0008-076 (SFD)LICENSED CONTRACTOR DECLARATION
I Hereby affirm under penalty of perjury that I am licensed under provisions of
E- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
O M License # Lic. Class Exp. Date
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�� r— 67 0 4 B 7/3 1
Z Date Signature of Contractor
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Ca ��
J U OWNER -BUILDER DELL ATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
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 isnot 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).
Ch () I am exempt under Section , B&P.C. for this reason
U')
N Date Signature of Owner
O�
Q WORKER'S COMPENSATION DECLARATION
C) cc z I hereby affirm under penalty of perjury one of the following declarations:
O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W �z compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
C0 Q () ( ) I have and will maintain workers' compensation insurance, as required by
p LO Q Section 3700 of the Labor Code, for the performance of the work for which this
a Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier STATE FUND Policy No. 046-0007338
co 5
O
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 a become subject to the
workers' c mp nsation laws of alifornia, and ree at if I should become
subject to h workers' comp satin rovisio of Sec 'on 370 f e Labor
3
Code, ,l f with comply ith thos ro . ions.
Date:( Applicant
Warning: Failure to secure Workers' Compensation coverage is un awful and
shall subject an employer to criminal penalties and civil fines up to $ 00,000, 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
r�Vip & 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 w' II City, and State laws relating to the building
construction, and hereby uthori a repr tives o his City to ent r on
the above-mentioned pr erty for I ction p rp s.
Signature (Owner/Agent Dat
BUILDING PERMIT PERMITM
DATE VALUATION LOT 0008-076 TRACT
5220,852.00 48 29457-1
JOB SITE
APN
ADDRESS 49-_45 RANCHO LA QUINTA DRIVE
649-100-019
OWNER
CONTRACTOR/DESIGNER/EN (NEER.
SPARKS CONSTRUCTION
SPARKS CONSTRUCTION
79-295 RANCHO LA QUINTA DR.
79-295 RANC'-HO LA QUINTADR,
LA QUINTA CA 92253
LA QUINTA CA 92253
(760)771-1941 CBL9 2996
`
USE OF PERMIT
SMOLE FAN= DWFILJNG
SFD-LOT 48 PLAN E1R - PERMIT DOES NOT INCLUDE BLOCK WALL OR
POOL, 75% PLAN CHECK FEE REDUCTION FOR MULTIPLE ISSUANCE OF
SAME PLAN TYPE.
CUSTOM CONSTRUCTION 2,635,00 SF .
PORCH/PATIO 267.00 SF
GARAGE/CARPORT (SF) 12,034.40
ESUMATED COST OF CONSTRUCTION
220,852.00
PERMIT FEE SUMMARY
CONSTRUCTION FEE 101-000-418-000 $1,063.00
PLAN CHECK FEE 101-000-439-318 $217.90
MECHANICAL FEE 101-000-421-000 $105,00
r -J
ELECTRICAL FEE 101-000-420-000 $162.01
_
PLUMBING FEE 101.000.419-000 $179.25
STRONG MOTION FEE • RESID 101-000-241-000 $22.09
GRADING FEE 101-000-423-000 $20.00
DEVELOPER IMPACT FEE $1,907.00
ART IN PUBLIC PLACES - RESIL 701-000-255.000 $52,13
1_0 --I
SUB -TOTAL CONSTRUCTION AND PLAN C"IMCK
$3,728.38
LE99 PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DITE NOW
$3,728.38
RECEIPTDATE
B
DATE FINALED
INSPECTOR
d0
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
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 - L -o R�-t�_8r�--
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
(y=dp
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
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)
COMMENTS:
�s �6✓�
(Certificate of Occupancy
City of La, Quinta
Building,, and Safety Department
r
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 79-795
I
RANCHO
LA QUINTA DR
Use Classification:
SFD
Bldg. Permit -No.: 0008-076
Occupancy Group:
R3 Type of'Construction:
VN
< Land Use Zone: RL
Owner of Building:
SPARKS, CONSTRUCTION
Address:
79-295 RANCHO LA QUINTA DR
City:
LA QUINTA CA 92253
,
By:
KIRK KIRKLAND
Date:
_8-15-01
Building Official
POST. IN A CONSPICUOUS PLACE