0308-049 (SFD)LICENSED CONTRACTOR DECLARATION
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
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
7281 tit
Date 2Z X
. i Signature of Contractor.
OWNER -BUILDER DECLARATION
I 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 the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. -are:
Carrier 01g) ftgp1)EI•,1C 1110,0 Policy No. 14' VCIODA3400
(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 provisionsr
ate: 1,. 4:' -AM Applicants
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) /�/r�.�c' Date
BUILDING PERMIT PERMIT#j5
DATE VALUATION LOT TRACT
JOB SITE
APN x
ADDRESS 4a-0:0.�ARKMA.Y NIS acUNhWE.. ;u�.��.c�� T
69,941%W-023
OWNER
CONTRACTOR/DESIGNER/EN (NEER
L1_NW,Tt HOMES OI= C'AT M1:{MAi
11il-41 1Z HO1f�1.a,� OF CIA' 4iIOR I
78-40) C HtCf1'•:RMAY 11.1
78-401 C IRG14-WAY 1 I 1
LAQUDJTA CA 9 2,253
UQi7INTA. CA 92253
(760)777,0131 MIX 3434
USE OF.PERMIT
• itaLE\i®LE" TANM i1 ,W%1.19G
SX0 � Lt37'; PLAN X. PWZM1T tarrJES NOT 1=1.,UDE. BLOCK ')k7s11.L:.
i?tX4.4 SPA, OR DFtiti'I,'cT&Y t�,PPR(AA(,"H
i R'ACT C ON0,TR13ICTIt: N 2,121,00 S
45.00 SF i
a0
0 SF
EUDAMD COST OF C:OLE1"GERITM- 011T
12413VA9
LMTG 2+MFMi1? ' . Y
WASTRUCTION TION FTT', 101-000-418-000 $727.00
PUN CN.WX YZE 01-000-439-316 $597:4.4
URC'ksANICACL 1<'E 101-000-4-21 -000 $47,00
S LFZ TRJ CA1.,:IL'M 101-000.4.20-000 $tE6.68
I' LUMMIG Me 101-000-419-000 $1446.7i
T1t!'i1Nu�i MOTIL 'F'13.t� 1 1F3 12}1-f100-2 '1-600 til t.43
(3PLA.6' ING Clays' . 101-000-47,3-000 VAN
DZIEV3' 1.,C)PER1MA&C1 1FEice
W."I- -TOTAL CO130'1.7i13Ci`TOX AND PLAN ti"'k.lrWK.
$4,067-29.
IMS PRWPA D :7♦`8FS
$r1,00
T(MjL I?. +�"VVY-1"1"'lb°L"L?,S DUE 140 W
&.19067.2.0
. 1
RECEIPT
DATE
Y _a i ; L
BY
r 'sir r;
D, E INA
INSP TOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
Set Backs
Forms &Footings
Slab Grade
Steell�
Roof Deck
APPROVALS
_
Ib _ _ _
_
/ _ _
/ �_
MECHANICAL APPROVALS
Underground Ducts i
Ducts j �= n„
Return Air _�-(�/'j"r
Combustion Air
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
`Q
Compressor
Insulation
Fireplace P.L.
O _
Vents
Grills'
(/
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
r "— —
Final
_
�-7
POO S - 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
_ a
Gas Test
Electric Final
Waste Lines
J V
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
_ _
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral_
Sewer Connection
_ _
Pool Cover
Encapsulation
Gas Piping
_
Gas Test
Appliances
Final
COMMENTS:
Final _
Utility Notice (Gas)
ELECTRICAL PPRO ALS
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)
�Y
YI �
as '
REGISTERED INSPECTOR'S WEEKLY REPORT
JON T'ANDY
78-194 Elenbrook Ct.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT,
❑ REINFORCED MASONRY ❑ FIRE PROOFING
G"
❑ O -HER
JOB LOCATIQ N
R,. EPOBT SEQUENCE N0.
TYPE OF TRUCTURE
PERMIT NO. CL (�
DATE
DAY OF WEEK
MAZERIAL DESCRIPTION CC
ARCHITECT
INSP TOR
Hq& CHARGED
2�
ENr(NEER
011 roc
ASSISTANTS
HRS. CHARGED
INSPECTION GENERAL
DATE .CONTRACTOR_,
CONTRACTOR
w r, %
w - w : �.,.� -►moo.
COPY SENT TO CLIENT ❑
CONTINUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
'NOTED, I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
,
SIG URE OF REGIfIERED INSPECTOR
DAlt OF REPORT REGISTER NUMBER
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
728102 B HIC 9/30/04
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I 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 i$ 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:
Carrier OLD REPUBLIC INSU Policy No. MWC100845400
(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.
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#
0308-049
DATE VALUATION LOT TRACT
$124,530.00 2 29323
JOB SITE
ADDRESS _ 43-658 PARKWAY ESPLANADE EAST
APN
609-380-023
OWNER
CONTRACTOR /DESIGNER / ENGINEER
LENNAR HOMES OF CALIFORNIA
LENNAR HOIvMS OF CALIFORNIA
78-401 C HIGHWAY 111
78-401 C HIGHWAY 1 1 1
LA QUINTA CA 92253
LP. QUINTA CA 92253
(760)777.0131 CBL# 3434
USE OF PERMIT
SINGLE FAMILY DWELLING
SFD - LOT 2, PLAN 3C. PERMIT DOES NOT INCLUDE BLOCK WALLS,
P0014 SPA OR DRIVEWAY APPROACH
TRACT CONSTRUCTION 2,121.00 SF
PORCH/PATIO 45.00 SF
GARAGE/CARPORT 447.00 SF
ESTEKATED COST OF CONSTRUCTION
124530.00
PEIZD= FET 5'UNIMARY
CONSTRUCTION FEE 101-000-418-000 5727.00
PLAN CHECK FEE 101-000-439-318 $597.41
MECHANICAL FEE 101-000-421.000 $47.00
ELECTRICAL FEE 101-000-420-000 $116.68
PLUMBING FEE 101.000.419.000 5146.75
STRONG MOTION FEE - RESID 101-000-241-000 $12.45
GRADING FEE 101.000.423-000 $15.00
DEVELOPER IMPACT FEE $2,405.00
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$4,067.29
LESS PRE -PAID FEES
$0.00"
TOTAL PERMIT FEES DUE NOW
$4,067.29
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR