0101-279 (SFD)LICENSED CONTRACTOR DECLARATION
U) 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
04 W Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
r` LO
iLLJ_
Z r ,pate ,I ' '� "'� I Signature of Contractor `� -- -7
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0,(^W OWNER -BUILDER DECLARATION
Ha r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
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).
co () I am exempt under Section , B&P.C. for this reason
LID
N Date Signature of Owner
ON
rn
Q WORKER'S COMPENSATION DECLARATION
CL
o Z I hereby affirm under penalty of perjury one of the following declarations:
LO O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W compensation, as provided f)r by Section 3700 of the Labor Code, for the
m� Q performance of the work for which this permit is issued.
Q C) ,( I have and will maintain workers' compensation insurance, as required by
O Q SWI
3700 of the Labor Code, for the performance of the work for which this
d H permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No.
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 shall forthwith comply with those.proyasi6` s. t )
,Date: Applicant i _ °; -ir 1 a`, `�1 a �I t
Warning: Failure to secure Workers'tCompensation 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
4 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 inspectiompurposes.
VSig"nature (Owner/Agent),,--,,6; �/` 1,4lki DateNIJ
BUILDING PERMIT PERMIT# ,
DATE VALUATION LOT E}�.�1�,•-.� _� TRACT
S 49 23-190-7
JOB SITE' IAPN
ADDRESS
1+9.-T70 >G. rmuf'
t 7,1 t 418.9
OWNER����yy
CONTRACTOR INFER
R / DESI��GNER�/ EN
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MMS
34'13d1('�;G. A?1MAL AVEME WE, 32
..7-400 (Xi`t':iRAL AVOM S TE 325
R TWM"q F_ CA 92306
RIM. =E• CA 92506
(909)68.2w5352 C3L# 5386
USE OF PERMIT
1;1 ICTUS , FAXaAULY D'VR ..1.1x7
ip
SVD— 17dAX'2AR. iC3'1AL). PERMIT i7OPS'NOoT YNCLU
BUXKWs IA41F'OtJJ1.dDR5V97WA.Y APPROACH, `iS% PLMI CHl±XT YN
11FID JCiT1014 FOR Mi71' TIPL&I 1 x5xIMCE, OF A.A119 P14W TYCa'�.
PORCIVIP.A` IO X14.05 Sy
(OF) 10,444,00
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COaN; TRUCTION F .E 101.000.41 S -OW SJ1129.30
1%I,A14 CHWIN, F82 101-000-439-318 $233.°"
1dltv.,Ckd011C.A1 FEE 101.000-0.421.000 $05,3{6
P:1IM11TRICAL FEI1r' 101.-000-420-4)00 $164.31
FLUMBING ME 101-00.419400 5131.7
STROM MOVON rte?.-1iUF'''1 101-000.241 -t1d?ti $21.w
(21RA01190 T?FA 101-000-423-000 000 $20.00
INFRASTRUt'TURF,FES 225-441(2 443•:a42 $!,oV7.00
ART M PUMAC P Al WS USE 701 -000 -255 -WO SMAR
010'•Ti:A['L CMNSTALi•CM'iJ.iZ'N f'UL'WA.).R'L6AN R. i.E:1..raCK
Zr PRU-PAM
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AAL
RECEIPT
DATE
BY f /p/
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 I 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
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:
f,
CITY OF LARffAp
��Fc„wva BUILDING & SAFETY PAI%TM1T
`y OF Ttn•
777 701 6
INSPECTION RE(VES_qIN
777-71r910
Owner
SHEFFIELD HOMES
Contractor SHEFFIELD HOMES
Permit Number 0101-279
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-770 CITRUS
SFD-PLAN:2AR LOT 49-PERAIIT DOES NOT INCLUDE
BLOCK)VALLS/POOL/DRIVEWAY APPROACH.
TYPE OF INSPECTION
DATE INSP.
FOUNDATION & SETBACK
- C/
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
ilaz/J
JOISTS & GIRDERS
ELE TRICAL GROUNDWORK
1..2/S
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
• ROUGH ELECTRIC
ROUGH PLUMBING
1 ROUGH GAS & GAS TEST
- _ C:
HEATING & VENT -A/C
FIREPLACE
ROOF
_ Q
BOND BEAM
O:K, TO WRAP
7 7 -
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
ELF az
' PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
' EXTERIOR LATH
POOL PRE PLASTER
I POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
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 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
ollowing:
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R3 Type of Construction:
Owner of Building: SHEFFIELD HOMES
Building Official
79-770 CITRUS
VN
Bldg. Permit No.: 0101-279
Land Use Zone: RL
Address: 3400 CENTRAL AVE STE 325
City: RIVERSIDE CA 92506
By: KIRK KIRKLAND
Date: 7-30-01
POST IN A CONSPICUOUS PLACE