9707-132 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chanter 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 ! ,i ignature of Contractor'
OWNER -BUILDER DECLARA ION
I hereby affirm under penalty of perjurythat 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&RC. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
Thereby 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-) I have and will maintain workers' compensation insurance, as required by
S€2tion 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carder & policy no. are:
Carrier Policy No.
rr. , � , • 'i tat '+` 11 ,C f.
(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 t e wp(kers' compensation provisions of Sectio 0 of the Labor
/Dode, I sh II forthwith comply with those provisions.
ate, r' � ' Applicant `
Warning: Failure fo secure Workers' Compensatieri 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 thisapplication 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-fo Ir n pection purpo es. - /
Ignature (Owner/Agent)Date
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BUILDING PERMIT PERMI97))7-1132 CONTROL
V.
DATE VALUATION SJ#j9.i6,S9.40 LOT 91 TRACT :* ���
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JOB ADDRESS 7 0,r91,.f4.5i DELRIO
APN
OWNER
CONTRACTOR ! DESIGNER / ENGINEER
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792951"t,AId III LA QLltI ITA ilk..
(760)_171-1911 O3i,,,11 2!9? i
USE OF PERMIT
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Y11 74 15
AUG 2 8 1997 10FAII, IPERiUff i1.iVVA 0111F, Nalli'.
RECEIPT
DATE
HY
DATE FINALED
INSPECTOR
e
t D SPEC MIM RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE INSPECTOR
BWLDWG APPROVALS
MECHAN=L 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 Wail 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 AP VALS
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
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
fnal
, ty'Notice (Perm)
COMMENTS:
U31/98 CITY OYLA QUINTA 1
C INSPECTION SUMMARY REPORT
Permit Number
9707-132
Site Address 78-915 CASA.DEL RIO
Rereference Number
Date
Site City
Inspection Type
Inspection. Result Inspectors Comments
Location of Project
Date Applied for
7/25/97
PASS
Date Approved
,
Owner Name TD DESERT DEV LTD PA
Date Issued
8/28/97
PO BOX 719
Date Finaled
3/30/98
LA QUINTA CA.92253
Date Expired
B9-INSUL
PASS
1/26/98
1/26/98
Contractor Name SPARKS CONSTRUCTION
Valuation
$169,659
79295 RANCHO LA QUINTA DR.
Fees
5,444.64
LA QUINTA CA 92253
Description of Permit
SFD - VENTANA PLAN V2=R. ART IN PUBLIC PLACES CREDIT OF $174:15 PER AGREEMENT W/
PASS
COM. DEV. DEPT.
PLAN CHECK FEE REDUCED BY -75% FOR MULTIPLE ISSUE OF SAME PLAN
DO -E -FINAL
TYPE.
3/30/98
INSPECTIONS SCHEDULED OR COMPLETED
Scheduled
Completed
Date
'Date Time
Inspection Type
Inspection. Result Inspectors Comments
12/15/97
12/15/97
135 -ROOF
PASS
12/18/97
12/18/97
B7 -WRAP
PASS
1/12/98
1/12/98
138 -FRAME
PASS
1/15/98
1/15/98
B9-INSUL
PASS
1/26/98
1/26/98
CO-DWN
PASS
1/26/98 -
1/26/98
C1 -LATH
PASS
2/17/98
2/17/98
B21 -G -TEST
PASS
2/27/98
2/27/98
DO -E -FINAL
PASS
3/30/98
3/30/98
D1 -G -FINAL
PASS
3/30/98
3/30/98
D2 -COMP**
PASS
10 Inspections completed.