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0004-273 (SFD)H N U) w O =) M t-- CY U-) W o Z O O F— C J D LLJLUa U) Z cr) N ON 5It IL Q Z QIr O LL 0 JJ m U U O rn H "'t Z ob O 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 ,r 690645 B loll; A 46f30f2t VEDIVDa,te`'�" ` -3 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 1119, COMpAATY OFT Policy No. LNpT,li0041900 (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 of the Labor Codeyfshall forthwith comply with those provisions. /Date:H'"s_tc Applicant Warning: Failure to secure Workers' CompensStion 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) t-.r�l�!'?"� Date'��-��' J y�� � 5* BUILDING PERMIT PERMIT# DATE VALUATION LOT 0004"27 TRACT $214041SO 0 25389-5 JOB SITE APN ADDRESS 9, CXP7 MSS Pcin Ii °1V.E 71150460 -ow OWNER CONTRACTOR/DESIGNER/EN (NEER RiT•.w1e',i`P "rs. INC. P Ti 1NV::C�i'.t�Ami m, wrc- 1425 p LrN1:Vf,,IWCYDRIVE, 1425 R VN_rV:k=N DRIVE PHOlCNM .AZ 8534 PTT©ENDt.' AZ 85034 (602)257.1656 CBTO 4990 USE OF PERMIT �IATGLE IFAIYM-Y DWM LWO ;FD- L4,*)T 40 PL 3k. PERMIT DOM NOT INCLUDZ BLOCK 'W.A1. , OR POOL CUSTOM CONSTRUCTION 2.610,00 SP PORCIOPATIO I40.00 SF CfAltNOWCARPORT (SP) 9.764.80 xsnmAm oosT or commexCmon CONSTRUCTION FEE 101.000.418-000 31;042.04 PLAN CHECK FEE $214.03 k � # MECHA141C.A.L EEE 101.000.421.000 8105.00 ELECTRICAL FEE 101-000-420-000 $158.21 PLUMBING FFE 111-000-419.000 8180150 � STP,ONQ MOTION FEE - REBID 101-000.241-000 $21.49 a" � f C; OR&DINO Fri E 101.000423-000 $20,00 DESlLpLOPER IMPACT FEE $1,90.00 ART IN PUBLIC PLACES , RESIt 701000.255.000 $31,41$ ;11% B-WrAL CONMALTCI1' OST AND PL" CB.C.,TC. $3,686.28 1,M8 PRE -PATO Lti 9 $0.00 T9 ASG--e"WXYEE9 WE, NOW E $'x,656.28 RECEIPT DATE Y V"! DATE FINALED INSPECTOR INSPECTION RECORD r OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backsa- Underground Ducts -- Forms & Footings Ducts Slab Grade L ( Return Air Steel Combustion Air Roof Deck - �2 ,_ GU QL L 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 5 - 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 }- Q 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 - - O ' Utility Notice (Perm) - COMMENTS: ulttttls uAli j 77 CITY OF LA QUINTA BUILDING & SAFETY DEPARTMENT OF 777-7012 INSPECTION REQUE_ 777-7153 RJT INVESTMENTS, xNo.APR 2 5 Z000 owner UNIT' contractoAff INVESTMENTNVWQF 0004-273 Permit Number POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES CYjrMSSjljWT IJIUVT nu-noo JOB ADDRESS SFD-LOT 40 PIAN 3R; P D07ES NOT INCLUDE BLOCK WALL OR POOL. ... TYPE OP INSPECTION DATE INSP. FOUNDATION & SETBACK 7,77 FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL UN AL HOVE HAS BENSIGNED CONCRETE SLAB Y 4/ JOISTS & GIRDERS ori ELECTRICAL GROUND WORK JOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST 2 -- HEATING& VENT- A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP GROUT 0 4' 0 8' FRAMING INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR EXTERIOR LATH POOL PREPLASTER POOL FENCE & GATE SEWER SEPTIC TANK, FINALS ELECTRICAL PLUMBING FINAL GAS TEST !2 PNO - A/C RVOSE NUMBERS JOB COMPLETED TEMP POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO 'n ioki r)kl I IT11 IT199 r -%Q rv-rj iwv gi m nipon Ed Wd9E:ET TOOE 9T 'gad SOS9V9SO9L : 'ON XUJ S31W017-if 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:* -50-560 CYPRESS POINT DR Use Classification: SFD Bldg. Permit No.: 0004-273 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: RJT INVESTMENTS INC. Building Official Address: 1425 E. UNIVERSITY DRIVE City: PHOENIX AZ 85034 By: KIRK KIRKLAND Date: 2-16-01 ��• POST IN A CONSPICUOUS PLACE J ,