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9711 110 (SFD)U) N_ LU W O M r-- uo W oZr- O O" r _ , LL1 a - U) Z ce) LO N ON U °) CL Q Lin Q, O X W mUU O M H `t Z_ on'D 5 O J LICENSED CONTRACTOR DECLARATION 1 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 6 > IG 14 / t Date " t �z' let; Si nature 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. (y 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. o ATE (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 ofthe e Labor Code, I shall'forthwith comply with those provisions --� Date: ; �` f Applicant ✓� 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 fo(inspection I urposes. I Signature (Owner/Agent)—_"f `' f Date o� / PERMIT # CONTROL # BUILDING PERMIT 9711-111) 63 8 V DATE VALUATION LOT '17 TRACT i iix ,.est 2, , '7111-1 /8. 7311 CAURILLO iWAY APN 644-426-003 ADDRESS OWNER CONTRACTOR/DESIGNER/ENGINEER `ARKS COIY IRUCIC),I.). Ro. BOX 1716 79295 RAMC 1101.11 Q01NI'A I3R. i.A QUIN1'A CA 92253 LA t;IUIN'CA CA ►275:1 (7(1(1)771-19.11 USE OF PERMIT S1'f,1 II; LC.iI' 27, TEkPA7A PLAN i - PERMIT DOES KO [ -K—NAW ALCICK. WALLS � 0H POOL. A1110 C*MJ)tT t3F 5213.95 111,.2 t.t 3(mX1. 011. l:+.' T� (,'HECK fl, -r -(q,-'2 s% 170k WJLTI_fNSLTH-. R"�OAS41 DEC 0e) 1997 CIJSTO&I COidSTRUC ISSN 21r.3.t.t1U sil" 110RCH/1-WI'i0 F ''10F = n+ Ac�11r. Ar c�xT 4 1 � � LA QU1 NTA °.+;.'`HI,'1'iN."IPf? C'ON''[' 0F CONS Tft, U f10N Si'3:.m.n, PERMIT FFT'S IWMA Y PLAN r 1iEa. K F11, 101-000-419-318 S 193.64 (*014STRi if,'i'IC►N F1-_ 1011— I -d 1 P-(hM R hln gig '-11,WICAI.I1"�s 101-`a' 1�1-fl� STs0idr faxi, (ICA1, F1iii 101-000-120•-0100 5167.81 11CONISIN(Y kT1i 101-000-4194(}1) S142.01) STW)Ni MOTION RT - R$1810 I ()1-101.2111-1H)fl R I kv. Gttrtll)ING FEW 101-000-1121Ift 520.00 INFRk1rML11:1'UR17 FIFE 225 -WO -443-342 $4,IZ0t ART IN PUBLIC PLACI-ES - RESIC 701 -(X)0.251 -(1G() 5213.V5 AT(T IN 1111131.1(; PLAC9iS - Rr-Sir. 70r -()I)() -255 -nM -$«1395 C2,rf+=i'�t'AI.C(�N�'itt,r�'1Csu ��Nt� �1,ni� r11tiC1:. �5;�19.t►7 LESS PRE -PATI) ITES -x:213.95 TOTAll,ti'F, tflli'i' I� M;i� 1) tWKNOW 85,705.72 RECEIPT. DATE BY i' ' " DA E F L D INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE 7 INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs — Underground Ducts Forms & Footings — Slab Grade / Ducts Return Air Steel Combustion Air Roof Deck Exhaust Fans OX to Wrap GC F.A.U. Framing Pj_AK iwc Compressor Insulation Vents Fireplace P.L. r Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath - Drywall - Int. Lath -30— Final Final - POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover - Equipment Location Underground Electric Underground PIN. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping _ U 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:: � 2 - f � � ! � / 2 . ,? (� �(/'1 f � �^�G`1 I �� /��• G (2,1 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) 06/04/1998 05:43 619-771-1841 T f J . 1: A SPARKS CONSTRUCTION La ?',SANTA 1ITY OF LA OUINTA BUILDING & SAFETY DEPARTMENT r. c pp 777-7012 �� FtI11STPECTION REQUEST LINE . m-7113 T.D. DESERT DEVELOPMENT Cir+ ucW SPARKS CONSTRUCTION Poo of Nwf*w 9711-110 POST ON JOB IN SPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 78-730 CABRILLO WAY LOT 27, TERRAZA PLAN 1 SFD - PERMIT DOES NOT INCLUDE BLOCK WALIA QR POOL fYPE of INAPECTION DATE INAP. FOUNDATION A SCIISACK FOOTING STEEL ..' MAIN GROUND SYSTEM GROUND PLUMBING `l7777 7 PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNEO CONCRETE SLAB JOISTS 8 GIRDERS DO NO POUR CONCRETE UNTIL A ABOVE HAS BEEN STONED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS A GAS TEST HEATING 6 VENT -IVC BOND BEAM O.K. TO WRAP p GROUT O 4V ❑ 8' 1 PRE -ROOF l ABOVE APPROVALS DO NOT INCLUDE RIGHT TO n jow nu I ml Incfd ne rw t i ocov a m noun J PAGE 03