9609-034 (SFD)U)
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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
,•.Qhapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Dale
67,1074
Date - <7 r Signature of Contractor -1 ' "1
OWNER -BUILDER DECLARATION
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 Policy No.
8 T'A`I: ' FTYNt'1 f 3 7 'tf 0594
(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 CaliforniEC and agree that -if -,l should become
subject to the workers' compensation �rovlslons of,Sectio700'of the L7 or
Code, 1 shall�forthw)th comply with those provisions.
Date: �� ! L' Applicant—
Warning:
pplicant 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. ,
Signature (Owner/Agent} •� 7 Date z'_'{"
/D`/` -i[ -/,b., PERMIT PERMIT °°"TR°_`#
-,.BUILDING � 0 5 9
DATE VALUATION $311,18 LOT 1.0I' �I TRq T�S,4
JOB + �t�t�f�lllli C11 [tfr
APNj�N�F �3.5
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
',t`.13. DESERT D111VEILCYPINNIRN`1` 11P
SPARKS C:ONK1'„ C)C1'10*4
P.O; PJCW 1716
7�1235.1th1qC 1,10 LA Cit ii1+1'1 A DR.
I.A QUIN I -A. CA. 02253
LA. QIJ1.N'1'.A. CA 92251
7'71-13'41
(519?)771-1941 C'13T..it 2996
MAR.MXe.C'RAM—A l.,. 044.
USE OF PERMIT
SijVtai 1; tfAty9ILA," OiVi t.la)N6
236724lttt"1'f:f11_;KU .
fiY,AN `L 1'A1.tit",1�>''1'CtA4."1' 2'du52_1, ,
PINMIT VMS S 1011X(71' tVN ART IN k147fil,K',* 41I.ACT;S C;R11,10T 01'
r'"11, "i`t: q.rYitJ;a'Itt4Y0CTbN 3.t:b.i30 F
i'' tD€TT."11!1*nTIO 12ff►.00 SF
t,�;`i'11itA'l'N,i��GQS'1'C1H f: �il�iw"1�'ttl);`Fit)3�3,�I,�i1►
PERMIT VERSUMIVIARV
PLAN CIIIsC1;.M 101-fl00 1�9-31� S?,133.3t1
UWSTRUCROW T fits 101-tiUf1-<31zt-(3(1I3 Si 38&.yfl
NIT Ci HANXAL VRK 101_0( *-4214)00 5137.00
FIR TRtCAL I7,13P. $227.09
1111x311IM0 FEE $296,00
S1'OhtO tVl011014 FI -A" -12.i SID 101 •()0}-2111-'000 $1I 32
Of1tA[)1NC hT11. 101490-42:140l $20.041i
1H11 RANIROC fURE U.,000,00
F'fti:CISE PLAN 101-0004141-345. $25.X)
AX1 t1v PUSL1C PLA.(,? s - RPM, 701.000-255-10 .&512-93
ART IN1JTliifAC Pi,AM-WO-255-WO
NU, i-"iakAt C0,14.1.41AV ;.1'i'ON ANI) I LP01 C:.T ui.'i:
TOTAL PERMIT FEiM Mr. NOW
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
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 Wail Insulation
Condensate Lines
Party Wail 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 I I
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
r ateral '1
Pool Cover
Sewe onnection
Encapsulation
s Piping
Gas Test
Appliances
Final
Final
UU14 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
r
Final
Utility.Notice (Perm)
COMMENTS:
asp
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
m-7012
INSPECTION REQUEST LINE
777-7153
Owner T.D. DESERT DEVELOPMENT
Contractor SPARKS CONSTRUCTION
Permit Number 9609-034
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS -78-969-CARMEL CIRCLE
-cir
4t
,....
SFD PLAN 2 LOT 9 _ i' ( ��
♦ . a I. - b% ---
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
Y;R(N INr) PI IIMRINh _ 07i
'PRE-GUNITE .
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB - - j
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST L
HEATING & VENT- A/C
FIREPLACE
ROOF /
BOND BEAM
O.K. TO WRAP O
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR 2 -
EXTERIOR LATH
POOL PRE PLASTER
POOL F
SEWER SEPTIC TANK - L�
tLtC:l HIUAL
PLUMBING
FIIJAI r.AS TFST
FINALS
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
1/96 TURN ON UTILITIES OR OCCUPY BUILDING