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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
7i3.1 i33r�
Date r �� ' r Signature of Contractor y� f
Y � 9 ,
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.
'n'P17 I^7>*i"1 '�•"711f"<':iI
(This section need not be completed if the permit valuation is for $100.00 or less).
O 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�� become
subject to the workers' compensation provlVons of Sectiv,8 07 0 of fhe Labor
Dode, I shad forth comply with those provision<
ate: ` '� ' Applicant ,r _
Warning: Failure to secure Workers' ComperiaM n coverage is unlawful andV✓
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. sr'
1. Each person upon whose behalf this application is made & each person:at
whose request and for whose benefit work is -performed under or pursuantao
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 j
construction, and hereby authorize representatives ,of -this City to enter upon .�
the 'hove -mentioned prop Fty'fo I spectio urpdses., I
ignature (Owner/Agent] "N �' ("----Date 7 ? 7
PERMIT # CONTROL #
BUILDING PERMIT
9707.6X9' S6'52
DATE VALUATION LOT LOT TRACTJOB
SITE!
ADDRESS - % -7�.5 Q.,AISAL DIM RIO
APN 6166-33X002
OWNER
CONTRACTOR'/ DESIGNER / ENGINEER
TD k "I. -V ;.;: PA:;f�:1
�f: l, `"'.!'i'1S! �;fJt"I';:1'1
PO 130N. 71
79295 L,' ,1CHO 1,1\�if�1Tn3'f'A 'DR.
LA f,,1? tIN"IA (-'.A 9'),'1,5'3
LA QIJii'v'IA (:.'r'1. 922:53
(760)77t.lri.l.1 f''.RI.tJ 2"1 i
USE OF PERMIT
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ART IN P1Jf LIC.` 111,.AC'!:i3 . Pk�.Sal ";01-(�Kh15�-Sttttt �.k{!1n.15
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AUG z 8 1997 (rw
C! 9.. H of Lb"t OU NTA
RECEIPT
DATE
.BYf
DATE FINALED
INSPECTOR
NSFECTM RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUS LDbHG APPROVALS
MECHANCAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck - 4 .C7'11241,0z
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 APPRO ALS
Gas Test
Electric Final
Waste Lines MA Zo 1Heater
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
-'hemp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
.3/31/98 CITY OF LA QUINTA 1
INSPECTION SUMMARY REPORT'
Permit Number 9707-129
Site Address 78-855 CASA DEL RIO
Rereference Number
Site City
Location of.Project
Date Applied for 7/25/97
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
Contractor Name SPARKS CONSTRUCTION
Valuation $169;659
79295 RANCHO LA QUINTA DR.
.Fees 5,984.88
LA QUINTA CA 92253
Description of Permit SFD - VENTANA PLAN V2 -R. ART IN PUBLIC PLACES CREDIT OF :$174.15 PER AGREEMENT W/
COM. DEV. DEPT.
INSPECTIONS
SCHEDULED OR COMPLETED
Scheduled Completed
Date Date Time
Inspection Type Inspection Result Inspectors Comments
12/4/97 12/4/97
B5 -ROOF PASS
12/15/97 12/15/97
B7 -WRAP PASS
12/19/97 12/19/97
138 -FRAME PASS
1/5/98 1/5/98
B9-INSUL SEE NOTES NO PLANS R -13/R-38 INSTALLED
1/12/98 1/12/98
CO-DWN PASS
1/12/98 1/12/98
C1 -LATH PASS
2/17/98 2/17/98
B21 -G -TEST PASS
2/25/98 2/25/98
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.
y
83/30/1998
11:47 619—
o�,� 49OF LA QUINTA
BUILDI A SAFETY DEPARTMENT
�� 777-7012
Ora ASPS N REOUEST LINE
r'`` Q 7153
Owe 5ERT DEVLOPMENT
contractor SPARKS CONST
Parcell N4wgbw 9707-129
PObT pN JpB IN Cousin- O.US PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDREW 78-855 CASA DEL RLO
LOT 88 V2 R
TYPE OF INSPECTION. I DATE 'NSP.
FO_UNOATION a SETBACK
KWnnCi STEEL P . - •" i " .
Vy NOT POUR CONCRETE UNTILALLABOVE HAS BEEN SIGNED
CONCRETE SLAB. T
WORK
COVER NO WORK UNTIL ABOVE HAS BEER SIGNED
I. s C
DO NOT POU01 CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC,
, - • -t -
ROUGH PLUMBINQ
ROUGH'G" S GAS TEST
�
HEATING l VENT • ASC
.:
FIREPLACE.
ROOF
FINALS
BOND BEAM
-=i
O.K. TO WRAP
GROUT
FRAMING
-
INSULATION
�' �
PRE -ROOF
!
COVER NO WORK UNTIL ABOVE HAS BEER SIGNED
ORYWALL INTERIOA
<r J
EXTERIOR LATH
, - • -t -
POOL PRE PLASTER
POOL FENCE &CRATE
�
SEWER SEPTIC TANK
.:
- —
FINALS
ELECTRICAL
-=i
PLUMBING
FINAL GAS TEST
HEATiNQ3 A/C
-
HOUSE-NUM®EAS
�' �
JOB COMPLATED
TEMP POWER
ABOVE APPROVALS 00 NOT INCLUDE RIGMTTO
TURN ON UTILITIES OWOCCUPY SURMING