0008-086 (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 # Lia Class Exp. Date
6 4 4 B / 1/01
Date Signature of Contractor
OWNER -BUILDER DECLAR TION
I hereby affirm under penalty of perjury thatI 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 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' co pensation laws of California, and agree I should become
subject I a orkers' compensate pro 'ions of ection 3 00 of abo
Code,1 I o Jwith comply wi those pro io .
Date: ( 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, i
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 oubjoot to tho oonditiono and raatrictions set follh 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 this application 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 aut rize repre p 'ves his City to enter upon
the above-mentioned pro erty for pe Ion ur os /
Y
Signature (Owner/Agent, Vater�
BUILDING PERMIT PERMIT#
DATEVALUATION LOT 0008-086 TRACT
$240,117.10 58 29457 -1 -
JOB SITE
ADDRESS
7 -6 RANCHO LA QUINTA DRIVE
IAPN
649-100-019
OWNER
CONTRACTOR / DESIGNER / EN (NEER
SPARKS CONSTRUCTION
SPARKS CONSTRUCTION
79-295 RANCHO LA QUINTADR
79-295 RANCHO LA QUINTA DR,
LAQUINTA CA 92253
LAQUINTA CA 92253
(760)771-1941 CBL9 2996
USE OF PERMIT
SINGLE FAMILY DWELLING}
SFD-LOT 58 PLAN E2R - PERMIT DOES NOT INCLUDE BLOCK WALL OR
POOL. 75% 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
r
ESTIMATED COST OF CONSTRUCTION;
240,117.10
PERMIT FEE SUAIMEARY
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
ELECTRICAL FEE 101-000-420-000. $169.24
PLUMBING FEE 101-000.419-000 $173,73
STRONG MOTION FEE - RESID ` 101-000-241-000 $24.01
t : -
GRADING FEE 101-000-423-000 $20.00 .
DEVELOPER IMPACT FEE $1,907.00
ART IN PUBLIC PLACES - RESIE 701-000-255.000 $100,29
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$3;832.03
I= PRE -PAID FEES
$0.00
TOTAL'PERMTT FEES DUE NOW
$3,892.03
RECEIPT
DATEBY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs -
Underground Ducts
_
Forms & Footings
Ducts /
Slab Grade /Z /3-
Return Air /
Steel
Combustion Air
Roof Deck _ 9 Q�� _�
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
POOLS - - PAS
BLOCKWAL A PROVALS
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
/—
Waste Lines/ �2
Electric Final-' ,
Heater Final
'Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances --
Final
COMMENTS: .. .
Final
Utility Notice (Gas)
ELECTRICAL A PROVALS
_
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)