9907-394 (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
1-37252 6 32/291201
Date �?�� 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).
( ) 1, 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.
MY AT, INS. CO, 0171 PTC 45±.x;`
(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 thoseyprovisions. f
Date: _� K Ar Applicant y.✓#
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.)
Signature (Owner/Agent) "�`�� �, fl Date i �?
BUILDING PERMIT PERMITy9f7-39.4
DATE VALUATION
VALUATION 1277,4112." LOT 54� TRACT , f�_fyJOB
SITEADDRt/SS79-114! 1,14Gt�
APN 71i��'i1i�k1 �}2
OWNER
CONTRACTOR / DESIGNER / ENGINEER
r1'SE:t'P tiUUSIr:<r 1,?..t�
'I.�.�;.�;1t 1~ .DEAN :" AL CON&M. INC.
i PARK PL:U A SM -100
3 PARK PLAZA, SiH11, 400
IRVINH' CA 0'2614
IRVINE? CP. !)2614
USE OF PERMIT
SINGLE FAMILY DIVIBLU NOt
ZrD - LOT 54 PLAN 2A PO"T i,+i.iF.S NOT Mk"`L,UDE iii,('it" K �VEi.LL OR
C't}"7'i)rtI Cv,NSTIRLC T;0N 3,37 PJ SIl
PORCIi PAii6 3I^ .(►if
GARA.0YQA1*10R1' ti51 i.t}t► SP
x M � T iiit%iryxL � `•' i ': iR1.01N
77;922.190
PERMIT FEE SUMMARIV
C•''t iN!IiTRUt `i'IOK FE LF l01-(}()0-�11941100 $1,262.5v
Pt, AN47,JTTM FT? 4014,1101-41391-3tR $1,1YtrS,t:e
N110IM1CAL 1 0H 1i;) -M- 12t4t(1(1 S7�.lttJ
O.i -CrITOCAL FEE 101 -000 -420 -ON
1104HIN(J}
°�1 n iV�f M't1T1hI I�Fj - FF :3lfil it) I-t}titl-7A 4t()(} o's'i?n'
r .•:
�itAI:JiTdt3 ti's TQt•4)Cl0-d23-4011 $2{►.ikl'
� -
Ui�fsl.t./Nlsi�'Ti�iE'd\CI�I:i:Ei
AZT IN 0JE LIC PLA013 - RP MC 71)I -(M- 55-011
SF)13-"ISS'i/+t.t`Q'�i �ti ITON AND PJAN( 14Rt';k.
LESS PRE:-PAI'D FEES
$0.09
TESTALT, VI?;RMt'1!' .ti+"MS 011C NOW
Sys. 0. t.7
RECEIPT
DATE
BY) r/f�
1
DATE FINALED
INSPECTOR
c-
INSPECT IOW RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Q_ tv
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
- (j
Compressor_
'L .S
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
Ste- O
Final
�ef
POOLS - SPAS
BLOCKWALL
_
APPROVALS
steel
Set Backs
Electric Bond
FooGn s
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
OX for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas 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) -- -
CITY OF LA OWINTA
cFboe r�� BUILDING & SAFETY DEPARTMENT
m-7012
^eT INSPECTION REQUEST LINE
777-7153
DEC 2 91999
Owner DESERT HOUSING LLC
Contractor- mr- • ITS RF.CIDENITAi. CONST
Permit Number 9907-394
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-187 LIGA
SFD- LOT 59 PLAN 2A. PERMIT DOES NOT
INCLUDE BLOCK WALL OR POOL
TYPE OF INSPECTION DA INSP.
FOUNDATION & SETBACK
FOOTING STEEL�-
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL AL .ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST cU
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP 410
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION v 441
PRE -ROOF .11
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL 0
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
W El
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
Type of Construction:
Owner of Building: CATELLUS RESIDENTIAL CONT
—7-&' -t
Building Official
79-187 LIGA
vni
Bldg. Permit No.: 9907-394
Land Use Zone: RL
Address:
5 PARK PLAZA SUITE 400
City:
IRVINE CA 92614
By:
KIRK KIRKLAND
Date:
2-5-01
POST IN A CONSPICUOUS PLACE