0008-044 (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
B
Date 'f f Signature of Conti
OWNER -BUILDER DECLARATION
`713
I hereby affirm under penalty of perjury that I 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. 046.0007335
(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' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions r
Date: Applicant 1 �%
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 authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes. ! %'
f
Signature (Owner/Agent) ,� f rDate r/ % 01 y
BUILDING PERMIT PERMIT#
DATE VALUATION LOT (M-0" TRACT '
$240,117.10 16 29457.1.
0
JOB SITE+
APN
ADDRESS(TV_L-760 T?ATW 0 LA Qmi�' DWVJC_n
64.9,40Qe" 119
OWNER
CONTRACTOR / DESIGNER / ENGINEER
SPARKS CONVI UC1110M
PARKS C:ONB'ifttl'C'1: ON
79.2951LANCW0 LA QU1N'1'APAR,
79-295 R OOCIIO .Q.Ubr AD -R, ---
LA QIM41-A CA 92253
LA Q13WT'A : CA 9.2253
(760)771.1941 C BLH 2996
USE OF PERMIT
�'PiJ'C11�'i 1�A1� I�'JJEL,1'.�3C3•
SFO -LOT 16 PLAN EIR - PERMIT DOES NOT INCLUDE BLOCK: WALL OR
POOL. 73% PLAN CHECK C.GE REDUCTION FOR MULTIPLE ISSUANCE OF
SAME PLAN TYPL
COSTOM CONSTRUCTION 2,924.00 SF
PORCH/PATIO 233.E+0 SF
GA1t GEIC:'AitPCjRT (' 9,212.00 .
1 911MAIX-D C09r OF COiUNSMUC'.P ON
240,13.7.10
PSI'EZ11r3I`r FEE 9UMMARY
CONSTRUCTION FEE 101000-418.000 $1,133.00
spy
PLAN CHICK IZE 101•-000439-31$
MECHANICAL FEE 101-000^421.000 $130.50
L., �
ELEC'fRIC.ALFEY 101-000-420-000 $1.69.24
PLUMBINCI YU 101.000.419.0010 S17S.75
STRONO MOTION FEE - RESID 101-000-241-000 $24.01
I �: ;-
CiRADINO FEE 101-000.423-000 $20.00
s •
DEVELCIPL*R.IMPACT F92 $1,947.00
. •, j.
ART 1N PUBLIC PLACT , RESIL 701.000.255.000 5100:29
RUB-7MAL CONMULvr109 AND PLA9 CEMCK
vA,897_03
O PRE -PATO MS
I0100
101 AL PP3ZA►1nYEPES DUE 'ROIN
0,€92,W3
RECEIPT
DATE I
By {'' J
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
7--i 21—al
Return Air
Steel
Combustion Air
Roof Deck
fjL 6'
Exhaust Fans
O.K. to Wrap
_ _
F.A.U.
Framing
Compressor
Insulation
/2
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
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
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Water Piping
A_
/�
Heater Final
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:
08/30/2001 10:32 '7607711841 SPARKS CONSTRUCTION PAGE 01
CITY OF LA QUINA
,� 1 BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST I
777-1153
SPARKS CONSTRUCTIO—K,
L/
Owner
SPARKS CON
Contractor
0005-044
It, I I kk
W -
Permit Number_
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLESPACES
vvv IN'A'A VJUV E
JOB gwess
-EZR-
jLU 1 1:0 jrLUq -PERMal'VOJEN NOT
INCLUDE BLOCK WALL OR POOL.
TYPE OF INSPECTION
FOOTING STEEL
i MAIN GROUND SYSTEM
GROUND PLUMBING
PRE -GUN ITE
00 NOT POUR CONCRETE
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WOR
7-
60 NOT POUR CONCRETE
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HF_ATl NG & VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 0 8'
FRAMING
INSULATION
PRE -ROOF
OyAl
mw
POPow-
ALL ABOVE HAS BEEN
COVER NO WORK UNTIL
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
ELECTRICAL
PLUMBING
FINAL GAS TO
H NG - A/C
_q0USE NUMBERS
i06 COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
LICENSED CONTRACTOR DECLARATION
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
CN W Professionals Code, and my License is in full force and effect.
O =) C„) License # Lic. Class Exp. ate
d u7
�LLJi 6 4 4 B 7/3
oZ r, -Dater Signature of Contr for
(O 0' "r
J U C:) OWNER -BUILDER DECLARATION
U W I hereby affirm under penalty of perjury that I am exempt from the Contrac or'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 isnot intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) .1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
cr) O I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
ON
rn
FL _Q WORKER'S COMPENSATION DECLARATION
p cc 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 U u- compensation, as provided for by Section 3700 of the Labor Code, for the
O � JQ performance of the work for which this permit is issued.
m Q U ( ) I have and will maintain workers' compensation insurance, as required by
O 0 Q Section 3700 of the Labor Code, for the performance of the work for which this
d t Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier STATE FUND Policy No. 046-0007338
ao �
1� O
eo 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 so as to become subject to the
workers' compensation laws of C.,. ornia, an ree that if I Id become
3 subject tot rkers' compens ion provisions Section 00 o the Labor
Code, I sh I rtith comply w)(h those provisions.
Date: Applicant
Warning: Failure to secure Workers ompensation coverage is unla 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 at 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, an tate laws relating to the building
construction, and hereby authorize rep sent Ives o this City to enter upon
the above-mentioned pro rty r ins ction pu os
Signature (Owner/Agent)
BUILDING PERMIT PERMIT ti
DATE VALUATION LOT 0008-044 TRACT
OD $240,117.10 16 29457-1
JOB SITE
APN
ADDRESS 79-760 RANCHO LA QUINTA DRIVE
1 649-100-019
OWNER
CONTRACTOR/DESIGNER/ENGINEER
SPARKS CONSTRUCTION
SPARKS CONSTRUCTION
79-295 RANCHO LA QUINTA DR.
79-295 RANCHO LA QUINTA DR.
LA QUINTA CA 92253
LA QUINTA CA 92253
(760)771-1941 CBL# 2996
USE OF PERMIT
SINGLE FV ILY DWELLING
SFD-LOT 16 PLAN E2R - PERMIT DOES NOT INCLUDE BLOCK WALL OR
POOL. 75% PLAN CHECK FEE REDUCTION FOR MULTIPLE ISSUANCE OF
SAME PLAN TYPE.
CUSTOM CONSTRUCTION 4924.00 SF .
PORCH/PATIO 235.00 SF
GARAOEICARPORT (SF) 9,212.00
ES MATED COST OF CONSTRUCTION
240,117.10
PERMIT FEE SUAD4ARY
CONSTRUCTION FEE 101-000-418-000 $1,133.00
�>
PLAN CHECK FEE 101-000-439-318 $232.24
r:�:•
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 - RES1D 101-000-241-000 $24.01
GRADING FEE 101-000-423-000 $20.00.
DEVELOPER IMPACT FEE $1,907.00
ART IN PUBLIC PLACES - RESIL 701-000-255-000 $100.29
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$3,892.03
LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE NOW
$3,892.03
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR