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0008-038 (SFD)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 6 40/4��ii B 7/3 01 Date �L�?`"� Signature of Contrac r OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor', 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 STATE FUND Policy No. 046-0007338 (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 Califor ' , an gree that if I sho become subject to t e rkers' compensatio provisions f Section 3 of a Labor Code, I s II f hwith comply with ose provision Date: G' Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful an shall subject an employer to criminal penalties and civil fines up to $100,000, ' addition to the cost of compensation, damages as provided for in Section 37 6 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 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, d State laws relating to the building construction, and hereby a orl prese tatives his City to enter upon the above-mentioned prop y for i pection p rp es. Signature (Owner/Agent) ate BUILDING PERMIT PERMITk DATE VALUATION LOT 0008-038 TRACT $240,117.10 10 29457=1 JOBS APN ADDRESS 79-700 RANCHO LA QUINTA DRIVE 649-100-019 OWNER CONTRACTOR / DESIGNER / EN INEER SPARKS CONSTRUCTION SPARKS CONSTRUCTION 79-295 RANCHO LA QUINTADR, -79-295 RANCHO LA QLIINTADR, LAQUINTA CA 92253 LAQUINTA CA 92253 (760)771-1941 CBL4 2996 USE OF PERMIT SINGLE FA1vl DWELLING SFD-LOT 10 PLAN E2R - PERMIT DOES NOT INCLUDE BLOCK WALL OR POOL. 75%o PLAN CHECK FEE REDUCTION FOR MULTIPLE ISSUANCE OF ` SAME PLAN TYPE. CUSTOM CONSTRUCTION 2,924,00 SF. PORCH/PATIO 235.00 SF GARAGE/CARPORT (SF) 9,212,00 ESTIMATED COST OF CONSTRUCTION 240,111.10 PERAM FEE SUAUAARY ' CONSTRUCTION FEE 101-000-418-000 $1,133,00 PLAN CHECK FEE 101-000-439-318 $232.24 - MECHANICAL FEE 101-000-421-000 $130.50 f i ELECTRICAL FEE 101-000-420-000 $ 169.24 PLUMBING FEE 101-000-419-000 $175.75 STRONG MOTION FEE = RESID 101-000-241-000 $24.01 GRADING FEE 101-000-423-000 $20.00 DEVELOPER IMPACT FEE $1,90. 00 ice' ART IN PUBLIC PLACES - RESIE 701-000-255-000 $100.29 SUF3-TOTAL CONSTRUC 014 AND PLAN CHECK $3,892.03 LESS PRE -PAID FEES $0.00 TOTAL PERMIT FEES DUE NOW $3,892,03 RECEIPT DATE B DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTO BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade zZ 7 Op Return Air Steel Combustion Air Roof Deck ..p 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 POO6,;��SPAS BLOCKWA '-?% L PPROVALS 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 — 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 COMMENTS: Final Utility Notice (Gas) ELECTRICAL PPROVALS 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) "