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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
/i 3023 S ` I 1i30il
10 ate 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. are:
Carrier Policy No.
(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
su fect to the workers' compensation PEovisions of Section 3700 of the Labor
glide, I Shall forthwith comply with thane provisions.
w0ate: ' f of 0 Applicant ' 1"' V %
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`1o� inspection purposes.
i,Signature (Owner/Agent) �% % Date
PERMIT#
` BUILDING PERMIT
DATE 11� / � VALUATION 3322J011117jea LOT 26 TRACT i_ LA ,t ;JOB
SITE -_
ADDRESS 79449 CETMO
APN 772-116.626
J
OWNER
CONTRACTOR / DESIGNER / ENGINEER
CrrR :S DEVELOPMENT 11C
KARVIN HC1WS
51-374 AV HER IMAS, Sit'. 1
78-468 CALL E P,SI'ADU S"11-.201
LA QU1NTA CA 01153
LA QUIM'A CA 0225;
(7b(1)771•2%7 04,4 5407
USE OF PERMIT
S1N61A,' FA.M IJA !)iNtt,L N6
; 11:1 -1. -.fl 1 �,h, PLAN 1xAR_ .. PkaU11T C.x)R-13 NOT tNc.'i.1.'1D: di 0CK WA1A.
354.00 SF'
IAN. WT 753m4) SF
6:S'i'INIA'I ED CMT OF fi3N1 TRU(MONN
322,337 41
l t_►N 1 kt.n "!'1{ JN FEE 104 A {10 -418 -OW S l.4 dL+ iX1
IN AN 041;0K l;44; 4t)1-,yj(►_,43'}•'L1R 1.1 i 4R S"
'Ftt;CYY•l,"JYr',11, FIX" 101 1001 4.:1 tom(? xt?h 50►
EI.Ec1KR.,e".1Fj• .' WI-WO-420-t►i)i) 1 11 11 39
llY.t+NWINi;; FEE 101_049)1_41940) V14.Q0
.9'rR(_)N(4A1(1Tf4*iNi+V r.)V410 ffit411(m.°.If-t1j)fl Ari^• ?4
;RA'1)I ;`, 1 i to,1 .000-1e t I'm
11A;KA: 'fRiX`1(AtE I Lit ::`54X)0.44.3 -.'W2 1,!Kr; uu
ART IN f't_HAIAC KAi *FS - Rlt.8111- 701 (011-155A W 1.0. .�.,
qi M 11 1'Af, (0 N1q' 3tt_IC'i10N AND Pl -AN 1144 'K
LE&S PRE -PAID PEES'
$0.00
T Yl All FEM f WKS Hili,' NCAA
SS,"7.9Z
r
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RECEIPT
DATE
BY jj
DATE FI ALED
INSPECTOR
4
It 1
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION I
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
-
Underground Ducts
Forms & Footings
Ducts
Slab Grade
_
Return Air
Steel
Combustion Air
Roof DeckS
- -
Exhaust Fans
O.K. to Wrap
Framing
��_. 6'.C�•
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
•Z- u/
Final
Final3= L9 • utr-
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:
V
,A DEC -18-02 WED 09:10 AM MARVIN HOMES
FAX NO. 7607715057
MARVI�T ]HOMES
78-080 CALLE E�TADO
SUITE 2.01
LA QUINTA, CIA 92253
760-771-25(,;7'
760.77`9 -5057-FAX
P, 01
To: FROM.,
A,I C;O, -7
COMPANY: DAT..
PHONE NUMBER: TOTiL NCti. OF flAG'E'S INCLUDING COVER;
FAX NUMBER:
U URGENT FOR REVIEW 0 PLEAsr-- commz-.i,iT 1.1 PLEASE RrzPLY
Please see the following:
:)
DEC -18-02 WED 09:10 AM MARVIN HOMES FAX NO, 7607715057
CITY OF LA QUINTA
81JI[eWG ETY DEPAFITMENT
INSPECTION REQUEST LINE
NOV 0 91999 777-7153
Contractor��
Permit Number
POST ON JOB IN CONSPICUOUS
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS— _ 79-469 rr.TBr�-��
" SIF10- LOT 26, PLAN IXAXt. YLRMIT DOES
NOT INCLUDE BLOCK WALL OP. I1001r,
TYPE OF INSPECTION DATE - - -- INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM'
GROUND.PLUMBINQ
PRE-GUNiTE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS Bf=khe �nIGNL:D
CONCRETE SLAB
JOISTS A GIRDERS
ELECTRICAL GROUND WORK 7 - - ---'- - 1
D NOT P UR CONCRETE UNTIL ALL ABOVE HAS BEt: B4 SIGI4LD 1
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH (IAS a GAS
+, HEATINGBVENT•A/C -.- _ .._...
FIREPLACE
ROOT=
BOND BEAM - . •--,._....,
O.K. TO WRAP
(TROUT 0 4' O a, -�- - -
P. 02
7JiT��i '
(
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN MOVE 0 -
ORYWALL INTERIOR _ r Lam,..__
TEMP POWER
EXTERIOR LATH
POOL PRE PLASTER-
' t
FENCE A GATE
:r
Sewim SEPTIC TANK
�1 FINALS
��
ELiACTAICAL,- _..,.�.
,
PLUMBING
'
FINAL GAS TEST
y
'
HEATING - AIC ,
.' �
HOUSE NUMBE ,. --•----_ ..,_.._
P. 02
7JiT��i '
(
JOB COMPLETED
TEMP POWER
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,,5•tI�
•`: �. ,;;,;,•
ABOVEAPPROVALS
;tDOidOT•INCLU ER
4 ICHTTO
; ,'�•,
'''"e
•r;' TURN ON UTILITIES OR Or BUILDINEi
�•,1, ,.s •;C•'`''��1:•,f�. ;;-`• ;t'r,`r;.,.
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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
79-469 CETRIN0
Type of Construction: VN
Owner of Building: MARVIN HOMES
dt" l
Building Official
Bldg. Permit No.: 9908-133
Land Use Zone: RL
Address: 78-080 CALLE ESTADO STE 201
City: LA QUINTA CA 92253
By: KIRK KIRKLAND
Date: 12-17-02
POST IN A CONSPICUOUS PLACE