9903-304 (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
-11252 2129/00
/� f
Safe A A 17/7., 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.
r
}p r�r�rAt]r AN%-- ' ?SX � lo -a
(This sectio ee a comp ted if the permit valuation s fo"r 0000 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,,l shall forthwith comply with those proyisions.
Dater- Applicant
xf
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.
gnature (Owner/Agent) -°%�� Date k., -�
BUILDING PERMIT PERMIT#
DATE I VALUATION LOT 9903-30,4 TRACT
305,2,22.60 43 21490-6
JOB SITE
APN
ADDRESS
79-539 LIGA
769-700-02'3
OWNER
CONTRACTOR / DESIGNER / ENGINEER
DESERT :-IDUSIRIG LI.,C
CATELLUS R:ESIDISN)'IAL COWMf IN:TTIES,
3 PARK .PLAZA STE, 400.
5 PARK. PLAZA., SUITE, 4W
1RNINE CA 92614
IR'V.INE CA 92614
(949)251-6100 CBL# 5072
USE OF PERMIT
4ebe%'s w' r [r 9i Yi•.'f fli
0D. t O'T443 , FLAN wS:.R-01 . PLAN CHECK rFE: R:t~"DUCM, ?91Jo FiOR,
IMU1,,TIPLE ISSUANCE OF 5A.ME 14, AN TY.P2 . PMNIIT DOES NOT Cid+; LUL'+E
VIT r "?AT v Cg OnnT
CC, S'TON1 CONSTRUCT (ON 3.690.00 SF
PORC141PAT Iii 312.00 SF
4' 1A►I311C.}F,IL:ARPORT 695.16? .5.F
ESTIMATED COST OF L;°t)NSTRI(fO'iON
3055 222.60
t<'VKW'T FEE SUA$11IARY
CONS~I'RUC-VtO FER 101-000418'-000 31,w,50
11LAIti CHECK FEE $278.54
IME C HAN Q -M, FC:i> 0l (x(10 421-000 $124,00
91AC'1`RICAL 1• 101-ONA-20-000 $227.05
PLUMAINGFEE V14,50
S 'ROI` Q.N1t T10N'.1h.kkX—.tL 3[D 101-000.241.000 $30.52
GRAOiM FFFX 101-000-423.1100 V".00
,
INFRArfi"i'SRUC' 'UPW FEM 223-0000443-342 Si5fi D1),00
$5.13.05
A1i.'i' TN PUBL.iC PLACES - RPSIC 701PA
5UB-Tt,�1"t+L CONSTR.UG'710N.1Nll PLAN CHECK.
S9;768.17
�.. LESS PME-PA113 FEES
$0,00
MAY 141999 TOTAL PE RAVY FEES DVE NOW
$8,768.17
y �
. CITY OF LA QUANTA : r
RECEIPT
DATE
B r
DATE FINALED
INSPECTOR
NC
INSPECTION RECORD t
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
. C
Ducts
Slab Grade
-
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
- 2 "c—
Compressor
Insulation
- 4r—
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
CAI_ t77
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer LateralPool
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 . G'
UU14 Notice (Perm) 2 .e
n
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: 79-539 LIGA
Use Classification: SFD Bldg. Permit No.: 9903-304
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: CATELLUS RESIDENTIAL COMM Address: 5 PARK PLAZA SUITE 400
INC
City: IRVINE CA. 92614
By: KIRK KIRKLAND
p�1�t Date: 12-9-99
Buildin Official