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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
13 )131M)�
Date Al Signature of Contractor j
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.
IA IU, F iIi•+^'V 1371 Cf`! 5"1?
(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•Sectlon 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant r }
Warning: Failure to secure Workers' Coi'npens tion coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100f000, 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)"r ( Dated r�
PERMIT # CONTROL #
BUILDING PERMIT
97111 -ONS 6 3
DATE h
VALUATION 5±",40900 LOT n TRACT,JOB
SITE
ADDRESS 78.98 (:ARK1L11A) WA.N'
�
APN
fid- 10-002
OWNER
CONTRACTOR/DESIGNER/ENGINEER
T.D.
SPARKS ::ON, f'1li1t::11011,14
1' 0. BOX 1710
",9295 Rj1 NCHO LA QUOTIl A DR.
LA QUIKI-A CA 92253
1.9t; UIN'TA CA 922.5_3 F
f7ttc?i77t-19.f1 CI31.tt '"K':�
PA!®
USE OF PERMIT
LOT 2, TERttrlZ.AFLAN 2 - i'i"sEtivUT TOe.S NOT INi,L-tiDE RL0 "K WAils
UR POOL, AKI' IN PUTALIC 1q,Ai k:i CROAT OF 5226.02 PER DEC 0 3 1997
AORKH&U..NT W/ (Y.1ifirLM. 01:4*v. W?!''T.
tw 1Se v i C_'iair l�li :.I'T+'�N Z,'�,K`SX) NIF
t'Vk%f�tJ�r\3IV I 115.0) si
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I Sdi l KIt:Al. FlUi 317! 4M
PLUMPf NO NEI: 1.01-000-404M S 169.00
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t;#:.r1I3IN�.; I�I'sti 101.0(1Q-�I33-OSKI S«'O,t>t1
INF—RiW'I'leCkrfiffi(R ('k'E 225 -CA -W3-.1<12 ii,249,79
AkT IN 1"(11111, IC F'f.+1t.3iS - RE.*W: 701-11()(.1.255-000 V1.26,02
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. ;��,7t i,ft5
Ll.S:i I11;1. -PAID FEES
-�2yn,C2
M't'AI, PIh RA11T N'I %_44 00F, NOW
$4.485.03
1m.,.t,::3
RECEIPT� � �
DATE ` p � - / �
BY � �, `' r(
DPT I A D
INSPECTOR
INSPECTION RECORD
OPERATION
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 Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
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
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)
COMMENTS:
z:-
03/09/1999 12:03 7607711841 SPARKS CONSTRUCTION
QUffl,q, 41A QUINTA
BUILDING & SAFETY DEPARTMENT
011997 777-7012
INSPECTION REQUEST LINE
FINANCE DEPT. 777-7153
T.D. DESERT DEVELOPMENT
Owner
Contractor SPARKS CONSTRUCTION
' Permit Number 9711-085
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
78-980 ABR1LL WAY
J08 ADDRESS
LOT 2, TERRA7A PLAN 2
SFD - PERMUT DOES NOT INCLUDE BLOCK
' • ► WALLS OR POOL
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK - !
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING _
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS B EN SIGNEp
i CONCRETE SLAB AaAr
JOISTS & GIRDERS
j ELECTRICAL GROUND WORK
I DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT- A/C
BOND BEAM
O.K. TO WRAP
GROUT Q 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABQYE HAS BMN SiGNE
DRYWALL INTERIOR
EXTERIOR LATH i
POOL PRE PLASTER
FENCE & GATE
SEPTIC TANK
FINALS
PLUMBING
FINAL GAS TEST !
HEATING -A/C
t HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING