0101-291 (SFD).. 1.
LICENSED CONTRACTOR DECLARATION
N I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04
W Professionals Code, and my License is in full force and effect.
CD ChLicense # Lic. Class Exp. Date
U-)
LLJ T-
62 1'� 681.5895 MAJ 0n
oZ ,,Date 77—!Signature of Contractor �� ar'•+*
W 0
r` �_o OWNER -BUILDER DECLARATION
H aco
r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
Cn 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, Businee;s & Professionals
Code).
�
, () I am exempt under Section , B&P.C. for this reason
n 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.
,( )r I have and will maintain workers' compensation insurance, as required by
SeFtion 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.
32
STATE FUND 1!016M74-00
(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 •�
ate: Ti • - f' Applicant _ `_ •�*� k��,�x '
Warning: Failure to secure Workers' Compe sation 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.iequest 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.
t Signature (Owner/Agent) 1t�' i� �gf1{jn Date -L! h
�y
BUILDING PERMIT PERMIT#
DATE VALUATION LOT O.101,_21DITRACT
11
48 2RA9 .7
JOB SITE f /r
APN
ADDRESS
79460 CATRUIS
OWNER
CONTRACTOR /DESIGNER / EN (NEER
Ia`r�Milio-D HOMES
51UNFI 1LI'm HCWSS
3400CS-14x dt LAT--,W , M, 325
3x•,00 CE %'CALr^� E'l-MY,
RxS1Ta -191 ME LSA 92506
x1W::RSlrf:. E CA, 925006
C7 IJ 538E
USE OF PERMIT
613.LY\Y%+.ii• d't'1LVJS%.9,T..k.� Vv1�C...Ii�E Y
s�.
�A'CT- l:°% ":281Z LX1'FA3 P!'..kMIT lJOVS iNOI 1N` uUDE
4
CUSTOM CONSTRUCTION UR6100 vF
F1t;2Ft(+lfr'1F'.ATIO 3L -9.0€i SF
'r
OAkAGWARPOl2"t' (M .1013M,00
5 :C3i ' rJF C`4 D3'd #T C Ia.O
.239.712,6
C41-15Ti1,litr°P1Cs;r FEE 101-000418-000 $141.2950
PLr m CliECK'LIE 101-040,439-318 $91548
`
MERCl3MICAL LVER 101-000-421-000 $85
S0
FILErCI-RIC J., FEL 101-000.4204.00 $16431
PlaIlMBIN43 Elt : 101=000415'-000 $11<&1
`bis
MTRONG JQ<4'OTJDI� PIE • lid 201-000-241-000
:tRAD11404 ME 11,01-000-423-000 $20
00
1"NkAS'1']tUC TURZ ME 22:5-•000.443-342 sliriv
00
Xfi:F N Fi BVIC P.LAMS - ROSE 701-000-25,5-000 $9928
LEMS PR:k - AIDET
R5 $0.00
TM'AL PF10TITNTES DUE NOW
t -1j :,26.79
RECEIPT
DATEBY
f r
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
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 ��'� 6- O (L�
Water Piping
Heater Final
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:
04;6
A
. s CITY OF L UST
O
c BUILDING & SAFE P�TI�JT
OF'I'Nt'° 777-701 oa
INSPECTION RE sitsNu
777-715 ZQ
Owner SHEFFIELD HOMES
Contractor SHF FFiFi D HOM US
Permit Number 0101-291
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-760 CITRUS
I
SFD-PLAN 2BR LOT 48 -PERMIT DOES NOT INCLUDE
BLOCKWALLS/POOL/DRIVEWAY APPROACH.
TYPE OF INSPECTION
DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
/
MAIN GROUND SYSTEM
GROUND PLUMBING
I L
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
j CONCRETE SLAB
JOISTS & GIRDERS
ELEC ICAL GROUND WORK
✓
-
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
- (J
HEATING & VENT- A/C
FIREPLACE
ROOF
L- _. dl
BOND BEAM
' I O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
- Gt
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK / n/
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO I
TURN ON UTILITIES OR OCCUPY BUILDING
0
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
Type of_Construction
Owner of Building: SHEFFIELD HOMES
Building Official
79-760 CITRUS
Bldg. Permit No.: 0101-291
VN Land Use Zone: RL
Address: 3400 CENTRAL AVE STE 325
City: RIVERSIDE CA 92506
By: KIRK KIRKLAND
Date: 8-01-01
POST IN A CONSPICUOUS PLACE