9707-136 (SFD)LICENSED CONTRACTOR DECLARATION.
I hereby affirm under penalty of perjury that'I am licensed under provisions of
4- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
ccw Professionals Code, and my License is in full force and effect.
1.1 O M License # Lic. Class Exp. Date
IZ
i •�
OZ Date j Signature of ContractorF �""
6 O
J U C:) OWNER -BUILDER DECLARATION
HWW r— I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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).
C0 () I am exempt under Section , B&P.C. for this reason
N Date Signature of Owner
ON
O
Q WORKER'S COMPENSATION DECLARATION
C:) cc I hereby affirm under penalty of perjury one of the following declarations:
Lo � O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W �L- compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
CD Q C)(j() I have and will maintain workers' compensation insurance, as required by
O0 Q Section 3700 of the Labor Code, for the performance of the work for which this
li rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
-�t Z Carrieri Policy No.
[q jr`
I- Q
J (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 -1 should become
subject to the workers' compensation prom. ions of Section 3700 of the Labor
Code, I s all forthwith comply with thoserovision
✓Date: 917 ' Applicant—
Warning:
r
s
Warning: Failure to secure Workers' Compensate n 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 erfter upon
the above-mentioned property forinspection-purposes.
'"
VSignature (Owner/Agent) Date 4-1-9
PERMIT # CONTROL #
BUILDING PERMIT
5664
DATE VALUATION s41+;i�% �lb.�;� LOT E�'r� TRACT / �i y -�
2d `j
ADDRESS �% VIA Rei+ Td353ii
APN Qt+M 1-0 12
OWNERCONTRACTOR
/ DESIGNER / ENGINEER
i g f DF.St"1 f1 Df X L i ii p? Y.
Sf'of KS 6
. S/�ON'— nil JCII.3a:
PO E:;:,: X u I J
1144.E tU1Nt 4,10 LAQi;.i.WA DR,
LA Q! yINXA CA 12253 3
I.A. t,1ro !dNTA CA (K'k S.i
t7(vf)i77t.10,-4J
USE OF PERMIT
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V*!)tit'!-l! BY 7.'V a F0X NOT1. fCPLE JSSVV t0.1F tcANW. PLAN fiYPR.*
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ART Jkl P11fit t, ��Y Ate �; . RF'`lt! '3)11,4991" 110-4010 x$174 41't
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AUG 2 8 1997 ���•���, ���I,�z����• ���,��� 3��f� �����
s�a�,zs��.��
/ X N V' 1(0 W -L G.� � 3 C5�rT J
i
RECEIPT
DATE 9
BY
DATE FINALED
INSPECTOR
f ^-
INSPECTION RECORD
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
Exhaust Fans
O.K. to Wrap
F.A.U.
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
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 APPROV S
Gas Test _
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral i
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:
''• . CITY OF LA QUINTA i
BUI SAFETY DEPARTMENT
100 m-7012
F X;P' INSPECTION REQUEST UNE
777-7153
DES j.pEVLOPMENT
Contmetor S ONST
PwwM NuX&r 9707-136
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR, MUST SIGN ALL APPLICABLE SPACES
- 78-840 VIA MELOIDIA
TYPE OF IRISPECTION DATE INSP.
FOUNOATtON A SETWK
FOOTING STEEL
MAIN GROUND SYSTEM
• '
..GROUND PLUMBING /
PRE-GUNITE .
DO NOT POUR CONCRETE UNTIL ALL 80V HAS 8 EN41GNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
t ,
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS d GAS TEST
HEATING & VENT - NC
` FIREPLACE
ROOF
' BOND BEAM.
O.K. TO WRAP �
GROUT ❑ 4' ❑ 8•
` FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNE
DRYWALL INTERIOR Aa
EXTERIOR LATH
` POOL PRE PLASTER
- NCE a GATE
. � SEPTIC TANK : , _.• •
FINALS
ELECTRICAL
PLUMBING /
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
• TEMP POWER
w ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Z0 39Vd NOIlon8ISNOO SA8VdS TtST-T/L-619 bO:Ii 8662/Z0/b0
4/ 2/98 _
OF LA QUINTA
%CITY
INSPECTION SUMMA_ RY REPORT
_
Permit Number 9707-136
'Site. Address 78-840 VIA MELODIA '
Rereference Number
.Site City - ,
Location of Project _
Date Applied for 7/25/97
Date Approved
Owner Name TD DESERT DEV LTD PA
Date Issued -8/28/97
PO BOX 719
Date Finaled . .4/2/98
LA QUINTA CA 92253
Date Expired
•
Contractor Name SPARKS CONSTRUCTION
Valuation' $168,560 _
79295 RANCHO LA QUINTA DR. '
Fees 5,37$.63,
LA QUINTA CA 92253
Description of Permit SFD - VENTANA PLAN V 1-ER. `ART IN PUBLIC PLACES CREDIT OF $171.40 PER AGREEMENT W/
COM. DEV. DEPT.
PLAN CHECK FEE REDUCED BY 75% FOR MULTIPLE ISSUE OF SAME PLAN
TYPE.
I N S P E C T
1-0 N S i S C WE D U L_E D O R C O 'M P L E T•E D
Scheduled Completed
Date Date Time, -
Inspection Type Inspection Result '• Inspectors Comments ,
12/31/97 12/31/97
135-ROOF PASS
1/21/98 • 1/21/98
B7-WRAP PASS '
1/29/98 1/29/98'
r 138-FRAME PASS
' 2/9/98 2/9/98 -
139-INSUL PASS r _ -
2/13/98 2/13/98
"-' CO-DWN ., PASS
2/13/98 2/13/98
'C1-LATH PASS '
..3/10/98 3/10/98
B21-G.-TEST .• PASS _
-3/19/98 3/19/98
DO-E-INAL.._ PASS
4/2/98 4/2/98'
D1-G-FINAL . - PASS
4/2/98 ,. -4/2/98 , .
D2-C0MP** PASS 1
10 Inspections completed.
{ r