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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
1u740i� '% 43 %131r99
Date L +Signature of Contractor c �'�
OWNER -BUILDER DECLARATION 1/
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.
(W 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.
STATE. FUNtr) 137 11-059"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•l'shouldbecome
subject to the'workers' compensation provisions of Section 3700 of the Labor
Code, I shallhorthwit comply with those'proVlsloris.
Date: �-) i) 1/� Applicant—
Warning:
pplicant 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 ins
pec
tion
purposesi"., lO—f-,
�j
Signature (Owner/Agent)f ”' r r Date /I
PERMIT #
BUILDING PERMIT
CONTROL #
/ 9711-084
DATE j !� j�� VALUATION %1�eyr�S�i 1�+� LOT r
178-MCABRIJILOW11`'
TRACT 7��3 a 9
ADDRESSJI
JOB SITE
APN
646-410-001
OWNER CONTRACTOR/DESIGNER/ENGINEER
1'.0. DESWr'DEVI-1fDMI HN't' SPAR KS COMMIMCPION
P.O. BOX 1716 7929S IZANC HO LA
QPIN 'tl DR_
LA f 1ANTA CA 02753 LA 01.I1N1'A
CA 92253
(760)771-0311
i, rll4.t1 2996
_
USE OF PERMIT
Rp
St•l�
LOT t, TERR jZA PLA i - P5AJ i3 i F)0Fs a NOT
CII KX-11- AWV 1N FOUt7LIC PLA(:I:ti 0W, )ITQV $:!0 05 PW
A(JRh1ti11+rfiNT W/ CONINL ORV. flAU T. DEC 0 3 1997
0,,1TY 0F LAUiNTA
crxat7Ai C Oly: r':tr_3CTION Z2Ir.11N.
t: rAkA0FJCAHIK?RT 486 W SF
PERMH ir" ,,F, SiJAiMARV
PIAN CHKX FIM- $771-54
'
1^0NSrR!X7Vh?NF14, tilt-rxx)-4184)(Al $%tI�50
Cir��;�i1t�A1,1'r:r: 1L,I_000-,41 tl J t S°r;.�.0
F:1 B7MICAL rEr: 10n1 -OW -4210 -NO 5167.81
PLUMBIW) FET -1 101-4()(1-419-000 S142.00)
mwown kio,i'ION F0- OW3111 101 -W -241-(K91, $1356
GrWtANO FlIE 101 -000,42.1 -OW $7u.00
iNFRPNS'rR0CTfAd FF.t. 2 a -Mi -43 -342 s1,t2it,71
ART 1N PMBLIC I)LACIi.S - RE140" 701-(XY0,-25:4-1344 32I'�,!►S
ART T tN t?t_rftl-rC iK A(,T:R - Rf Ntf; 70I403-,^,-55-01KI, �ZI:i,95
til( TC�t't'14.•C_'(:NCI`R.IK:f9ONANr)MAN (;[tK;rt,
�Slir5tN3.i7
1XSS PRE -PAM HUNS 4211.95
7'0.I'A1, i'11;1tM1*1' FFV.S I)t)i, NOW
s6,Z86.62
RECEIPT
DTEBY
_
DATE INAL 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
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.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
UEG
IN PtCTION I�L�UEST LINE
FINANC9B94.
Owner T.D. DESERT DEVELOPMENT
Contractor SPARKS CONSTRUCTION
Permit Number 9711-084
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-990 CABRILLO WAX
LOT 1, TERRAZA PLAN 1
SFD - PERMIT DOES NOT INCLUDE BLOCK
WAT,LS OR POOL
f TYPE OF INSPECTION DATE INSP.
}. FOUNDATION 8 SETBACK
FOOTING STEEL -
MAIN GROUND SYSTEM
DRYWALL INTERIOR =0
EXTERIOR LATH -07 K1 I ,
FINALS
ELECTRICAL
FINAL GAS TEST
HEATING - AIC
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
PRE-GUNITE e
DO NOT POUR CONCRETFKVNTIL
ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
!`• ' JOISTS 8 GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
1
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH CTAS A GAS TEST
HEATING 8 VENT- A/C
FIREPLACE
I ROOF
BOND BEAM ,
O.K. TO WRAP
7,7 - `,' `?
GROUT ❑ 4' ❑ 8'
FRAMING
cGi
INSULATION
^ -e i-
'•:PRE -ROOF
-
DRYWALL INTERIOR =0
EXTERIOR LATH -07 K1 I ,
FINALS
ELECTRICAL
FINAL GAS TEST
HEATING - AIC
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING