Loading...
0008-229 (SFD)H N C/) ` w O =) co t- CY O '� rw - o Z r - to O O F- � J www U) Z Co LO N ON 5 °) a_ Q Z Lo a IXO xw_ C0 < O aM Z 00 � r` O Q J LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chwpter 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 690845 B MC A f 07/01/2( 4; Date Signature of Contractor OWNER -BUILDER DECLARATIONi 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 IP1S, COM:PA14Y OFT Policy No. WDRI 0041900 (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 th9se provisions. Date: Applicant ' 0 .�- Warning: Failure to secure Workers' Compe sation 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)«%x' Date: `'fT BUILDING PERMIT PERMIT# D / VALUATION LOT�� TRACT .°►163,11�i4. ti 23 25389-4 Jde ITE ADDRESS APN / .I3RFVrNIi7C}]. pRIVE OWNER CONTRACTOR/DESIGNER/EN (NEER R T'l' HO:ty U I.W = WJ.a:JTMEkTr8,1NC. F0 BOA: 810 14251', !JN_ iN0.. fY 17It1.`>rE LAS QUINTA C.►'?, .02253 PROMW AZ 95034 002)257,16515; CBI. 4990 USE OF PERMIT MaLEFAM .y DWE ZING SYD-1,U'T 75 PLAN 413 -PERMIT TTf ES NO'T INCLUVE 13IDCK,'WALL OR PCKiL.75 4 PLAID CIIRCK FRE FtEDUMON FOR MULTIPM ISSUANCR OF SAME PLAN 'TYPE; CUSTOM CONSTRUCTIO14 1,9$4.00 SI' PORCH/P.AVO 77.00 SF OAR.ACt ICARPORT (8,F) 9,466.$0 MWATIM COW 00 C0T_*VTKi7+C�`IZ0N 16.54)44-50 CONSTRUCTION FU 101-000-418-000 1470.50 PLAN CHECX FEL 101-000439-318 $I1rJ1.70, MEIVANICAL "M 101.000421 0430 $60.00 F".CTRICAL FEE 101-000-420-000 $136.60 PLUMBING FOR 101.000+419.000 $157.00 STRONG MOVON NEF • RE -SID 101-000-241-000 $16.50 GRADWO VZV 10).000-423000 $20.00 INPRAS!'RUC:TUIt.L FLY, 22�-C,bO-4.43.342 $1,90.09 ,ART IN PUBLIC PLAC.&I - RESIL 701-Qg0.255«000 5162,61 i u t-T�`#, ' ON {"�Tl ©1`i A MP%.tI*1aTew-cF: $3,i0l,91 �5 'AMP ;fiA.0t3 TO'>".�,-L PEMT (FEES DUE NOW W/ 91, ,ssg RECEIPT DATE BY F ED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs q- —tom Underground Ducts Forms & Footings ' . 2 _ lid— Ducts Slab Grade ZV. Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap Qa F.A.U. _ Framing 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 I 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: 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) i 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: 78-847 BRECKENRIDGE DR Use Classification: SFD Bldg. Permit No.: 0008-229 Occupancy Group: R3 Type of Construction: VN Land Use Zone: R3 Owner of Building: RJT INVESTMENTS INC Building Official Address: 1425 E. UNIVERSITY DR City: PHOENIX AZ 85034 By: KIRK KIRKLAND Date: 3-7-01 POST IN A -CONSPICUOUS PLACE