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9909-294 (SFD)�¢. W. C) c) r - (f lI) ' W it o Z � OO H ( J D W W ►- a U) Z ch LO N ON U °) CL Z �aIr 0 0 J J mUU O d In H Z_ cb /ryZy Q 'J 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 �itirR95 I3 �A if3(t� .'.ik Date �' Signature of Contractor It 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. tott1U,tln .. ♦•t^Yf".Y.•4 WY 1, 1t0ov_O a.a.li !r[\R�1.\ 2YlSt l..tl4lt VY y1Y lVV.MlM , (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: IrY 2 All 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.$100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT-Applioation ie hereby-mado to -the Dirootor of Building and Eafoty— for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to 1 any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La.Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced'within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property,for�iff'sIrpection pur oses. Signature (Owner/Agent) Date t PERMIT# BUILDING PERMIT ry DATE 1()11)711 "VALUATION LOT �� TRACTJOB SITE ADDRESS 79-320 C -liU'i OWNER CONTRACTOR/DESIGNER/ENGINEER c- 4l.rT:r:n:r rfti%AF S ..t•...! ..,..,D 115 r e;r t ;�• .kll,.'i/l.;i.i, t.f�ttit..! 3-iOG Cr-NI—Ki iL AVENUTC tiffs 325 :WOD i:I" ZI-1UiF, AVENUE Slli 325 RIVERSIDE (,A 9506 1Z1b' RS1DR CA 9250_i 60)".1.53i7. 1311.01 5196 USE OF PERMIT , r44"►l,8 r'fii+,1II, i iaWF.1;.FANC, tit'U. i,V? i$, i''I." l -'J1j <1M1_t IXlti`S NUi 1Nr1LL VK v".JL,7."16 HlA)t.lt; rltjf1 t -)N PLi16N t f ffi K FEE* FkAt ML IIA'Iftli I.S.S .tA N(Ai ur gAM[-. PLAN TYK, i U TOM CON.', TI R.U(`TION Z 162.0) 1*1F i.;ARAi ti:' CA10U:1t4T St! 1.+N► til; W-4 4'41D ,1 'r'1j Ap /' 4Y'!1' l �� !'V'lhiiY' 4141 '7"Yp"! ! ♦'i.YY ltY�i1RA�.Rl M�♦II ��' 4.-!1 V.)�.MAI�..R k\!Irl 16,0 #.At It t {. A,glIwMJ•1.� iY7l�tsl'1�Lx�l'1+.)tYd�L'�i t1t9.111;+4-+iff3-(>{N! Vii,+)yi.tbl i�i.AtJ t`'►ii'�r�k F3�. t(11-Ilf><1.4'1�-�F1t t:+'?t 37 NTI;' IA dIC.'J.I'G1; IU1 tS10 •14111.000- . t sl.i t:`I l0 AL FM I t� l OLlU .1It7 l,+U(! i L S.19 r 1'LUMBIN(JPHE It'll -Wil-419-M) xrrtr awn ow,r'tflti h'1?i?. its:<;vn tlil.flfN1.?d1.1►f1f1 t*� it�t 1 + CMIA, 7INt:; FEE 1:Ii OGGO •`�3'fi0(1 ;�� rta r m—kl' (N& I' iM.f0 PI.m,Hi - Rath) 70) -000*-255.000 E. - fJ13V17.tlNi�t ifaltYAS'1' r1:1: �5i;�st7.tK� . `.! ST 1Tt-'T f, rVIT\IRM11I H'710M ANi7 Kii ,AIDS f-1+4Isrrilc 'i"OTAi, PVR1%1lT F1 V.% t)IJI, N0W RECEIPT DATE BY ( v/ 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 2 ? Compressor Insulation2Ol Gc� �/,�� Fireplace P.L. Vents Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - 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 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 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 Final Utlity Notice (Perm) -PIAN. 28 O � s s CITY OF LA QUINTA cF�of rr�°� BUILDING & SAFETY DEPARTMENT 777-7012 INSPECTION REQUEST LINE 1, 777-7153 Owner SHEFFIELD HO Contractor SJURR&IELD-HOMES Permit Number 9909-294 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 79-JZU c l"I'KUJ SFD-LOT 18, PLAN 1. PERMIT DOES NOT INCLUDE BLOCK WALL OR POOL TYPE OF INSPECTION I DATE INSP. FOUNDATION 8 SETBACK ,_ - 2"- g FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB - JOISTS 8 GIRDERS ELECTRICAL GROUND WORK r DON T PO R CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS 8 GAS TEST W HEATING 8 VENT -A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP Gtl GROUT ❑ 4' O 8' FRAMING 1.rZ j INSULATION < PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR EXTERIOR LATH l 8 GATE CTANK FINALS ! PLUMBING FINAL GAS TEST HEATING - A/C HOUSE NUMBERS r JOB COMPLETED TEMP POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING CITY OF LA QUINTA BUILDING & SAFETY DEPARTMENT 1of60 777-7012 i P INSPECTION REQUEST LINE 777-7153 Owner SHEFFIELD HO Contractor SUFFErRy D BONUS Permit Number 9909-294 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 7y-JZU ullKUJ SFD-LOT 18, PLAN 1. PERMIT DOES NOT INCLUDE BLOCK WALL OR POOL TYPE Of INSPECTION DATE INSP. FOUNDATION & SETBACK lz - FOOTING STEEL _ v - MAIN GROIJ14D SYSTEM GROUND PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB . JOISTS & GIRDERS ELECTRICAL GROUND WORK I 2 , DON T POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST W HEATING & VENT -A/C FIREPLACE i ROOF — i BOND B D.K. TO GROUT O 4' 0 8' FRAMING :2 INSULATION PRE -ROOF i COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR FOOL PRE PLASTER F NCE & GATE EWER EPTIC TANK FINALS ' ELECTRICAL _ � PLUMBING FINAL GAS TEST , G�1 HEATING, NC , JOB G TEMP ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING