9706-048 (SFD)LICENSED CONTRACTOR DECLARATION
U) 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
N W Professionals Code, and my License is in full force and effect.
O =) C*3 License # Lic. Class Exp. Date
CE L0ta1�10'id 13 ;C �7131r97
Z Dated Signature of Contractors
T
O � t i /`•
U 0) OWNER -BUILDER DECLARATION
CD
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ U) 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
ON
a)
Q WORKER'S COMPENSATION DECLARATION
CD 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 �= 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.
CD Q U ( ) I have and will maintain workers' compensation insurance, as required by
OU Q 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:
� Z Carrier Policy No.
cb O STNI` ., Ft N) 07 LOW,
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' compensation laws of California, and agree that if I should become
3subject to the ,workers' compensation provisions of Section 3700 of the Labor
/Code, I shall forthwith comply with those provision's. �y
,Date;!. ) . ,,I, '� 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 vpi if
work is not commenced within 180 days from date of issuance 9f/such''/
permit, or cessation of work for 180 days will subject permit to canL<ellat oo�n/.
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
A above-mentioned property for inspection purposes.
c �, �—
YSignature (Owner/AgIent ) Date'
BUILDING PERMIT PERMIT# CONTROL#
4WOU 5305
DATE 61 5197 VALUATION %191,7.19,641 LOT 13 TRACT p% 51 Y
JOB SITE
ADDRESS 78.87: RIO SK(M
APN
64&332-()11
OWNER
CONTRACTOR DESIGNER // ENGINEER
[, t ( t tt 1
�i1i,i DEFI!:l..1� 1�i: Y� 1�1•SJ 1'11
j/
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JI�11,C\{�4j
110 BUA 719
7929:+ RANCHO LA QUINTA DRl
(A f:11.11AI rA CA 92j33
LA 01 IiNi•A CA 97253
. f7ti(Ij771-IpA1 ('111,11 '>�ti
USE OF PERMIT
St�(a
SF01.v1 73 KAN V 441(
CUSTOM CONSTRU01'10N Z,%*8.00 SF
GAKA(JIf(_7A141kA(T 639,W) SI:
USTINIXf E, D COST OF COINIST:<tUMON
191,739.60
>f'.i•�kI1tIT lr i+:F, ISIJAlN 1ARY
CONS•IitUCT"ON 1:FK 1014M-419{ 01KI $961..50
1 QkN CtlY t:'. 1''1 1i 101 -W -4V-:418 $75!!I.Ski
NII SIA NIC,P 1J, IX 101 -000 -121 -USI) ss i.5u
ELEA71RIC;AL ctrl"s 10140.420-000 $142..16
PLIM11INCj FRb 101-000-41941M $I56 50
S'ftJNE314ICtint,)NFk-E-Rfmw 101 -W -2Q1 -0M 114 t'
GB&DIiNC; ISIS 10.1-000.421-tfW S6t).t3t�
I1 I4U—.8TR1K71 kE FET. 225-WU-443-342 $4,314.14
ART IN PUBLIC PLA.r"F..9 - k1 -X11) 701-0011-755-000 $229-35
P1,A_N CtI11C"K Tl; 10! 0tK)-439-?1�3 .t"7 67
;
SUB -1 MAL. Cr:.?NMIJC110N AND PLAN CHECK
K711.08
47 LESS Pit Fs -PAID FE41.S
45'97.0
TOrAl, PT:Iil11T FERS DUE NOW
$6,124.41
RECEIPT
DATE V
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 Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath -
Drywail - Int. Lath
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
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
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
Fi
Utility Notice (Perm)
3/31/98 CITY OF LA QUINTA
r INSPECTION SUMMARY REPORT
Permit Number 9706-048
Site Address 78-875 RIO SECO
Rereference Number
Site City
Location of Project
Date Applied for 6/5/97
Date Approved
Owner Name TD DESERT DEV LTD PA
Date Issued 6/5/97
PO BOX 719
Date Finaled 3/4/98
LA QUINTA CA 92253
Date Expired
Contractor Name SPARKS CONSTRUCTION
Valuation $191,739
79295 RANCHO LA QUINTA DR.
Fees 6,712.08
LA QUINTA CA 92253
Description of Permit SFD LOT 73 PLAN V3 -3R
INSPECTIONS S CHEDULED OR C OMPLET ED
Scheduled Completed
Date Date Time
Inspection Type Inspection Result Inspectors Comments
9/11/97 9/11/97
B7 -WRAP PASS
9/23/97 9/23/97
B9-INSUL PASS
12/19/97 12/19/97
DO -E -FINAL PASS
3/4/98 3/4/98
D1 -G -FINAL PASS
3/4/98 3/4/98
D2 -COMP** PASS
5 Inspections completed.
03/04/1998 11:19 619-771-1841 'SPARKS CONSTRUCTION PAGE 02
CITY OF LA DUINTA
'qlllWoFllkQjjMAFETY DEPARTMENT
77740112
JUN 2 p J�ECTION REQUEST LINE
r/7 -71S3
Own�FINAR@BW DEVELOPMENT LP
SPARKS CONSTRUCTION
PMI I Mu+nb�r 9706-048
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
,108 /i00RE83 78-875 RIO SEGO '
SFD LOT 73, PLAN V3 -3R
rfK OF INSPECTION ( OATE I INSC.
MAIN GROUND SYSTEM I
V f -
awouNe aI-uYRIIin I —"7 ., — T,
00 NOT POUR CONCRETE UNTIL AL VE AS BEEN 1 ED
CONCRETE SLAB 6
JOISTS 6 GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING 3 VENT - A/C
FIRE"CE
O.K. TO WRAP
GROUT ❑ 4' O S•.
FRAMING
COVER NO WORK UNTIL ABOVE
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE 3 GATE
SEWER SEFgM TANK
FINALS
ABOVE APPROVALS 00 NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING