9906-089 (SFD)M
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LICENSED CONTRACTOR DECLARATION
zI hereby affirm under penalty of perjury that I am licensed under provisions of
(,'hapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
.ha %lcen� # , 4 ' Llc. Class Exp., Date
4Date_ , r _ Signature of Contractor �
OWN ER-BUILDER-DE'CLARATION
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 the9prbperty, am exclusively contracting with licensed
contractors to construct the project (Sea 7044, Business & Professionals
Code).
() I am exempt under Section B&RC. for this reason
Date Signature of Owner
_ j C,
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
() I have and will malntain,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.
.91. ..i1 i5 I.' Wily%.
13101-ililSPi~fy3'-. s
(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
�•
subj ct to the r workers' compensation provisions of Section 3700 of the Labor
Code; I shall'forthwith comply withrthose provisions
Date`. m 1.�: Applicant/ --^�
Warning: Failure to securekWorkers 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 ins • ction purposes.
dry ,�
Signature (Owner/Age nt)rf' / Dated% Z-�'n
BUILDING PERMIT PERMIT; .
).906-M9
DATE (oxosam VALUATION $282,371'00 LOT 21 TRACT , 26524 -
JOB SITE
ADDRESS 799-465 �5R41�. OKV i LE APN 7817-040-009
OWNER CONTRACTOR/DESIGNER/ENGINEER
?',3:?. 31OES*F..RVr DEVE1.0 ;t3�S;NT SPARKS CONST1,11Jr-11-1NI
i�.0. BOX 171 G 79-29i .TZ[\NC.HcJ }.1i Qll.l"i`I C�`. SSR.
UA QUIN T A CA 92253 LA QUINA CA 92253
5 3
f`i6 r7t-i9at cm,# 10,0(,
USE OF PERMIT
SING, R FAMILY DW.Ftl:%rv�r
ST: D -1)ttivil71)-03', KO T' I NC''s.MR 13L0CK WAi,LS 0R P0UL
'Mi'vi %i:Giv61'ici;P"'TIU;v 4.778100 SF
1'ORCT•1IPKC10 26-5.00 SP
(.;ARA(.%t: CAR. 1QRT 976.W 8F
J
fYCP^t'f'P1ii a x'f;�►"A Y'T4, 0.` OUEr /�nn10fG1'CHi7i i!i'a'fd4R,Y
%.OX ��+'1'+•Y D b\i \. D. i.\el'v
P,E..uAA4JT FRE SU9Y!l%'f.ALRY
C0NS'I'R1JC: r'10N T h -H
101 -OW -48-000
51.280.00
PT,;c N (7ffF(, JITH
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&4i-CNIANICAL a Ts£
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hL,E 7I1...K1CA1 FLE
101 -(?L°()-4217-000
f1 T85.9
pr_cTmil►'ntr
-900-4 11.4-000
STRONG MOTION FUM - R;CS€J
4101.-000-'241-U(it3
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-120.00
IX V.L1.cA1.ER IMlPA.C; (' V KE
S T,907.10
ARY INP1191,1C KACRR - RPSW 7044)110.255=000
$415.93
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t �.sr i,(Sr r'afr� 3;lyl,e a•tiSn(i)
I'MAJ yle.10711 1i'1:M OUC NOW 1 $5,144.10
0
RECEIPT I DATE I BY
INSPECTOR
t4�
INSPECTION RECORD
-� OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
• MECHANICAL
APPROVALS
�►
Set Backs
Underground Ducts
FornLs & Footings
Ducts
Slab Grade
Z a —cam '
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
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
_
Zia
_
POOKS- S AS
BLOCKWAL A PROVALS
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
_
/—h -ZD
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
-3
�y C -d A"r
(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)
P.O. BOX 1504 PPLICATION ONLY
Building Q Q /� ` 78-495 CALLE TAMPICO
Address / U�r%,C U��� C► LA QUINTA, CALIFORNIA 92253
Ow—" 6?U / h
Mailing BUILDING: TYPE CONS
^�& G 1 +
Address %�, Qr �Q� %/ji A.P. Number / 770 o o 1p —7
Cit> Zip/� Tel.
