9706-051 (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 # Lic. Class Exp. Date
7/31/97
Date ; �` Signature of Contractor / { , — -- __—
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.
(,q) I have and will maintain workers' compensation insurance, as required by
SeStion 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.
S"TA714•"irnlr) 137 11 W 5%
(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
s&ject to the ' orkers' compensation provisions of Section 3700 of the Labor
ode, I ~hall f rthwith comply with those provisjons.
Date:41 >- - / 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 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) Date' � � ��
PERMIT" °°NTR°`A
BUILDING PERMIT
✓f7
DATE &,,"7 VALUATION & 73vo a LOT '71 TRACTJOB
SITE
ADDRESS 76-935 R10 4ECO
APN "45-332-014
OWNER
CONTRACTOR / DESIGNER / ENGINEER
M DESERT DEV i. CD PA
SPARKS CONSC UL t ON
Pt; Bt)3±i 713
N295 RANCHO LA QUIN'TA DR.
LA, Q(AN4'A. VA. 922.53
LA Q1'1NTA C.'..A 92253
(760)771-1941 CBLY 2996
USE OF PERMIT
SFD
WA) LOT 76 ,PLAN V2 -3.R
C.'USTOM CONSTRUCTION 1074.00 SI'
GA[U\OWCAPWOki SF
93TiMEtXILD COST OV CONSTRVC110N
173,657."
iYk,RM1'1 PCE SUMMARY
(100 TRU("T10N 1.7ra 101-090-418-000 Sf ,io
K AN C'+IHC K 1� .4. 101-4J0 4-19-318 $731.35
Ad -k tANLCA4, i- 10 t-000- 42 I _0W $79.00
1!Y RC-fRICA1...fr& 101 -000 -420 -OW $JX1.43
PL.U1v1;31►fC3 'Eli 101-000-410.000 $143.^63
1Tr0 n MOTION F V+ - RFIR17) 10:1-000.241-1100 517.37
tom' ADINCr FM 101-(100-423-000 $20-W
INI.RA!TrRitC11Lfl. 6 I. hill* 225 -(W -"X342 53,907.30
Aft,r .tN f tf14L1C' rL,AcR.4 - R; Lahti 701_000_254,g-000 StR4.14
Pt, AN Cf f TOK 17 F:11 101-0011.439.318 -s-W,51
1
i
F
1
SUB-TWAL CONS"TitUC"tION AND PLAN CHECK
$6,114.'14
LM PRE -PAID FEES
4548.51
T At. PERMIT r9CS 011E NOW
$S,.'161i,R3
a
ilk
RECEIPT
s
DATE +
BY1
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 Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
W=
Drywall - Int. Lath 4,f ,z
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
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:
4/9/98
CITY OF LA QUINTA
INSPECTION SUMMARY REPORT 1
Permit Number 9706-051
Site Address 787935 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 4/ 9/98
LA QUINTA CA 92253
Date Expired
Contractor Name SPARKS CONSTRUCTION
• Valuation $173,657
79295 RANCHO LA QUINTA OR.
Fees 6,114.34 LA QUINTA CA 92253
Description of Permit SFD LOT 76 PLAN V2 -3R
INSPECTIONS"
Scheduled Completed
SCHEDULED OR 'COMPLETED
" Date Date Time
9/23/97 9/23/97
Inspection Type. Inspection Result Inspectors Comments
9/29/97 9/29/97
B7 -WRAP PASS
B8 -FRAME PASS
.10/3/97 10/3/97
B9-INSUL PASS
10/8/97 10/8/97
CO-DWN PASS
10/8/97 '10/8/97.
C1 -LATH _ PASS
1/29/98 - "1/29/98
B21 -G -TEST PASS
4/9/98 4/9/98
D1 -G -FINAL PASS
4/9/98 4/9/98 -
D2 -COMP** PASS
8 Inspections completed.