0006-285 (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
68 8,,95. B 04M/2(
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 f 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
per for . ance of the work for which this permit is issued.
( K II 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 SUPFSRIOY NATIONA Policy No. W047$0310.A
(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 shay
fort�;`� ith comply with those.proyisiorls.
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,atti5mey'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 12n
BUILDING PERMIT PERMIT#
DATE) ^N LUATION LOT "285 TRACT
�
S2 ,T.;S6.60 41 M90-7
JOB SITE
ADDRESS 79-690 Cff. Rul;
769-71.0-011
�ENINEER
OWNER
CONTRACTOR/DESIG
9MIVM,D HOMES
MEOREW HOMES
3400 CMVIRAT AVE (JE € D; 325
3400 NTRAL AWWR �I'.E STF1, 325
RPVE OW11 CA 92506
i r"MoS�E Cly 9.2506
(979632.5352 cpl, 5386
USE OF PERMIT
:#%T GlY- FAWLY D 10
SI D• LOT41 PLAN I PERMIT DOES NOT INCLUDE BLACK, WALLS OR
POOL 15 PLAN CHECK FELE REDUC T ION 1kilk ISSUANCE OF SAME
PIAN TYPE
CUSTOM CONSTRUCTION 2,712.00 SP
F6RCHMATIO 294.00 Sig
OARAOIUCARPORT QM MOM
ESTROATM COST OF C0HS=V(,"nOX
2213,756.60
1ERiVM FEE S'Uiviit+ WRY
1;:U10T.RUCTIOTI FU 101-000.418.000 $1,091.40
PLAN CHECK FEE 101-000-439.318 20223.17
MECIMNICAL FEE 101.000.421.000 2$5.30
ELECTRICAL IEE 101-000-420-000 $183.19
PLUMBINO FLY, 101.000-419.000 $1$1,73
'
STRONQ MOT1014 EEE • RE.51D 101-000-211-000 $23.613
ORAAJNO FEE 101.000-423.000 $20.00
0FVftDP2R IMPACT FEE $1,907.00
ART IN PUBLIC PLACES -RESIL 701-000i,.255.000 VIAS
4�
SUB-'WrAL COWTRUC2`iOU ANC) PLAN i[N Et: K
S3, -Y86.36
LM PR,7 -PAW FM
$0.70
TOTAL FEIVI +E FUS DUF. INOW
,7i3f,g3
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
G&
Underground Ducts
Forms & Footings
-W
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
�.
0. K. to Wrap
- GtU
F.A.U.
Framing
,?J
Compressor
Insulation
_
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
—1 _ cT
Final - —
BLOCKWALL APPROVALS
steel
POOLS - SPAS
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 6 I
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:
f+�L r .. - L -L L
S -CITY OF LA QUINTA
OF. BU� & SAFETY DEPARTMENT
v $ ,777-7012
SO- INS$_ECTPON REQUEST LINE
777-7153
Owner SHEFFIELD HOMES
Contractor SHEFFIELD HOMES
Permit Number 0006-285
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS
*� 79-690 CITRUS
SFD= LOT 41 PLAN 1 PERMIT DOES NOT
INCLUDE BLOCK WALLS OR PERMIT
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK = Ctf
FOOTING STEEL - cc/ -
MAIN
MAIN GROUND SYSTEM _
GROUND PLUMBING G
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
T�40*
DON T POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
nyy�n rwmvn��a
ROUGH GAS & GAS TE
HEATING & VENT -A/C
t FIREPLACE
t ROOF
BOND BEAM
0. K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
( PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR 2_"2 (lp _0v I
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST - l
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
C
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R3
79-690 CITRUS
Type of Construction: VN
Owner of Building: SHEFFIELD HOMES
Building Official
Bldg. Permit No.: 0006-285
Land Use Zone: R3
Address: 3400 CENTRAL AVE STE 325
City: RIVERSIDE CA 92506
By: KIRK KIRKLAND
Date: 4-11-01
POST IN A CONSPICUOUS PLACE