9VS-j Legal Description �'�+
Contractor Project Description c6 � e las Q q
Address ir
1 0.
r
v
City Zip /` Tel
�� y
��t�u�hfnc.
State Lic. City
& Classif. �� Lic. #aC� �j Sq. Ft. 7b 2 No. No. Dw.
Arch., Engr.,
Size / --l' Stories Units
Designer �yf '� fjl �J �� /�u�j i NewX Add ❑ Alter ❑ Repair ❑ Demolition O
Address, , /•�/� T. �i�_ O �
City,. ,! J/� Zip n �/� State
�W Olv� Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or County which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to 'Its issuance also
requires the applicant for such permll to file a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis)j4
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. Al. L��C�_
subjects the applicant to a civil penalty of not more than five hundred dollars (E500).
C 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. I •
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees, Mech.
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical
of proving that he did not build or improve for the purpose of sale.)
1 11, as owner of the property, am exclusively contracting with licensed contractors to con. Plumbing
strucl the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.1.
such projects with a contractor(sj licensed pursuant to the Contractor's License Law.)
it 1 am exempt under Sec. B. & P.C. for this reason Grading r,
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
177 Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances. }
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.J Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to -
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: joll J90Aate_Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above.
mentioned property for inspection purposes. Validated by:
Signature of applicant Date r,.. i 1i V 1
Mailing Address Validatiott:�% i,J
City, State, Zip
t
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
M1
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192 ,
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOCATION^'
o Cv; l�6
G4. ,r'
REPORT SEGUENCE NO.
TYPE OF STRUCTURE
SF:) L °�
f
Z� ® �57'�tNuq S1
PERMIT NO.
'7106 G S%
DATE
g I D a
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT
INSP CT R
p- '-qi
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL �' Q QX5
CONTRACTOR 1"
CONTRACTOR
-'
1� d W k k
6bse/2'ledQ
ID"
Ln� �µ-lQ�� t7a(2i0tlS �OGc2tIOf�1S
�'�nd2D�
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ILSL
30�iclyso
COPY SENT TO CLIENT O
CONTINUED ON NEXT PAGE O
PAGE
OF 1
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
7 "�-DO14
SIGNATURE OF REGISTERED ROPECTOR �/
1 0 jO 1111 7 -LA —.7/
D1kTE OF REPORT REGISTER NUMBER
WALLING & McCALLUM / LIMITED
\ A R CMI T E C T U R E • PLANNING • ENGINEERING
Lima
45-930 CLUB DRIVE (760) 360.0250
INDIAN WELLS, CA 92290 FAX (760) 3600786
November 5, 1999
Mr. Mark Harold
Department of Building and Safety
CITY OF LA QUINTA
Post Office Box 1504
La Quinta, CA 92253
REF: The Estancia
Lot 0 QJ La
La Quinta A 92253
Dear Mark:
I have reviewed the truss calculations and find them to be in compliance with the
drawings.
Yours truly,
Jo Walling, A.I.
September 12, 2000
WALLING & McCALLUM / LIMITED
ARCHITECTURE • P L A N N I N G • E N O I N E E R I N D
46-190 CLUB DRIVE
INDIAN WELLS, CA 92210
City of La Quinta-
Department of Building & Safety
Post Office Box 1504
La Quinta, CA 92253
Re: Estancias
Lot 21, Brookville, La Quinta
Gentlemen
(679) 360-0260
FAX (619] 360-0766
I have inspected the shear walls, posts and beams and their connections to the srtucture for
this residence, and have found them to be in reasonable compliance with the drawings.
J94(n G. Walling, A.I.A.
JGW/mlm
ARC,ytT
\G� GNB -MAN ���
v O�
No. C 7424
9 00 �Q-
�� � - 2-28.2 Q�
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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:
Occupancy Group:
SFD
79-465 BROOKVILLE
R3 Type of Construction: VN
Owner of Building: SPARKS CONSTRUCTION
Tem AM47
Building Official
Bldg. Permit No.: 9906-089
Land Use Zone: RL
Address: 79-295 RANCHO LA QUINTA DR
City: LA QUINTA CA 92253
By: GARY HARTMAN
Date: 4-23-01
POST IN A CONSPICUOUS PLACE