0008-028 (SFD)LICENSED CONTRACTOR DECLARATION
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
N W Professionals Code, and my License is in full force and effect.
O M License # Lic. Class Exp. Date
r- QIn
r; 674874 B 407//2(
oZ r— Date 902 Signature of Contract
O�
r.H0 OWNER -BUILDER DECLARATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contra tor's
~ a 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).
M () I am exempt under Section B&P.C. for this reason
LO
N Date Signature of Owner
ON
0)CL Q WORKER'S COMPENSATION DECLARATION
o Z I hereby affirm under penalty of perjury one of the following declarations:
Lo O () 1 have and will maintain a certificate of consent to self -insure for workers'
X LJ LL- 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.
D] Q U ( ) I have and will maintain workers' compensation insurance, as required by
O LQ Section 3700 of the Labor, Code, for the performance of the work for which this
F<:
permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No.
ao =) STATE FUND 046-0007338
0
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 b e subject to the
workers' compensation laws of Cali , and agre at if I hould become
3 subject to he orkers' compens Ion pro • ions Section 37 0 of the Labor
Code, I s I orthwith comply th those pro ' ns.
Date: �� Applican
Warning: Failure to secure Workers' Compensation coverage is unlawful a d
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 3 O6
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 applicationand state that the above information is
correct. I agree to comply with all Ci , an State ws relating to the building
construction, and hereby But/horizepre en Ives f this City to enter upon
the above-mentioned propec' purpos S. Signature (Owner/Agent) Date (740
BUILDING PERMIT PERMIT# ----
DATE VALUATION LOT 0008-028 TRACT
$220,852.00 17 29457-1
JOB SITE
APN
ADDRESS 79-770 RANCHO LA QUINTA DRIVE
649=100-019
OWNER
CONTRACTOR / DESIGNER / ENGINEER.
SPARKS CONSTRUCTION
SPARKS CONSTRUCTION
79-295 RANCHO LAQUINTADR,
79-295 RANCHO LA QUII`TTADR
LA QUINTA CA 92253
LA QUINTA CA 92253
(760)771-1941 CBL4 2996
USE OF PERMIT
SINGLE FARM•Y DWELLING
SFD-LOT 17 PLAN EI R - 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
GARAGEJCARPORT (SF) 12,034.40
E913MATED COST OF CONSTRUCTION
220,852.00
PERMIT FEE SUAIMARY
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
ELECTRICAL FEE 101-000-420-000 $162.01
'
1
PLUMBING FEE 101-000-419-000 $179.25
STRONG MOTION FEE - RESID 101-000-241-000 $22.09
_
=
GRADING FEE 101-000-423-000 $Y0.00
DEVELOPER IMPACT FEE $1,907.00
ART IN PUBLIC PLACES - RESIL 701-000-255-000 $52.13
--;1
SUB -TOTAL CONSTRUCMON AND PLAN CrEM 'K
$3,728.38
LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE NOW
$3,728.38
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms 8 Footings
1.Underground
Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
0. K. to Wrap
_
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
G
Final
Final
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
/
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMEiRTS:
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)
08y(30/2001 10:32 7607711841 � SPARKS CONSTRUCTION PAGE 02
s
CITY OF LA QUINTA
BUILDING &SAFETY DEPARTMENT
I 'f
777-7012
INSPECTION REQUEST LINE
777-7153
Owner SPARKS CONSTRUCT
ID
Contractor SPARKS CONSTRU1�1
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79770 RANCHO LA 011MIA DR=
SFD-LOT 17 PLAN EJR-PERMIT DOES NOT
INCLUDE BLOCK WALL ORPOOL
TYPE OF INSPECTION DATE INSP.
FOUNDATION S SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING -
PRE-GUNITE
DO NOT POUR.CONCRETE UNTIL ALL ABOVE HAS BEEN IGNED
CONCRETE SLAB
JOISTS S GIRDERS
ELECTRICAL.GROUND WORK
DU wdT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
j
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATI NC & VENT - A/C
i FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4'' Cl 8'
FRAMING40
INSULATION
PRE=ROOF
COVER NO WORK UNTIL ABOVEr HAS PEEN SIGNED
DRYWALL INTERIOR
POOL PRE PLASTER
POOL FENCE & GATE
SEVYER SEPTIC TANK
FINALS
ELECTRICAL d
PLUMBING
FINAL GAS TEST 4'
Fi NG . A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHTTO
TURN ON UTILITIES OR OCCUPY BUILDING