9810-074 (SFD)LICENSED CONTRACTOR DECLARATION
Ihereby affirm under•penalty of perjury that I am licensed under provisions of
b. 6 6i er 9 (com'mencing with Section7000) of Division 3 of the Business and
Professionals -Code, and my License is in full force and effect.
.`L icense u > Lid. -bass Exp. Date
6110100
,I �Dafia" ' ' Signature of Contractor
OWNER -BUILDER DECLARATION
1 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 theperformance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier :. 66,,y: ryt +T f�t1, Policy No. if -12
035- y q 30
f
(This section need not tie 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,J shall 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 & eachperson aC' R
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 'nspection purposes.
Signature. (Owner/Agent) Date 1�
PERMIT# CONTROL# f
BUILDING PERMIT
DATE VALUATION $2..t.)j74t.1A.0 LOT TRACT
422
JOB SITE—
ADDRESS 9-'"S 0RONJA ..
TPN769-4.60-009
OWNER
CONTRACTOR /DESIGNER/ ENryGIINNEEy'NR
RSt��i'���11Z MT I.7i`� TS, IIII.. -
PU 130.I 81.4
14,15E. UNI•V1;lafi1`i"i' DRIVE
LAQLiIl3'!A CA 9225$
k°ETtZENIX A7 8503-4
w
5746E CUP, 4M
USE OF PERMIT
MILV D�.):
G&GLJ A
SFDJ OT II 50,-PLAN130k PE MUT DOES NM INCL'i'iM BLOCK. WALL
-.
X312 �tE3I.. I'l���i'1' k«E� R}3N7iJi;�' Ii"l'' 7S'�o!;'J�� MU1r�'ti?i,> IBSiTAIVCI"s �J1
4AMTs t�l..e�2d' `�E
CtT"�T%�"tiv'I a saPiS%I'ith"`d'iCaid ",Fj3.C61 ��•
PORCAMATIO 130.00 V. '
GAF.A40W(%ALW0RT 578.00 SF
. LSn.YTlt� A $'L:r,D l..081' OF �'!.l.t'�rS A MfMONT
VERM T F 1�TE S :fN t ARY
CC).NSTRUCTIt:D'NkE15 101 -OW -418.000 $1,108,50
All e:KNICALFf— 3.1.0.00
ELECTitXCAJl F•F1 I{ii;-(i(H3 I°ai1.flC10 21.68,22
1'1..i7flMIiNG FEE 10140404M 2180.5di
S^1'��Mr :MiyiTt�At,�*,� -k'9 S1� I�:1.-►,llK►-`€q.l,-f�?(i - $�;3T
•
A0P,q Tz'.L.T� 10: -OD.0-42,3.000
' ifvi a.4 tI C7TUFF.tti i:v1 15,220A4
ry25-()(ids—�Y�3�-(��}�29
x %A�t2T tN IJU.�LIC''.£.7�.:i�CES - IkESI.tr 70)^'U�JV`£':1'. -ow
F
'.To
1.I.; CONI 1 =D__QN ANI) MW CRECK
f 7,i%i
LESS P: '. �-PA:ID t F S
v �d
$0.l3G1
OCT 14199 ro'r:f►3:: I*RR+d:1T FEE -8 VU Bq, NOW
MYS6.4
-Try
r Lb"a��l�Ta��
1,u
s•.
RECEIPT -
DATE
6Y
DATE FINALED
INSPECTOR
�,
INSPECTION RECORD
0."
"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
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
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
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 I
Utility Notice (Perm)
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
111/115/lyy5 b1:41 /bUbb4JJ41 LA• UU1NIA FAIHWAYS
HAUS b'1
�
CITY OF LA QUINTA
. —51.111-A U FEIY DEPARTMENT
- ......�....... � :�...► . ,_., . (;�....... 7 7012
INSPECTION REQUEST UNE
UCS, .i. 41998 777-7153
VArbi e♦ r LC
Contractor
Permit NUmbsr 9819-074
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS
SFD, PLAN 3GR5 LOT #50, PEMT DOES
NOT INCLUDE BLOCK WALL OR POOL
TYPE OF INSPECnON OATE
FOUNDATION A SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING 16
PRE-GUNITE
d0 NOT POUR CONCiiEt!' UNTIL ALL ABOVE HAS E£ 1p0NED
CONCRETE SLAB
JOISTS A GIROeRS
ELECTRICAL GROUND WORK
L _."40T POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS A GAS TEST
HEATING A VENT -)VC
FIAFPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT 0 4' ❑ 9'
FRAMING ... ' `71l!
INSULATION
PRE-ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR i 1
EXTERIOR LATH
POOL PRE PLASTER
`
• FENCE A GATE
SEW SEPTIC TANK I
FINALS
ELECTRICAL -�
PLUMBING
FINAL GAS TEST
i' TING • A/C
�,vo+JSE NUMBERS
JOB COMPLETED
TEMP POWER i
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Certificate of Occupancy.-._
Cit of La Quinta
Building.and Safety Depcj'rtment.
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: • 79-465 TORONJA
Use Classification: SFD Bldg. Permit No.: 9810-074
Occupancy Group: R3 Type of Construction: VN " Land Use Zone: RL
Owner -of Building: RJT INVESTMENTS INC Address: 1425 E UNIVERSITY DR
City: • PHOENIX AZ 85034
�a By: ' KIRK_KIRKLAND
Date: 6-23-01
Building Official
POST IN A' CONSPICUOUS PLACE