0004-274 (SFD)LICENSED CONTR'-.CTOR DECLARATION
C/)I hereby affirm under penalty of perjury; that I am.licensed under provisions of
I— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C14 W Professionals Code, and my License is in full force and effect.
O =) i,.) License # Lic. Class Exp. Date
I LU
r- .5 1:33 ki
69064{C A. �..D ( 0€�/30/2(
o ZteUt Signature of Contractor
cD O o f
OWNER -BUILDER DECLARATION
HUJ I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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).
(Y)() I am exempt under Section B&P.C. for this reason
N Date Signature of Owner
ON
rn
Z WORKER'S COMPENSATION DECLARATION
C) Z I hereby affirm under penalty of perjury one of the following declarations:
Lo H O () 1 have and will maintain a certificate of consent to self -insure for workers'
X LLI tL compensation, as provided for by Section 3700 of the Labor Code, for the
O � Q performance of the work for which this permit is issued.
m:.Q U ( ) I have and will maintain workers' compensation insurance, as required by
0:0 Q Section 3700 of the Labor Code, for the performance of the work for which this LO
cl:H permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No.
oo INS O�r?,Il'PA;£lig 0171' WDE1`iiDO41900
�O
J (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
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those p ovisions.
ate: .,ice �� Applicant__ ''?n d)h
v
- ..
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
Q� construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) / _ 2(4 Date,
� G BUILDING PERMIT
PERMIT #
DATE
0004 -?74
VALUATION LOT
$I
TRACT
41 25489.5
JOB SITE
APN
ADDRESS AJD^ Cl NRBS ✓:�O I �T2iZ$i�F
759••M -W8
OWNER
CONTRACTOR/DESIGNER/ENGINEER
RIT INI° LMMMTS, INC.
R31- I.i VESIMF.NTS, INC.
1425 R UM'vr=4YrY DIM
14251^ U3NIVX FXIT DME
P11011{ AZ 83034
moin4m AZ 83034
(602)257-1655 C: Y -A 4990
USE OF PERMIT
SW I..a?FAMILYDVJU7INCA
aFD- LOT 41 PL 2A PERMIT DOFS NOT INCLUDE
H1..CICK WALL OR POOL
CUSTOM CONSTRUCTION
x,349.00 S
PORCHIPA`I'IO
134.00 St'
QASiAGE/CARPO1kT (SM
1111995.60
XSTV"M COST
Ia T` KS:7.140A1i.RY
OF CONIWMETCM014
195,` 64.90
CONSTRUCT 10;0 FEE 101.000-418.000
11975.50
PLAN CHECK FEE 101-000-439-318
$199.74
MI: HA1NICAL FEE 101.000-421.000
998.50
ZLECTRICA1, Pat, 101-000.420-000
$1511.94
PLUh%TNG FEE; 10'1.000.419w=
$1$6.30
STRONCI MOT1014 FEE • R SID 101-000-24.1-000
819.58
ORADINO FEE 101.000-423.000
$20.04
DEVELOPER IMPACT FEE
$1,907.00
fy.5 1 ► -
=A -MA , CONWRTAM1014 QWD
T(YfAb',P]U ; X
PIS Cf=
UO3 1 °TvpAtO F.=#
YiFES DUE NOW
$3,527.76
$0.00
RECEIPT
DATE
B
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs --Gtj
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck U Ci (�� C
Exhaust Fans
O.K. to Wrap Qrj
F.A.U.
Framing
Compressor
Insulation _
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath -7
Drywall - Int. Lath L
Final
Final /o a
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines GJ
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test lei
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final l
Utility Notice (Perm) Cita
COMMENTS:
FROM RJT_HOMES FAX NO. 7605646505
.26- no
,u
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
o� 777-7012
--- INSPECT
Owner
ION REQUEST LINE
777-7153
RJT INVESTMENTS,poo
Oct. 25 2POO 01:53PM P1
ContractorRH ENVESTMENWM ZODU
0004-274
Permit Number b���
POST ON JOB IN
pp
I�NSPECTTOS$R MUST SIGN ALL APPLICABLE SPACIFS
PLAN 2A; PEIMIT DO US NU""'-
UgCLUDE BLOCK WALL OR POOL.
TYPE OF INSPECTION
,. DATE - INSP.
FOUNDATION & SETBACKFOOTING
STEEL
STEEL
; r'
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE .
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS 8 GIRDERS
ELECTRICAL GROUND WORK
Du -'NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING $ VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT O 4' O 8'
Ly
FRAMING
INSULATION
/ C:J !
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGN D
DRYWALL INTERIOR _
EXTERIOR LATH
POOL PRE PLASTER
4!99,L FENCE & GATE
3EWRR SEPTIC TANK rt t
v FINALS
ELECTRICAL /7 -
PLUMBING
\L GAS TEST Y (0
&__�Tl NG - A/C
RS
TEMP POWER
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R3
50-580 CYPRESS POINT DR
Bldg. Permit No.: 0004-274
Type of Construction: VN Land Use Zone: RL
Owner of Building: RJT INVESTMENT INC
Building Of icial
Address: 1425 E. UNIVERSITY DRIVE
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 10-20-00
POST IN A CONSPICUOUS PLACE