9907-396 (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. t
License # Lic. Class Exp. Date
6.57252 H (12129/; a
Date l��7tl%:1 '�iG._ .. �•.� =ttt.� 1
t i 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.
i{�►4' ..il�ii3. �.'C3. •[ !, ' P'tom'459 1
(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. r
Date: ^124444 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 forinspection purposes.
Signature (Owner/Agent) /.=i» ..�- y',. Date
PERMIT #
BUILDING PERMIT
9907,496
I
DATE F1/ 1 j � (f VALUATION �irq+� x� LOT t'. TRACT g4gCro iy
j J II ffG�i P! •i1
JOB SITE
ADDRESS 79-212 LFG!L
APN 70-"0-006
OWNER
CONTRACTOR / DESIGNER / ENGINEER
rg.,C'C?0-1, S if rS Inti': t i t +
11 t•,JI.l\! Ill 1L/mf -Z
IZ\%-v7; r i r iQ T> v -c, ',mr3'r �. 1 r i �*iC•T TAtrl
1...41 \,IIIA+JrJ 4\.Y•N.AJ S-./, S iIt 11 L.4.i+F/1.y 5th\.-.
5 PA ItK,PLA A 9M 400
5 PARK I%,SUM 11(ic�
IRVINE x::11. 92tA4
IRVINE CA $'2614
(9,1+1'i'�Si• itM (,'4tf.# :5()77
USE OF PERMIT ,
SINLiLr II[1'viiLY 1O WELLF60
SFu - LiD T U irLAIY 2'CR-01 YacIllff Z-00,; NOT iNC i.UM rSi..l,.W_1K 100TA L
QK I CKIL.7i% PLAN i;}i h_ K IWt.)L'Cf1Q,N VPLIP_1) FQK StUL i IAJL
SiMS11'f`1'AL.
C=rox) : Cmm, <1' o"q 3.690 ,010 sr
PCIItt^HRIATIC> 312.001
riAithc"akJl;tliLl•d;1f4'I' b'3i.{;!1 .•iE�
11:n. q 1a f RN. WfE t Y �. 41A' \. f r J Y •LAI s
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PERMIT 3+RlYl..ilUWN$r It Y
K ONXi'3tt.ft~I'uUN FEE 1014)04184M
FA.r1W %1" 51
h1L I.'tt7:CAI. tt'I : if1i-QfII3• I,'I•i}t}tl Xt,^,I.(#1
!`sl.iil'TtilCtld. EI:G 10 1-000-420-000 S^27,frS
1PLUP&IM0 Mi IU 1 -W(1 -4I 9-M
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ART IN t'I.AM- YWSW 1014)-2,S5.t,00
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♦
L I
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LESS "J UI_PAID PEiE�
Si0,00
1M At. PF,RE� 0.' Ff(.' S Dill) r N(W
$4,675.17
t.
RECEIPT
DATE
BY j\
t
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
V
Exhaust Fans
O.K. to Wrap
-00
F.A.U.
Framing
LSO 2 _
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
POOLS -SPAS
` BLOCKWALL
APPROVALS
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
C1
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
i
Encapsulation
Gas Piping
Gas Test
_
Appliances
Final
c ..
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 -a
Utility Notice (Perm) T- at
CITY OF LA QUINTA
c�b0_ r,,•8l,1,lL6AG & SAFETY DEPARTMENT\,
777-7012
INSPECTION REQUEST LINE
2 9 X999
DEC 777-7153
�ivner T HOUSING LLC '
Contractor CATF,T.T.TTC RF.CTnF.NTIAT S".(INS•T
Permit Number 19907.396
POST ON JOB -IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL"APPLICABL'E SPACES
JOB ADDRESS 79-212 LIGA ` -
SFD LAN 2CR-GLPERNUT DOES` .:..,
NOT INCLUDE'BLOCKWAL Oft POOL `
TYPE OF INSPECTION
DATE. INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALLABOVE'HAS BEEN SIGNED
CONCPIUE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
Iot, aC✓ �r
DO NOT POUR CONCRETE UNTIL ALL ABOVEMAS BEEN SIGI4ED;.:-
ROUGH ELECTRIC
ROUGH PLUMBING;
ROUGH GAS & GAS TEST
HEATING& VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP "
GROUT ❑ 4' • ❑ 8'. -
FRAMING 1 .Q-
INSULATION L �/
PRE-ROOF
COVER NO WORK UNTIL ABOVE HAS EEN-SIGN D'
DRYWALL INTERIOR
'EXTERIOR-LATH • (/
POOL PRE PLASTER
POOL FENCE & GATE
SEPTIC TANK �% cf
FINALS
ELECTRICAL
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
11
SO
xC
ertificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Bul Iding 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:
79-212 LIGA
Bldg. Permit No.: 9907-396
VN Land Use Zone: RL
t
Owner of Building: CATELLUS RESIDENTIAL CONST
Building Official
Address:
5 PARK PLAZA SUITE 400
City:
IRVINE CA 92614 -
By:
KIRK KIRKLAND
Date:
3-2-01
POST IN A CONSPICUOUS PLACE