9705-035 (SFD)H
N U)
W
O co
N C) LO
T
W
Z n
c—o�o>
LU Lu (0
I— tl
to
Z
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
/- a 40 i 13 „ 7�3
Datl D
e Signature of Contractor -7
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).
(r) 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.
;11r1T FUI I.i^lOYi4
(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,,andaagree that if I should become
subject to the workers' compensation provisions, of Section,3700 of a Labor_
"ode, I,shall „forthwith comply with those.provisions. ��
/ Date: 7 Applicant r
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.
% .� �...
t/Signature (Owner/Ageni)�� ----) Dae
BUILDING PERMIT PERMIT# CONTROL#
4705-113;5 5091
DATE VALUATION 51t't,�f�I.S� LOT. �I1 TRACT
t iK31�
ADDRESS 79_656 G%BR1#•#.0 WAV JOB SIfE
APN 64&020-00-55
OWNER
CONTRACTOR/DESIGNER/ENGINEER
., I'.t7. I?f?EIiTt`i' I71:4'EE,t�t'A4fis"s'I' I..I'.
`;PAHSS CONSI'RUCC'tt7N
P.O. Iti:.1X 1716
71,4295 RMCHO LA QUINi'.I'A DR.
LA c jUINTA CA 921251
LA tit fIN'I'A L''A 92253
(76M771-19,11 C11f.ff 29%
USE OF PERMIT
ciAttl1;.11:Jt.:AktiN,:?k'C 4f3+'i.1�) :i1�
#;..'1•CtIt4rS."�'l�.d f.:'C'+�•.0 L33+' �':t��N47'Y:[3t�"T1's7i� ..:
�w"" j8�„`�1S„yip
PI -AN CIf11C K h!:►i 101-000.419-319 5774.54
C;C)NfITRI IC ION 1;1.1; 101_000-11I94A'!t1 $4,11 ► 40
-
N0-1IAN lCAL FJ0 1ni t}t}U �121•U0U °L11��,; SU
`c:1.N t;,1'1t1��At. �i;; T i11-Ut111-�1ili-tai t•}�1 � 11.i7.f`;1
� ;'
P1.1 fM.►t W1 FlY 1014M411 -00H) t 1.1a t M►
NC}N40'F1c?Nrt:F.41 -(W
ORM)INIG
C1121 "eg
ti3ii"(2t.P..,r1ttFt:,".#'1lt2li[rll -t 2254►t3i}•443-342 S4,t:A:71
ART I PUMLIC KAt:H 3 - RL%1t; '101-%)_255.000 5213.195
Q
S1 r(3-11YI;AL CO N91'RUC110N AND PLAN Ct;f;t:Ct:
`"'" $6,5(it157'-
LESS PRF.-PAII.;T EFS
. F0,00 ;
TOTAL PERMIT I+'ERS DUK'NOW
S6,W.57
RECEIPT —�
DATE
BY
DATE FINALED
INSPECTOR
W
INSPECTION RECORD
OPERATION
r 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
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wali 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 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)
CITY OF LA QUINTA.
'QING & SAFETY DEPARTMENT
777-7012
� A IN PTION REQUEST LINE
777-7153
Owner ��N� T.D DESERT DEVELOPMENT
Contractor SPARKS CONST
Permit Number 9705-035
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-656 CABRILLO WAY
TERRAZA, PLAN 1 LOT 41
/ TYPE OF INSPECTION D INSP.
FOUNDATION & SETBACK
FOOTING STEEL -
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL 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 /-7-
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION2-
PRE-ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH li
POOL PRE PLASTER
FENCE & GATE
/SEWEFI SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
7/96 TURN ON UTILITIES OR OCCUPY BUILDING