9612-015 (SFD)*� LICENSED CONTRACTOR DECLARATION.
1. 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
tI,Professionals Code, and my License is in full force and effect:
License # Lic. Class Exp. Date
674074
Date/ -t .',,�f �tfSi nature of Contractor''
g
OWNER -BUILDER, DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) l,'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 (Seca 7044, Business .& Professionals
Code)..
() I am exempt under Section 'B&RC.,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 the performance of the work for which this
permit is issued. My workers' compensation, insurance carrier & policy no. are:
Canter Policy No.
(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' compensationlaws of California, and agree that if I should become '
subject to the workers' compensation provisions -of Section 3700of th_e Labor
Code,. I shall forthwith comply with these p�ovlslons.
Date: A, A•%/ 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 a4
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 insspjection,purpose
Signature (Owner/ geP +�-�' f r �'� Date A. J�/'
PERMIT#• CONTROL#
BUILDING PERMIT
96,;Z-oIs, 442
DATE VALUATION S1",r4 LOT' 3'y . . TRACT 78343
JOB SITE
ADDRESS 718-1 4 p�it'R CARMEL� -_ - _TPN
.-IC!'�'� .G.�',�P�•� -
OWNER
't'.t��
CONTRACTOR/DESIGNER/ENGINEER
)t mss. .l'.i7ELi l., :!'141f "N 1 e; ;
21, t�,�.RKS CC;1",f.STkiJG�' 0'-',,
l�.ia.. Ci .i'_Ab.
-79.95.iLx%NCHO.LIIO�+iNTAUk.
LA, Qt3'NI A. CA,(9U53
LA QUIMP.A CA 92253
µ.
(119Y111-1941 Mr? 2996
.
USE OF PERMIT `
Sf&A- X"FAM.rL Y >: WE LLINC'I
P MNIrt M' S'PVFJ.WT AN ART IN PUB -11C KACT3w (XV-t?t'T O
5213,95 P1lm AoRVmvtpld'P w0m cfiwTtdl'PY.IJ�VtuLrJi��aFT�7
trWITOAlf CU011TIZ11 ;.''CION, 2s2;.t.00 W
110RCHOt AM' 010.00 AF
t;;'rNRA{: PI AiCPOIYT 4$60) 3V
tVVIA'3 r ' �" r' t ?' C %ia: zl ".['ION
gj y ti pj�,q(t y �g. yy iipp ■■ �p}• qq ,(yy5y7E'
T�IEfJD�A9@X•�� [��..�� 7lJ.tl.H�9,hi,Yl 9t -
_
i'LN1..4C':MC FPY, 101-000-4.19-31.8 1�Q.s1
tif.�tv.i3tl t;TC:1 ON'1 fry 101-000-418-000
i}rG,00.4°204100 st.i61.91
PLUl4filINO F93 101-000-•4t9-000 3. (42.00
PITO (3 NICi f`l'o-N FFF 3 RH-;1141 0' 1 %
• tTdriaA11°l`.fEds�=1't,kt'<I:�i�'ri� '���-inti-fi�3r3i1 ��e.i��'�1
AR'r IN PLI'131,1C Pt, ACES - RY,3iU 70I -000 -25s -b f1 hof;� Via'
ART Rfi.391? 7014KK)-255-000 .$4E3 �5
v
SE i?t•`i'E t��I�C:ON'4T`ttt,f{;"l'ib,N';�I'�1Dq�{p��3♦`.AyNy�(C�:lT)FC
1$,,5()0,57
y�
'3DH'r1$. L}E.l8i1AtHT1' 11 +; :.N DUE MP0V'
- A
RECEIPT
DATEBY
D FINALED
INSPECT �,/
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
TINSPECTOR
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
Utility Notice (Perm)
V.
Ill
.. 2
a
s i
_ CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION "ftTq fA QUINTA
777-
Owner T.D. DEVELOPMENT DEC 1 0 1996
Contractor SPARKS CONSTRUC ION
Permit Number 9612-015 FINANCE .
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-776 VIA CARMEL
PLAN 1 TERRAZA
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK — 3
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING ICYA
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB -/
Ilelle-
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST 7 L
HEATING & VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION '
PRE-ROOF-
COVER
RE-ROOF
COVER NO WORK UNTIL ABOVE HAS IJEEN SIGN D
DRYWALL INTERIOR -
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FI NA
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT -TO
7/96 TURN ON UTILITIES OR OCCUPY BUILDING