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9711-098 (SFD)9 - CV 11.: O0Q U*) W o Z ti co 0o wwr' Z M L0 OF N U °) a -a �2 Lo H 0 XLuLL C0 U C) O a 0) NT Z_ ob ��•f� � C) Q J 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 Date �'� ?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. TAPE's i UN, I3;1095W (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,bec mo e,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.forthwit comply with those•provisions. L -✓� Date: 11. I 'N f `/ Applicant !�' 1 1 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. Signature (Owner/Agent)""''F �+ � � Date I 2 BPERMIT# CONTROL# BUILDING PERMIT ,J ! ! !-tH11i DATE VALUATION �18 S.S+yI�, LOT 1 TRACT .-375 � 7 5 (~ � �7 ADDRESS n.xii) (�tiRRIIAX) `SAY JOB SITE APN .646410-015 OWNER CONTRACTOR/DESIGNER/ENGINEER "ARK" P.Ci, BOX 1716) ?929:5 R NCii0o I.A. QUINN-tIA DR_ LAQUINTA t;A 92253 1,A QOINTA CA 92251 f'7((t1?71.194I t: #A1.# 2996 f f USE OF PERMIT LOT t5. TERRAr QL K.AN i - R'I;Itlti iT I}OLS t+it. P 1t4CI iJT)ii (IL0CX K'f�S OR fN 1C:N.. All IP CREDIT CJI :S2J'.% 95 Pik CO&Iht. DUV. I>h:I''t',: t1I..AN � I FFX (71 t' a FOR tN[If,'I'i-IS'iil? , 1 DEC 0 3 1%7 CUXI'0.'ii ::ONS RRIC 100 F'OItC,'iiI'ATTG 470.00 81- TY' �=,T QUINTA t3Alt.ACft~JCAftNC.tlt'i' 4ftti.tit} :+ir G( s t .rw7'A 11t f1•L i1JiJ C037041? i.0 N371 ill. CF.110N R 81%53 1.910 PERMIT FCC StJMilir' RV P1, AN $01 LFf,% FHE Cy.)NITURI rC11014 FEE, IM -f" -.1184M 5u si1. Vit) Itl2iCIIANICAi.l F I�iI•iN)O�x�i-UOU S' .5t► ELEC 1 R.ICCrU. HTM 4 41-WO.420-Wi 1111ti 4114 J F FE 101-000.419-frii(1 S 1420) ;tON(i tlr�7'rc_Nf Fii:-1�I.RIf:! I{i�•t)(1(?-;'.fl.(lfi(1 C1ft,SK Ok'AL411.10 FIT. lot -000-11.3-000 V). (KI INPRASTRUCI'URFt TT &2W)O-44.1-34112 -44.1-342. $4,124.71 AItT IN PUBLIC 1411ACE3 - ki siT; 5213.93 if4 PIif".It; }�LY71':: - WIST ; 701-fNi{!•'.`'S IllH1 _$213 .f►5 S(JI.OKTAl. (X)Nt7R1K.TI0N ANTJ f'f,AN t~IircK S4;J14.67 LESS I ZE-11MO i EES 42113.915 TOTALi"1~:ltINI ;w i•;1!'..� IitII:I1 O W $5.704.72 RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION I DATE I 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 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 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) 08/27/1998 10:05 619-771-1841 SPARKS CONSTRUCTION PAGE 03 ..--^ter-?�-•_• . • - F LA QUINA ,(�Y OF LA QUINTA C �I G S SAFETY DEPARTMENT 7"-7012 ' FINANCE DATION REQUEST LINE m-7153 Owner T.D. DESERT DEVELOPMENT Contractor SPARKS CONSTRUCTION Permit Number 9711-098 POST ON J091N CONSPICUOUS PUKE INSPECTOR MUST SIGN ALL APPLICABLE SPACES Joe ADDRESS 78-850 CA13RILLO WAY LOT 15, TERRAZA PLAN 1. SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS OR POOL TYPE OF INSPECTION DATE INSP. FOUNDATION A SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING / _ : ;• . PRE-GUNITE 00 NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB JOISTS 8 GIRDERS ELECTRICAL, GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS A GAS PEST HEATING A VENT - A/C FIREPLACE ROOF BONO BEAM O.K. TO WRAP GROUT G x 0 8, FRAMING - INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS @EEN SfGNED DRYWALL INTERIOR EXTERIOR LATH POOL PRE PLASTER , POOL FENCE 8 (SATE SEWER $EPTIC TANK �• .� _ FINAL GAS TEST HEATING • A/C HOUSE NUMBEF JOB COMPLETEI TEMP POWER ABOVE APPROVALS 00 NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING