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0002-139 (SFD)LICENSED CONTRACTOR DEC s I li�4eby affirm-und®lr pE`nalty of perjury.that}I amr.� l Chapter 9 (commenci 6g�V t Section 7000) of DIV' Professionals Code •and --my License Is ih full fore., License # Llc Class` Date cv� L/dSignature of Contractor; ' LARATION cenkd.under provlslons of t Sion 3 of the Business and tnd effect, Exp•`. Date 1 �131Ii.'(9+jJ OWNER -BUILDER DECLARATION' '• I hereby-,afflrm�under penalty of perjury that I am exempt from the Contractor's License Law for-the_following reason: • a, ( ) "I;( as owner`of the property,..or •my, qmp gees with wage as_their sole . compensation, will- do'the work, and ther structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) I, as owner of ,the property,., am exclusively contracting with licensed .contra'c�ors�to :construct the project (Sec: 70r, -Business &Professionals " Code).:' ( .) I'am exempt'under'Section'-y B&P.C. for this reason Date i ��Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty Iof'•'perjury one of .the following declarations: () I have and will maintaina 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 workdrs'`compensation insurance, as requirea'by Section 3700 of the Labor C&de, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier 1 Policy No. �r (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• t I shall not employ any person in any manner so as to become`: subject to the! . workers' compensation laws of 'California and a ree that if'I' should become :•'subject to the workers':compensatior�provisions of Section 3700 o the Labor Code �, I,shall f A iwith comply with those provis* S. Date4ey 5 7� 0 Applicant ' ! Warning: Failure to secure Workers"Com tion 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. r $. 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. t,. :, . ..:•.. 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. andemployees." 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 authorize representatives of this City to enter upon the above-mentioned property fog •nsp' a •on purposes. ` (J Si nature {Owrer/P nene t) �— Date h/ -*BUILDING•PERMIT PERMI;��to-�-3`� DATE � VALUATION LOT40 TRACT 2 q: 'JOB SITE"' 7 .1 i RkNC�.i0"QIJHli.tl.N..y}: 1A7.11. APN ADDRESS �i„ _ �P3� • \�"'�--�.�,._ � -- OWNER f r1b7 r-``--. ", g- t,,-, �. CONTRACTOR / DESIGNER / ENGINEER (y(yT 1 {'/'' r ; h • •- :1 .� :. to h7 G•.ct..' i..fv 1. is J��s�l )rl.,, 1.y'(,c rc�r� n SPA s S,✓i.�IYW 1.a7\VL{...- SPARKS P0 j iN, fliio, 79-295 ki\14 H0 LA 0.4-INTA DR. LAQUIN .A. GA 922`+3 LA QWIN'1'A. C' -A 922.53 (76 i'�i <t 941 f;AT, v9 C USE OF PERMIT MN031­AwM1 }' DV't%.H f. UN6 q St.*0-LQd 40,:ttLAt+i k;7GR, I•'a:a'ZfbfFf UUtsa ti'C� i h25C1.•Uj +t7 .fsi3OG-K W..0 LS Cjk- 3'G�J,1.,15"ro PLAN CtflE K ti ItR.UU<; Tf�)I� IF Gf�11U1, f'ff'i�.!"s iSSiJE1l+I! }., L7d' . MST 011 CG ST i UCT IEG;"T S . I Z5,00 ('P f tie#1t.AS; lr%C �iit:l't�� t` 4.70,00 SF 19T.:MMED€ ST Off'CONSTRUCTION 240,11;.39'., ' 'PERMITITEV SUMMARY K i C(YN 'a:ftt;:C I'f0NT F'Ff. 101-000-4.18-000 31,'t33 r+U i1iEGEI. Jd%C`AL 1 ids--• 101-v(}a4211( o [ B.I �i'itl+ ' yt 'I j iw ! i} 1-t30G 12v-tsClu 8 169.24 f�f t t��f831iJtf t 7 ,F� 101-000 41 OO attk l`!�, rciCrf )N rSxf; P�, r�r 1(j}•(k111-?.di-tl(1fi 2A 01 i.lil�fir'.7 �'a4.i if/,�.�v-�� � .{©a^VVV-�'id�+•'UVV �.DI.�� t,�� .c",, DE, VEi.OPER l't :OAS .: r FEE, w 11£t'1' .12+t i�t3,1.11C,.t'1.ACk:S - kE.Sl.1: 7Ui-i)'JU-2�+S�i?f? $3�C►.:��� ><;(WS $4,1[41,03 ' LF SS ,P.R12 PAW FEE' Td"t'''�i?'Al ORMIT FEESAM"$Rrow ti, e:3j42.13:� i RECEIPT DATE /ABY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings 5 Ducts Slab Grade ga &—pV Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap -,i —.�y.a F.A.U. .Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall OF Exterior Lath Drywall - Int. Lath Final Final _ POOL - PAS BLOCKWA 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 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: r 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) �a f .1 P.O. Box 1504 c % 78-495 CALLE TAMPICO ('760) 777-7000 LA QUINTA, CALIFORNIA 922"53 FAX .(760) 777-7101 February 8",.2001 Mr. Nolan Sparks Sparks Construction P.O. Box 171"6 La Quinta, CA 92253 Dear Mr. Sparks: Please be advised of an address change for the following structure. The structure formerly addressed as 79-935 Rancho La Quinta Drive, APN: 649-100-01.9, Lot 40, Tract 29306, the construction for which building permit#0002-139 was i3sued, will now be addressed as 79-635 Rancho La Quinta Drive. Please note this change and'contact me if I may be of further assistance. Thank you. Sincerely, Diane Aaker Senior Secretary Building & Safety Department .