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)
"