0008-052 (SFD)LICENSED CONTRACTOR DECLARATION
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
F— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
WProfessionals Code, and my License is in full force and effect.
O C,) License # Lic. Cla E to
r- C3 LO
LLJ
6 4 4 B /31/01
oZ r- Date Signature of Contr Or
toot
JI.— CD OWNER -BUILDER DECLARATION
LU W I hereby affirm under penalty of perjury that I am exempt from the Con actor's
~ IZco License Law for the following reason:
Z_ ( ) 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).
ce) () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
O N
rn
d< WORKER'S COMPENSATION DECLARATION
C:) 2 Z I hereby affirm under penalty of perjury one of the following declarations:
r O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w �= compensation, as provided for by Section 3700 of the Labor Code, for the
O _ Q performance of the work for which this permit is issued.
m Q () ( ) I have and will maintain workers' compensation insurance, as required by
O UQ Section 3700 of the Labor Code, for the performance of the work for which this
rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
,�t Z Carrier Policy No.
O STATE FUND 046-0007338
J
(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 Ca' rnla' d agree t I should become
subject to h workers' compens ion provisio of ction 3 00 of the Labor
Code, fo with comply w h those pro ' io
Date: Applicant
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 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 thorize representative f this City to ente/up,,n
the above-mentionedpr a for1nsp do psSignature (Owner/Agent) ate
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0008-052' TRACT
. � $240,117.10 24 29457-1
JOB SITE
APN
ADDRESS 791W RANCHO LA QUiNTA DRIVE
649-100-019
OWNER
CONTRACTOR / DESIGNER / ENGINEER
SPARKS CONSTRUCTION
SPARKS CONSTRUCTION
79-295 RANCHO LA QUINTA DR.
79-295 RANCHO LA QUINTADR
LA QUINTA CA 92253
LA QUANTA CA 92253
(760)771-1941 CBL# 2996
USE OF PERMIT
SINGLE FAIvI LY DViELLI G
SFD-LOT 24 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
GARAGEICARPORT (SF) 9,212.00
ES'TErdATED COST OF CONSTRUCTION
24U,117.10
PERJVITT FEE SUN NL4RY
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 $175.75
STRONG MOTION FEE - RESID 101-000-241-000 $74.01
GRADING FEE 101-000.423-000 $20.00
DEVELOPER IMPACT FEE $1,907.00
ART 1N PUBLIC PLACES - RESIE 701-000-255-000 $100.29
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$3,892.03
LESS PRE -PAID FEES
$0.00
TOTAL, PE-RNLrT FEES D'LrE NOW
0;892:03
RECEIPT
DATE BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade 1J_ b
Return Air
Steel
Combustion Air
Roof Deck _/
Exhaust Fans
O.K. to Wrap�_ g p �'/�
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 -Z_ '�_7'-y
POOLS -SPAS
BLOCKWALL APPROVALS
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
G� r
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 �a t
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas) 70
ELECTRICAL AP ROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
1-7
Temp. Use of Power
Final -
Utility Notice (Perm)