9907-398 (SFD)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
6372 i2
Date/ "�~ ���'"%Signature of Contractorr�y""'^--
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:
Cartier rrr.1^.r sKty ,.n -%,_Policy No. Tt., iRrvx'.w
rtV s /1L. ifvtt....t.-. %ii' t "I� •t,J:'r y0
(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/
Date- " Applicant
ter:-. ....�...., —.....
Warning Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
I► permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
` correct. I agree to comply with all City, and State laws relating to the building
,,construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for.inspection purposes.
Signature (Owner/Agent) 17Date 4/j
._i
PERMIT#
BUILDING PERMIT
94xE7-3V+
DATE j/} ;! VALUATION:�.G�i Ci91 LOT } TRACTJOB
SITE
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
i''•Ti t'T: it^i•f.ltIT TCTl1i 7 Y I''
s.....,�r. R'. r t tJNU♦ • •A..�
.`A^1.4;e 1 t14 iat;t FY�17A F'�'f .�I!••{'tAFC'1', irFl-'
�:! f t.taa.b�� /wr.uat t.,.. u r "'J"INI � / v17
:► i'11iii� PW,*,A i ttli 40
5 PARK PLAZA, &I;M 400
[IMN13, CA 91614
UMNS CA 92614
(94912:s1.6J04) t'131r� ..50-,7
USE OF PERMIT ,
&iyi:t#.h PAX111,1 DWELLING
Sf't) - LOT 4 PL AM 2i,'12 -Ci PgRhft'f' W.WS NOT Mi—,Lb-DE iiLCit,'1r,. WAU
r::zft !'Q01,.75K PLAN E:?'EcK kii-D11CHON APPLtLO #?QR MULTIPLE
C U iTOM COPKSTIRUCT10H 3.690.00 Sr
PORCiOTIN.TIO J421.40 :M1•
UA1t.A.{iFJCAKt'0R1' 645MO .',i,1'
ts13,£14161At•V•lPNN lr$"g0 a"' !`x/Y'1►i K�"i-'IKlii'"i{'t/'14S
M:.•.i r Ati dt3. Y Gott �.-•tJ..Y'r. e.F.V %JA s,.# n ss 01k,. A. /+4�/1 It
''MIiR "iY • t �t
PF,RMI%T FEF, SUM lV ARV
r.:0N,';I7(i1(.:1V_)N}•ht; l(11-f}i)Q-�ititix3ti i,: (+.
Pr, AW r•f 1pr1l.; rr ri 4t279 ' NI
. �'a1f:%.'1[r1.`tdlCr�t.lTii :fll,Q4f3-ri�3•C{3C SI�Z.I'►U
t.i.E.a a 1tfCAL i�U' . fe7x_t'}00426.000 i22'f 05
frt,UPP4BINIC'sF= ..s' 1$t1•iH"rtt 4i:# i0tlt} S«t.;
A"1'tdOW41t►!ti'(3()74 S�'j -1t ;til ►
RTMV40 Fla; to I. 000-411134M)
tJ�9t:ILv1>T"sT� 1:�411a`rllti' i' s1`%Y S I,tiU"'.iht.k
'; t � � �!
AW1' 1N PUPIAC, PLA:"E,"S - Idt3Stf. 701 -00 -255 -OW
Km=it..rAL (70Nts'YRL.�(;;'1IONT A1111'3 €>bAN CJ1FC. K
$i4.�05.17
LESS PRZPAITA1ETS/
$0.00
TOTAL i'tf:ti!'►'If'1' ;Rf EK51 PUP, NOW
944675.17
RECEIPT
DATE_
B C11 !�
DATEFINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
AP ROVALS
MECHANICAL APPROVALS
Set Backs
— f
Underground Ducts
Forms & Footings
Ducts
-'—
Slab Grade
C/
Return Air
Steel
Combustion Air '
Exhaust Fans
Roof Deck
O.K. to Wrap
t9-
F.A.U.
Framing
r76
Compressor
_
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
�2
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
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
COMMENTS: '
,S� -� j cS �3 C 11t
G4 i j'� c, -T s -c-,
Pf/L—f (_ k- _R GG/r 2 J
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 U
Utility Notice (Perm)
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: 79-168 LIGA
Use Classification: SFD Bldg. Permit No.: 9907-398
Occupancy Group: R3 Type of Construction: VN Land Use Zone: LR
Owner of Building: CATELLUS RESIDENTIAL CONST
Building Official -
Address:
5 PARK PLAZA SUITE 400 _
City:
IRVINE CA 92614
By:
KIRK KIRKLAND
Date:
2-23-01
POST IN A CONSPICUOUS PLACE
i!n
CITY OF LA QUINTA
�Fb Foy BUILDING & SAFETY DEPARTMENT
INSPECTION REQUEST LINE
DEC 2.91999: 777-7153
Owner DESERT HOUSING LLC
&ntractor` '-f'�'Hl i ` 11,191 RT'4TnFNTTAi f (l TST
Permit Number • 9907--398 - a
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR -MOST SIGN ALL APPLICABLE' SPACES
JOB ADDRESS 79-168 LIGA
SIED&OsTQ PLAN 2CR-G1.PERMIT DOES
NOT IN.C.LUDE BLOCKWAL OR POOL
TYPE OF INSPECTION DATE INSP.'
FOUNDATION & SETBACK
FOOTING STEEL -
MAIN GROUND SYSTEM.
GROUND PLUMBING • ._oo
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED I
CONCRETE SLAB
I JOISTS & GIRDERS j
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTILLL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING, .
ROUGH GAS & GAS TEST
HEATING & VENT -A/C
FIREPLACE
ROOF
BOND BE
j O.K. TO WRAP a _
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION _ �)
PRE-Rnr)F
DRYWALL INTERIOR
7'
EXTERIOR LATH
POOL PRE PLASTER
L ENCE & GATE
EWE SEPTIC TANK - (,
,i
FINALS
ELECTRICAL'
PLUMBING
FINAL GAS TEST �.
HEATING -A/C arm
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING