9811-047 (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
744091 1
/ i 1: J „ ; f .
Date _Signature of Contractor , r '�
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.
Se( ) I have and will maintain workers' compensation insurance, as required by
ction 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:
Carriers �� 6,7 Policy No..
M9ia[' .
(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.
VDate: ^r' Applicant '� a N x
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, indemnity
& 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.
dSig lure (Owner/Agent); �'"— ~� - +�- Date
r
t
BUILDING PERMIT PERMIT#
M 3-047
DATE % VALUATION LOT TRACT
3�y2,37�.2U a 248"
V2 2 l 4� z
JOB SITE i "
APN
ADDRESS 7� r5 LIMA
769-590-02 i
0
OWNER
CONTRACTOR/DESIGNER/ENGINEER
NISPEI°�,O PROPERTIES UC
SUM V1S',1A ."DEVEi,,Qi's`l• CORP.
44.189'1'OWN C,.El�fM-it. 6Vt� i' SIS D-140
42590 BRIGl°tPON
1�rt1.A�1 DES1 R T Gtr. 92260
PAUVI DS SEX17 �;�'. 922) t
(766)771-7626 C18t#3 .5393
+
USE OF PERMIT
t�Pl�,eL.ks f�AAlif,i�' �)4Vkl....itdi,i
A 3
Sr 13 -1'i iit i7' i f>%31vc a:1' IIuOG,UD �u n�i�i~ b�°A(4,t► tsls Ifni..
Ur
-u JL5 998
O S1'ON.t CONIS'i i.,UMtON: .3,12,00 W
PGliCi/i'E1T[C'f 630.0o
f3ARAG1dCAft!'0KI' BUa AIA SF
#s.�'1.1l1FEATE 0C,0SYOFVON S7FIRUC.°.II10N
362,379.2P
�
i:CiNS �tUG'.i'iC)N :�`h'� 1 til-0j�3-41 ti-iM]0 �1.5dli.iki
OtAa'fJ tYH(f FFT(nlAt1 - 3q�; i 11%);272.fA
.
I E1Alv'Iti11[.T �t3 ttJ-000-:121-000 S15i.tiE
Isf ►:("':CRTC L FTS 1.01-000.420-U04 �.'ifi7.05
PT.t.fwiTNO4.;T_X 101 -000 -41% -MO
8'11110140 P4017.9N FSE - RGSID .101-000-241.000 336.Zi
G ADINCIFEE 101-W423-0000
fNNR,A-STRUCTUREFE6 225-0130.143-3.42 U,t1i4o)
A_RT 1?4PUBLIC MACES - RITS 3 701-000-25.54100
LESS PRE-IMID k'TES
411,4'1(IM
,h E3TAL PERIA11 1+ 3+:I+.:S d)L E NOW'
$9,173.90
a 'Lip
RECEIPT
DATE
By J
DATE FINALED
INSPECTOR
INSPECTION RECORD r -
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 2, 01Z f? _(
0. K. to Wraprr'
Exhaust Fans
F.A.U.
,fit
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
, ,�G—
Final a
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 I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines yj
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 O
Utility Notice (Gas) r
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)
R.
a _ �CITY OF LA Q UINTA
B iNG & SAFETY DEPARTMENT
777-7012
�G TION REQUEST LINE
I
777-7153
Owner V* NISPERO PROPERTIES LLC
Contractor SUN VISTA DEVELOPMENT CORP
9811-047
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
7
` JOB ADDRESS 8-875 LIMA
SFD - PERMIT DOES NOT INCLUDE BLOCK
WALLS OR POOL.
TYPE OF INSPECTION
DATE INSP.
FOUNDATION & SETBACK
w
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
- -
PRE-GUNITE
60 NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
" CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT- A/C
FIREPLACE
ROOF
- -
BOND BEAM
0. K. TO WRAP
3
GROUT ❑ 4' ❑ 8'
FRAMING
J .
INSULATIONS�C
PRE -ROOF
`
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR S I G'L
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST 6-
c -
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED G _
TEMP POWER
Notice: '
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 12/11/98
No. 18099
Owner NameNispero Properties LLC
No. 78-875 Street Lima
City La Quinta
Tract #
Lot #
Type of Development Single Family Residence
Comments
rtigation - SFD - 4342 Square Feet
APN # 769-590-020
Jurisdiction La Quinta
Permit #
Log #
Zip 92253 Study Area
Square Footage 1
No. of Units 1
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobileh.o,mes.
It has been determined the above-named owner is exempt from paying school fees at this time due .to tho.following
reason:
�'► 0. ��• .
Under Mitigation AgreementJo
EXEMPTION NOT APPLICABLE r�'� '- "�• T^
This certifies that school facility fees imposed pursuant to Mitigation Agreement in the amount of
628.00 X 1 or $ 628.00 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By cc/First Bank/Nispero Properties LLC Telephone
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Olivia Aguirre Payment Received $628.00
Check No. 48776
Signature
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the Districl('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
Certificate of Occupancy
City of La Quinta
1�W
Building and Safety Department 0 I
`
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: 78-875 LIMA
Use Classification: SFD Bldg., Permit No.: 98111-047
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: NISPERO PROPERTIES LLC Address: 44489 TOWN CENTER WAY STE 140
City: PALM DESERT CA 92260
By: KIRK KIRKLAND
9 Date: 6-30-99
Building Official
POST IN A CONSPICUOUS PLACE
n0"IV JON TANDY
n/ � _ A 37630 Medjool Ave.
REGISTERED INSPECTOR'S WEEKLY REPORT
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
7-' Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
O POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOCATION
b ( _ g �� A LA ^ (`''.CI ` V , -v\-r J
i -y
REPORT SEQUENCE N0.
TV . O�ijJdSTURE
PERMIT N0. � `"
Dt E � � � �
DAY OF WEEK
MATERIIAL DESCRIPTION n „�
'u{ U
ARCHITECT
I 0�
'��..)lf+
HRS. CHARGED
-0 l (J ry
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL
CONTRACTORJVJAv'C(�C(��^ CONTRACTOR � S'®ew &S
WC -11117 I �► re -
C oo Nec'�Tuov\'Tt� -70
-S40 UZK-O to c- Com- ou ti
o et� otA ale -
COPY SENT TO CLIENT ❑
TINUED 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.
CYv`
SIGNATU E OF REGISTEW INSPECT R
DATE OF REPORT REGISTER NUMBER