9602-006 (SFD)P
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LICENSED COWTRACTOR DECLARATION
I hereby affirm 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# Lig7doss B Exp. Date .--s{' if
Date Signatureof Contractor 7
OWNER -BUILDER DECLARATION
I hereby affirm 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.
(This section need not be completed if the permit valuation is for $100.00 or less).
() I c4&0WW1IiARQperformance of the work for whiW*is oWmit 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
Code, I shall f rthwith comply with those-provisio 1
Date: �. i7 r �' J f,, Applicant
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 application agrees to, & shall, indemnify
& hold harmless the City of Indian Wells, 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
If correct. I agree to comply with all City, and State laws relating to the buildings
construction, and hereby authorize representatives of this City to enter upon the
above-mentioned property for inspection purposes
Signature (Owner/Agent) DatB c A a 1 (rj
A""
BUILDING PERMIT
PERMIT'
ytltl� Ot36
DATE 21 D/%
VALUATION $2115,314,341 LOT 113
TRACT 77840
JOB SITE ADDRESS
APN
4X-575 C:APPSTRANO WAY646-.3941-04i
OWNER
CONTRACTOR
SPARKS CONS'1'1t U(ITON
T.D. DESERT..DEVEL.OPMENT LP
710-23.5 iL'1NCHO .LA. QUINT.A. DR.
Ra. BOX 14716
LA Q(ANTA CA 022:13
LAQPNTA CA 92253
i6101771. 041 C-'fti(.� 7CD9ti
DESIGNER/ENGINEER
(ft19)771.1 41
USE OF PERMISI1NG`L - FAMILY C���VE-11II�IGr
It"CH:O LA t4VIN-rA
TERRAZA.PLAN 2
FEE DESCRIPTION
FEES
Ci:3caom CJONSTRUC7noN 2,572,00 SIP
Pmai/pAi'3.O 1. 15.00 SF
GARA WC'AR OWr 685.00 SF
USTINIi'€ED COST Off" CONSTRUCTION
21.5,314.30
PERMIT FEE SUMMARY
PLAN C'1-TE'C:IC FEW ) 01-W-430-31.8 $879.46
CONSTRUC,"11ON.FEE 101-000-418.000 $1,043.50
MECHANICAL FEE 10.1-000-421ml[11)0 $142.50
R''LEC71'RIC',AL FM- 101.-000-420-000 $2+7.22
RT;0A46Nor, FIR 1.01-000"413-060 $188,,.
S'TONC. MOTION FIMP . RESID 1.01-000-241-000 S211,D
ORAIDtNC1 Fi<'s`E 101-000-42.3-000 $26.00
INiv1ZA.`4''1tUC,'-CIJIiEFEE 225-000-493-V42 $4.1310.16
P.RE'CISRP(IMU t01 -N)0-441-445 S 5.00
ART LV PUBLIC PLACE 9-1LESI3: 701. -000-255-000 3',1138.29
B •'t'O AL CONS'i'12tJCti" ON. AND PLAN CR EC K
$7,617.66
LESS PKC -PAID FEES
Saw
FEe 2 3 ^ TOTAL, PERMIT FEES'DUENOW
X990
$7,617,66
RECEIPT
DATE I
BY
DATE RNALED
INSPECTOR"
INSPECTION RECORD
12
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 8 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 I
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.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
a
s CITY OF LA QUINTA
fa.^ A. BUILDING & SAFETY DEPARTMENT
777-7012
Cl) INSPECTION REQUEST LINE
777-7153
Owner T.D. DESERT DEVELOPMENT
Contractor SPARKS CONSTRUCTION
9602-006
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 48-575 CAPISTRANO WAY
SFD PLAN 2 LOT 113
TYPE OF INSPECTION
FOUNDATION & SETBACK
FOOTING STEEL
DATE INSP.
MAIN GROUND SYSTEM
GROUND PLUMBING
177
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
% -
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
G)_ 70 .
HEATING & VENT -A/C
FIREPLACE
ROOF
-- 0 -
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
-7 -1_;zv G
COVER NO WORK UNTIL ABOV_ EE N GNEQ
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
NCE & GATE
EW R EPTIC TANK -
FINALS
ELECTRICAL -
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED {G
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
1/95 TURN ON UTILITIES OR OCCUPY BUILDING
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