9609-041 (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
67,-113 /4' 6 7(31J97
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 6Wner 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 Policy No.
STX1,131 FUND 117109$94
(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 L
the above-mentioned property for inspection purposes: df d1
Signature (OwnerNAg-ent) a ( Date s
/ PERMIT# CONTROL#
BUILDING PERMIT
9609-041 4 06 7
DATE !!) VALUATION 1s ��i3�,�+?� LOT 1.0r' 16 TRACT+�5� 1,
JOB SITE 7,% 065 VIA tei>`R[t'6,11,
APN 649-0210-03,5
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
f
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7921#3 kANCho L A.QU1t4TA DR.,
1,,AQt11f`T!A CA 91253
LAQ�i1NTA CA WT 3
771.1941
(619)771-19,11 C'F3l.1f 19%
�.T1�}ji `' tage�.� ;.;j, ist1.•
USE OF PERMIT
itVc_r1.t~.
2,AO7i8ltZ'!`?;..WA1 1341.
1'1�R?TYII f f !"•'!�', C?I<1�3��'.0"I.' t1t�! A!{'1' IN 1'i}BI 1.r° 1�I :/lC"�:�1?'I'tf�l')1'f CJF�
3:VY',5 PF. ? ileiREFINIM-. • W!`!"Ff CIOAdAr)t!NrIll 4 FNTIIJI(L IVIE T
01114100. cic )NS'.FRUC 1'1014 k 8.?" 00 ;,i
PtAICt PATK3 180V) St.
0Aii.A.Ctf_si °A1?P0R'r 466.0 aF
1'E1<tMIT C+` E SfIR1MAt4V
1'1.AN 8
C0 14Mi.1;Tit N FUi 101.000-11.8-000
MIK 4iANICALFEE 101 -0017"421 -Wo $137A0
> s F'(."VR At. VF6 101,40Y -420-W) $227419
PLII:f BiN10 F 1Q! 000.4.ln-C}QtJ "�^t)5.00
S7: z:�A %1. IC1`f's si+t F.m. 1tI 0 l i)!-f1a(hx t 1-U2iti i..;^a
ORAt) INO''F 101.-000-423-0170 $1210.00
i IF It A 1`415 rf""t t R� F.,1* J tti 225-0001 441-:342 S60A.00
PFE"CISF, PLAN 1017000-441-345
AR1' 1N.(3i, hJAC .PLAC S ., I+ ':'oll 701••000-255.000 S55V5
ART IN P1J"AAC MACTS RPM, 7111.000-2.5"4)I1t1 -555;x.15
l,ks'�4,ti PltF-:NA1:I I t'1:f'S
4 3x.5►5
°!'(3`1'43,1, f'FRA-If'F ��°'1�. 01JE NOW
$9,170.21.
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
. MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings _
Ducts
Slab Grade IF
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing — U
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
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 Lines -
Neater 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
Final
Utility Notice (Perm)
COMMENTS:
08/15/1997 10:32 619-771-1841 SPARKS CONSTRUCTION PAGE 01
ink
CITY OF LA OUINTA
BUILDING A SAFETY DEPARTMENT
0 I
177-7012
INSPECTION REQUEST LINE
777-7153
0,, niw T.D. DESERT DEVELOPMENT
I Contractor SPARKS CONST
pw"NPOS ON Joe IN CONSPICUWUS PLA E
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
79-065 VIA CARMEL
JOB ADDRESS
PLAN 2 SFD LOT 16
TYPE OF INSPECTION DATE
FOUNDATION & SETBACK
FOOTING STEEL
. p* & v;� -
00
J
KITE
POUR CONCRETE UNTIL ALL ABOVE HAS
TE SLAB
GIRDERS
NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNEE
ROUGH PLUMBING
ROUGH GAS A GAS TEST -
HEATING 6 VENT • NC
FIREPLACE. -
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF _
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
i
it
Owner T.D. DESERT DEVELOPMENT
i,9609-041
Contractor SPARKS CONST
Permit Number
POST ON JOB INCONSPICUOUS PLACE
I INSPECTOR MUST SIGN ALL APPLICABLE SPACES
79-065 VIA CARMEL
JOB ADDRESS
PLAN 2 SFD LOT lj
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL /.
MAIN GROUND SYSTEM
GROUND PLUMBING 7
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB _
i 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
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION "^
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH -
POOL PRE PLASTER
NCE & GATE
SEWE SEPTIC TANK Q L�
FINALS
�„�...,.. • ,
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
ABOVE APPROVALS DCS NOT INCLUDE RIGHT TO
TURN ON UTILITIES DR OCCUPY BUILDING
MWk
�.
CITY OF LA QUINTA
5
;
BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-7153
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH -
POOL PRE PLASTER
NCE & GATE
SEWE SEPTIC TANK Q L�
FINALS
�„�...,.. • ,
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
ABOVE APPROVALS DCS NOT INCLUDE RIGHT TO
TURN ON UTILITIES DR OCCUPY BUILDING