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I LICENSED CONTRACTOR DECLARATION
I hereby 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
Zate_:�
G9064543 001.1012CA
`-Signature of Contractor
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.
( ) I 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. aye:
Carrier .0 Policy No.
8,T.A'i'E Jl LINT1 Cs35>9li�i.;�E;
(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 forthwith comply with those provisions:`/._
fate: Applicant Vis=-
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 purposes. J >
;,Signature (Owner/Agent) Date ✓ e�! �`��i
BUILDING PERMIT PERMITk
9906-1817
DATE I)6/Z,)/1"VALUATION fi6..[fjQ,��� LOT ��, TRACT 2 53?1�-�
JOB SITE78430 {�A St .LE PANIN DRIVE
ADDRESS
APN 76i"0-744-0019
OWNER
CONTRACTOR/DESIGNER/ENGINEER
11.1'I' 1.i0IMPS LLC
RIT IN VES7`M,i^;M-S, MC.
I?,t;;r. ,'Box 8.10
4425 E. UNIV4: RS1'IT 0FJ V ;
LA QUIN�dT.A, CA 92253
PHOENIX, AI 8504
CIRLN 494.101
USE OF PERMIT
St:qGLE FAivi1LY Div'ELONG
SF 1) - LOT 19, PLAN 100 - REPTAMS HOUSE ISSUPE) Uie-JER I Ei2MT
#9803.20] (NOTC'O3dSYRUrv'1711A)). 13I.00K iV.A.:LS AN0 POOL F_X( ,UDEU.
Ckr5T �.lc4l:ONIS'I'RUCTICia ^4004.00 3F
:POI2.01AIXF10 43.04 8
r CIAfiNliiEfC P1I2I=C irtl' 484-00 SF
ESTY'ki ATE 10% COST 01P COINKYRU MMON
PERrvaX F M11 SUMMARY
Q0NST ktIYCI IGN t'Eli. 101-000-418-ra S8114,00
PrX,Nr;FTW(' t;FF tW-000.439-34R $^.15,74.
N:%: )ANICAL FME 101-00041411-000 56040
i l: idi, s'!>s IC AI, .FEE 101 -000 -420 -OW t137,32
►-►I 4181NO FW -1, 1101-000-4.151-000 S 166ko
n OT[� ON VrjF;._ 40tSOF) 10140-74J-00062
�a;��0;
�
it3:fly'A�i`Ilt(dt'i`i.3X"�Ts'd�4s}s 225..(jtW. 14• 342 $1,72.S96
111�`i' 9Ai Ityd7 i.Fti1 #ti3'.Af<:�3ti - tZ.1i:. W 701-000-255-000 S165.42
rt.F1 T010c
1,14-`t'(YrA1: CONS.TRIJC-MON'AND P1iN C'N• ECK
�;tit31.t?
LESS PRE -PAID FM
4500.00
TWAf� PE. KNIf fF4 1". FS WYE 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
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
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 I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines (p -
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
I
CITY OF LA dU' INTA
, BUILDING & SAFETY DEPARTMENT
b
F
777-7012
17.E
Owner RJT HOMES LLC PA
Contractor
R.TT INVESTMENTS IN
Permit Number 9906-187
POST ON JOS' IN COW . "
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-830 CASTLE PINES DRIVE
Sf~D - LOT 19, PLAN 100 - REPLACES DOUSE ISSUED
UNDER PERMIT 0803-201 (NOT CONSTRUCTED). BLOCK
WALLS AND POOL, EXCLUDED.
I
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 Z7ZZ _
I
l bT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST ) f I
HEATING & VENT -A/C
FIREPLACE
ROOF ��.� r
BOND BEAM
O.K. TO WRAP
GROUT Cl 4' Q 8'
FRAMING �'•• �; i
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR v'. •1 U 'T 7
EXTERIOR LATH
POOL PRE PLASTER
L FENCE & GATE
SEWER SEPTIC TANK (,-� — ? �1 _ �7, 771 /
HNALS
PLUMaiNG
FINAL GAS TEST
b "l-CiNG - A/C
E NUMBERS
JOB COMPLETED
TEMP POWER
1
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDINGTOOE TT
-,Adb S0S9b9909L 'ON XU -J _��• . r, ;;�.u:
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:
Occupancy Group:
SFD
78-830 CASTLE PINES DRIVE
Bldg. Permit No.: 9906-187
R3 Type of Construction: VN I Land Use Zone: R3
Owner of Building: RJT INVESTMENT INC
Building Official
Address: 1425 E UNIVERSITY DR
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 4-11-01
POST IN A CONSPICUOUS PLACE