0007-273 (CONR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provision's 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 # Lid. Class • Exp. Date
7474
Date>,'L-Q; Signature of Contractor—
OWN ER-BIJI LDER
ontractor 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 cunuaciing w1th Iluumiud
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.
(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 t 'the workers' compensation provisions -of Se_c�ion 3700ofth2Labor
`Code ) sjiall fghhwith comply withrthose provisions. % //
Date , /G^ /a 0 Applicant
~N
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to theFcost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application: I.`'
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this. application and state that the above information is
correct. I agree to comply I -with all City, and State laws relating to.the building
construction, and heretiy•authorize representatives of this City to enter upon
•..ahe above-mentionedPproperty for specl purposes.
Signature (Owner/Agent),-,/ ' k- Date
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BUILDING PERMIT PERMIT#
DATE VALUATION LOT a>-271 TRACT
JOB SITE
APN
ADDRESS
,49-,9ZVVXA KATAT MAL
OWNER'
CONTRACTOR /DESIGNER /EN (•NEER
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T. ynWrA CA' PUS$
Ll',, QUill".4% ' CA 922,53
l f) t,t1�a941 CB1101
USE OF PERMIT
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COMPA014 AREA 1470L HOUSE 44-4 NQ F7 , .AS PPR .APT%0VW, PLAIUS
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Ci��.3ii.CECK f�p��;',�€�C. ,- $�147.62'
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AR"? 279 PuQ-.1 m PLArrm �' Qlf)w 701-000 "255-000 $59.41
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MAR,*,16:2001 x
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RECEIPT
DATE
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DA EtFI
INSPECTOR
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INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings _ 3Q �l
Underground Ducts
Ducts
SlabSlab Grade
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-
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Return Air
Steel
Roof Deck
`
d
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Combustion Air
Exhaust Fans
-
O.K. to Wrap
_ _ 6
F.A.U.
Framing
Insulation
_ _�l
�
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall -Int. Lath
-
Final �- ! '
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Final
POOLS - SPAS
BLOCKWALL
APVROVALS
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
OX for Finish Plaster
Sewer Lateral
�lo//
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
'Final
Utility Notice (Gas)
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AS
ELECTRICAL PPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
_
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
t
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
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• City. of La Qu inta
Building U Safety Division t
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P.O. Box 1504
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• 78-49 5 Calle Tampico *�
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- La�Quinta, CA" 92253.
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Buildin Permit Application and Tracking. Sheet
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Name of Contact Person: X160 c9' S r�lC .
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Telephone = of Contact Person: , —77
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Estimated Value of Project:
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CityO La. Uinta
Developers Project Approval Form
Prior to the issuance of Building, Permits for the project listed below, the following Departmental
clearances must be obtained. Please return this form Nickie Gormley,Bailding and Safety
Department only after approval. Contact applicant: for resolution of condit;ons preventing or
delaying approval.
Project: Community Pool 'at
49-924 Via Katalina
Applicant Contact: Nolan Sparks, Sparks Construction, 771-1941 '
Application / Circulation Date: \ 8/21/Q1LAT3�'
o g LLDate
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Commun Development Department j c� T J 61 I �" ------�,
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(X�G A Z �O
Christine, brio, Planning Manager Date
? Public Works~ Department
Steve Speer, Senior Engineer `
Date--
o Building and Safety Department
v
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Greg Bulter, Building and Safety Department Manager Dat-
Health Department
Date
Fire Department
Date
Schools Fees Paid
Date
gA C
City of La Quintir..
Developers Project Approval Form
o ,
Prior to the issuance of Building Permits for the project listed below, the following Departmental
clearances must be obtained. Please return this form Nickie Gormley,Br-ilding and Safety
Department only i(ftr Opproyal: Contact applicant for resolution of conditions preventing or
delaying approval.
Project: Community Pool at
49-924 Via Katalina
Applicant Contact: Nolan Sparks Sparks Construction, 771-1941
Application / Circulation Date: ' 2 jG
Community Development Department
Christine di Iorio, Planning Manager' Datr
Public Works Department ,1D'1
Steve Speer, Senior Engineer Date `
Building and Safety Department
Greg Bulter, Buildingand Safety Department Manager Dale
,
Health Department
Date
Fire Department
Date
Schools Fees Paid
Date
CITY OF LA QUINTA
PLAN CHECK CORRECTION LIST
' November 28, 2000
Gouvis Engineering
4400 Campus Drive
' Newport Beach, CA -92660
PLAN CHECK NO.: • 0007-273 FINAL CHECK
r
JOB ADDRESS: ', 49-924 Via Kataliria OCCUPANCY: R3 }
AREA-S.F.- : 444 �.
.TYPE -OF -CONST.: V -N
{, The submitted plans and specifications have been reviewed,byVANDORPE CHOU ASSOCIATES . It' is
our professional opinion that the plans are insubstantial conformance with the l uilding codes and
regulations adopted by the CITY OF LA QUINTAand the State of California Amendment.
APPROVAL FOR A BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING
.APPROVALS/CLEARANCES FROM ALL APPLICABLE �CITY DEPARTMENTS, AGENCIES, AND.'
ASSOCIATIONS. i
Plans checked by:
Dorothy Gordon, P.E.
..; VANDORPE CHOU ASSOCIATES. ;
295 N Rampart Street, Suite A r
Orange CA `92868
�- (714) 978-9780 VCA File No. LQ -12355.3
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