9801-026 (SFD)LICENSED CONTRACTOR DECLARATION
N I hereby affirm under penalty of perjury that I am licensed under provisions of
N Chapter 9 (commencing with Section 7000)'of Division 3 of the Business and
N W Professionals Code, and my License is in full force and effect.
C�,� L' ense # Lic. Class Exp. Date
p U-) 674074LU B 7/31/99
r ~ ,
r Z t*- 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 is issued.
S) I have and will maintain workers' compensation insurance, as required by
S
SI
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:
Cartier Policy No. .
STATE FUND 137109597
(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
S Iect to the workers' compensation provisions of Section 3700 of the Labor
ode, l 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 $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result•of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
copstruction, and hereby authorize representatives of this City to enter upon
tye above-mentioned property for inspection purposes.
IV Signature (Owner/Agent) Date
PERMIT# °°►°`#
BUILDING PERMIT 9801-026
DATE VALUATION 5282,956.20 LOT 26 TRACT 24$ 8 4,
�/
v
1115(-48 _
JOB SIT 79-965 VIA CARMEL
APN 646-40"26
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
T.D. DESERT DEVELOPMENT
SPARKS CONSTRUCTION
P.O. BOX 1716
79295 RANCHO LA QUINTA DR
LA QUINTA CA 92253
LA QUINTA. CA 92253
(760)771-1941 CBL# 2996
USE OF PERMIT
SFD
LOT 26, PALACIO PLAN 2 - ART IN PUBLIC PLACES CREDIT OF
5457.39 PER AGREEMENT W/ COMM. DEV. DEPT.
CUSTOM CONSTRUCTION 3,434.00 SF
PORC-VPATIO 180.00 SF
aARAGEICARPORT 666.00 SF
ESTIMATED COST OF CONSTRUCTION
282,956.20
PERMIT FEE SUMMARY
PLAN CHECK FEE 101-000439-318 $1,038.95
CONSTRUCTION FEE 101-000-418-000 $1,280.00
MECHANICAL FEE 101-000-421-000 5105.00
ELECTRICAL FEE 101-000-420-000 $206.01
PLUMBING FEE 101-000419-000 $184.00
STRONG MOTION FEE - RESID 101-000-241-000 $28.30
GRADING FEE 101-000-423-000 520.00
INFRASTRUCTURE FEE 225-000-443-342 S6s,000.00
PRECISE PLAN 101-000-441-345 525.00
ART IN PUBLIC PLACES - RESIT; 701-000-255-000 5457.39
ART IN PUBLIC PLACES - RESID 701-000-255-000 -$457.39
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$9,344.65
LESS PRE -PAID FEES
-$457.39 -
TOTAL PERMIT FEES DUE NOW
58,887.26
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
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.. t
License # Lic. Class 1L,' Exp. Date
JDate. r�'%�'`� Signature of Contractors :+
V Y `r ) .�
OWNER -BUILDER DECLARATION f
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). • • '
O 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:
Carrier Policy No.
S1 AT11 RM
t:y'1if?jS3
(This section need not be completed if the permit valuation Js 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 tojthe workers' compensation provisions of Section 3700`of]the Labor
Code, I shall forthwith comply with those provisions" (�, ^-
Aate: .. f i / V Applicant
s a
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 haveread 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_ or Inspection purposes. `
t Signature (Owner/Agent),, Date
BUILDING PERMIT
PERMIT JI CONTROL#
DATEVALUATION u����t�t9,i1i LOT.TRACT
1;'15
�� ) ®® ti
S G 8 :,m .
JOB SITE
ADDRESS 94-190%AliAUsMVI.?Il.',
APN •.•14S!• (i�lt�.X
OWNER_
CONTRACTOR? DESIGNER /ENGINEER
L 1.
SPARKS COTNURWCillIN .
laG;�.I7I:5
1, 29
;5}7./it �:1tin�Lf�titiIN A;DP_
!;<A Q,IJh l f,.A �'.1�: 9275.:3
LA. QUINTA CA 9 25 .
M1f3t91d71:- 941. CB .-.2996 .:_.
t
USE OF PERMIT
RFD
LOT 1N P't1BLICPL,A(T19 CRM, -171 C')F
k p�_ � ! ,,
G� I .
nn
C U3T OM CVi�`ti1' TtiVt" IKN' 3,?a34.00 J
. C'3'K4!'t!t'tt.°f X\".�, ' t•w�-0�. ,` h "' " TY. '
F L u 0 U E NTA
TA
Ga1 3.i�ii�'.iCk11�P�.RT 66r ob'A
�.
ENT MAT '+ "U�h s OFC4;:`S
�4d1C"i 01s
282,9-5,6 zfi .
..
J&AN C1W CK.17 101-0130-4J9.;318
S1 0131N 915
r ►<f l l..i(�iLr9pE r3�i" t.�.t-000418-000
e . r +
��ay.Cq�^t+12 �. 1Q�-OO�d`�t•O(l,r
1.e��
'?
y4��u..t:•rWL
7 la��.l l�dt JV�•E•- '.. ,.' +• .. - ��i-�U4"�dr�liVu
,1Si,L,iSJt��
' .Y� -
#�£ CJtV[W�11� t''t? rF. 10.1-000-419-0(9)
t iityNC. 7*iF )"i iClty* N't r+ :�F_:w1[Ci '!01 �-;;A 1,-(3(1()
� 30
!ff i�IJ3t�s^:.C; I3 401-000423-00Q
3` I+ ��.t7Aiffiic:)ike;.)�.
PRJEC1,3)2 L.AN 101-000-44I. 34 ?
. $;' 00
0.15 0 f)-715" )<3
1;
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
-
Underground Ducts
Forms 8 Footings
ojw
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.Q.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_ L
Drywall - Int. Lath
Final zZi
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
Gas Piping
PLUMBING APPROVALS
Gas Test .
Electric Final
Waste Linesi
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
t
Final
Utility Notice (Perm)
COMMENTS:
_
'