0006-287 (SFD)LICENSED CONTRACTOR DECLARATION
U. 1,hereby affirm under penalty of perjury that I am licensed under provisions of
I— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
WProfessionals Code, and my License is in full force and effect.
O LU License # Lic. Class Exp. Date
66f$95 13 04/30/2(
oZ r- Date�- �`-'Signature of Contractor ~~ ---
0
� U
C> OWNER -BUILDER DECLARATION
w w r- 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). 4_ ;
�
O I am exempt under Section B&P.C. for this reason
O N Date Signature of Owner
rn
IL Q WORKER'S COMPENSATION DECLARATION
C) 2 Z I hereby affirm under penalty of perjury one of the following declarations:
U-) Fes- O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w Y= compensation :as provided for by Section 3700 of the Labor Code, for the
Oro J Q performance of'the work for which this permit is issued.
Q () ( kf'Save and will maintain workers' compensation insurance, as required by
O UQ Section 3700 of the Labor Code, for the performance of the work for which this
11 H permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No.
cb 5 SUPRIUQR N.ATIO14A WCNW038.A
�C)
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
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shat forthwith comply with those provisions.
Date: -^ 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
BUILDING PERMIT PERMIT#
DATE �.•y1 VALUATION LOT 0"_128? TRACT
' 28490.7
es.6 S239,71240 43
JOB SITE
APN
ADDRESS 79-710 CrMVS
769K410-013
OWNER
CONTRACTOR/DESIGNER/EN INFER
3400 CEN:C ALAVI?ME STE 3x5
8400 0,1KTRALAVYA4IJE V E 325
RIMSME CA 92506
R VE.RSJDB CA 92506
(909)682.5352 CBI* 53136
USE OF PERMIT
.3?0- LOT 43 PIAN 3 PERMIT DOES NOT INCLUDE t3=K WALLS OR
POOL 75 Vo PLAN CHECK FEE, REDUCTION FOR. ISSL3ANCE OFSAME
PLAN TYPE
CUSTOM CONSTRUCTION Z3$5.00 OF
PORCH/PATIO 324.00 Sl'
C}.I RAORfCARPORT (010) 10,384,00
1I +"0F+JI/i:IND COST OF 0014 s1`kMCnON
239,112.450
pfe2aw, T%ER sl;:tlehli+f"Ry
CONaSTRUCTION FEE' 101.000-418.000 $1,129.50
PLAM CHECK FEE 1011-000_439-318 $230.37
,1
MECHANICAL FEF 101.000421.000 $85,"x0
ELECTRICAL FEE 101-000,420-000 $188.31'
t ,:
PLUMBI.NO VEE 101-000-419-000 $1811'63
1
STRONQ MOTION YFft • RESIO 1011.000-241-000 $33.97
..;w.
GRA,UINCIFEE 101.000.423.000 120,00
7101
DEVELOPER 1NIPACT F>vE $1,907.00
AIT IN PUBLIC PLACU - RESIE 701.000-255-000 $99.28
SUB-TC1°AL CON SMUC'I101TAND PLM CI-DiC3C.
$3,665.68
LESS PRE -PATI? 1tM
$0,00
RECEIPT
DATE
�B `
DATE FINALED
INSPECTOR
00
INSPECTION RECORD
f.
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
GCS _
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
�%—
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
_ �_
F.A.U.
Framing
Compressor
Insulation
_ _
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
- ��
Heater Final
Water Piping
_
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
o
,�blw OF LA QUINTA
OF 777-7012
- BUILDING & SAFETY DEPARTMENT
` 777-7012
.�Q iA%% INSPECTION REQUEST LINE
777-7153
Owner SHEFFIELD HOMES
Contr$ctor SHEFFIELD HOMES
Permit Number 0006-287
POST ON JOB IN CONSPICUOUS PLACE
I INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS '79-71p.-0.177 US
"
SFD- kQT 41$ 2 PERMIT DOES NOT
INCLUDE BLOCK WALLS OR PERMIT
TYPE OF INSPECTION DATE IN
FOUNDATION & SETBACK 'Ca
FOOTING STEEL- - Qj
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE - G,
DO NOT POUR CONCRETE UNTILALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB _
JOISTS & GIRDERS
ELECTRICAL GROUNDWORK
/ ,
DO�NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
f ROUGH PLUMBING
f ROUGH GAS & GAS TEST • Q -
HEATING & VENT- A/C
FIREPLACE
ROOF -
BOND BEAM
O.K. TO WRAP 3
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION 12
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH /
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS ..
ELECTRICAL • ^ L- Cl ( /�Cl�'
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Certificate o,f 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
Type of Construction:
Owner of Building: SHEFFIELD HOMES
Building Official
79-710 CITRUS
vrii
Bldg. Permit No.: 0006-287
Land Use Zone: RL
Address: 3400 CENTRAL AVE STE 325
City: RIVERSIDE CA 92506
By: KIRK KIRKLAND
Date: 6-1-01
POST IN A CONSPICUOUS PLACE