTi: 701-(300-2: 5-000 SJ62.61
'['V±p r'3 i -POS V'r ►t33-Ot t-�t3 31R-s5oo.c,1�
'iLY#3=XTAr, CO'NS"'£RUCfJON AND P-f,AN CiR.CK,
$5M4,4R
r uSSA P E .n ArE3 FETS
W00,00
TCYCKUPERMIT FEM DUE NOW
RECEIPT
DATE
By"
DATE FINALED
INSPECTOR
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
0. K. to Wrap
Framing
F.A.U. _
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
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:
i
m
Q Lp
G CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
Al OF "� 777-7012
INSPECTION RE4S INS
777 0
RJT HOMES LLC
Owner
Contractort,YT INVESTI�F��,:
Permit Number
9906-186" '` > tiT •� i ; �i7,
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-820 CASTLE PINES DRIVE
SFD - LOT 18, PLAN 20OR - REPLACES HOUSE ISSUED
UNDER PERMIT #9803-200 (NOT CONS`1'IZUCTED). BLOCK
WALLS AND POOL EXCLUDED.
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
CONCRETE SLAB
JOISTS S GIRDERS
ELECTRICAL GROUND WORK
+ L T POUR CONCRETE UNTIL ALL ASOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST 1.-f
HEATING & VENT- A/C
FIREPLACE
ROOF _
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ $'
FRAMING � j • � � ..� ::-`:� .�
INSULATION
PRE -ROOF {.-..
Ed Wdbb:OZ tiOOE 9E 'JEW
NOV
r m -.
PIMAI c
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
SOS9b9S09z : 'ON Xbd
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section, 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R3
78-820 CASTLE PINES DRIVE
Bldg. Permit No.: 9906-186
Type of Construction: VN Land Use Zone: RL
Owner of Building: RJT INVESTMENT INC
Tom.
Building Official
Address: 1425 E UNIVERSITY DR
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 4-08-01
POST IN A CONSPICUOUS PLACE
a