9601-141 (SATT)LICENSED CONTRACTOR DECLARATION
I hereby affirm 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. 67,40 74 43 , -1i" I V7
License # e Lic. Class ExpDate 'f
Date /�., SignatureofContractor r, . \,el- .r
OWNER -BUILDER DECLARATION/
I hereby affirm that 1 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.
( ) 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 secty n_n ydlrlorofy completed if the permit valuation Is fpb*x,00.00 or less).
O I certify tiat 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 37,00 of the Labor
Code, I shall forthwith comply with those provisions. 'IV!'
Warning: Failure to secure Workers' Compensation c6verage 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,resultexof this appli agr",to, & shall, indemnity
& hold harmless the City of Indi Wjells, i 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
e •,uction, and hereby authorize representatives of this City to enter upon the
above-mdntioned property for inspection purp6se6.
Signature (Cwrler/A9er=,,/ ��' I"' 1� Da'�t
ALC'
BUILDING PERMIT
P "i'
DATE/, J�)6g
VALUATION �'I(j'J�};tt'x,5(! LOT
TRACT L7.SS35
JOB SITE ADDRESS
424-(i.10 VIA V AA.LA.AI Btu
APN
OWNER
CONTRACTOR
SPARKS CONS'1'RUC 1.10N
r.�:.'f)L,,Srr. 1T1,C3PR'llr^!'1 C,.!'
2U°. W'Al.,tiRtQrER.0NO.
• P.O. BOX Inti
LA QU1NT1L.t1.. SMS -5
LA,QUIN-A CA, 92253
(619j771-1941 C131A 1096
�1919i'%7A.-19<:t1.
DESIGNEFVENGINEER
PT'isAREK-(`jlANII —11., il`I.C.
236772 Uffrl CUER. DR.
USE OF PERMITS j1,161, M10_11.10'
1.tANC140 LA. QUIN'1'R
CASITAS I3UPL'6X PLAN 13
FEE DESCRIPTION
FEES
f ✓i) 't'G f. C01dS 1':KQC: t'1:.QN 1.967Ak) L
PORC'H/PA'1.10 244.14 SIF
GARACEICARIr'c rCr '. 447,00 Sr,
FST1iviXT:fiD COST OF CGINS 'RUCTi
1651.182.50
PERMITFEE SU1bil0!t:A RY
PLAN e714—FICK IF 9E :1G1 -OW -439-319
101-000.41..8-(0 X70.50
CO`�I/�Vr�tS]�Ti.'Eit;"N06
[[!!((FEE
&T.CH.AUhriC♦i'[rJ�,.r., i'iuL. - 14i=�'0�' :21--' ii v})J n",
.
fl JECf' UCA1:1;, EE 101-100.4420-000 $141.29 .
PLUM INC, FRE 3 01. -000419-91V $150.00
srIn- No donna F. a" - m, Lo 100-000-.241-000
GRADI%fGFEE 101-400-42.4-000 $20.00
1'd•#F"it"' R.VC"t URF1; FIEF: 225-000-441'3-347. $3,644.79
MT IN PUBRIX PLAC`Es - RE.:Srr, 701 -000t -255-0X10 $162,96
tPOTAL CONS Cl2UCTION .AN:0 PLAN CHECK
$5 ar�5.1Ja
D DESS A1R&PAiL' FES
FEB 1.4 1996 TTM, PE MT FEES DuE OW
$3,795:04
6y
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPE OR
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 APPROVALS
Gas Test
Electric Final
Waste Lines .2-
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
Final
Utility Notice (Perm)
COMMENTS:
/,7
_ CITY OF LA QUINTA
~ Bl(
�W�NG & SAFETY DEPARTMENT
i Or 777-7012
NSPECTION REQUEST LINE I
c �8 14 N' 777-7153 J
i
Owner 1xmtaT DEVELOPMENT LP I .
Contractor SPARKS CONSTRUCTION
9601-141
Permit Number
POST ON JOB IN CONSPICUOUS PLACE s
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
48-010 VIA VALLARTA`
JOB ADDRESS
I
SFA LOT Z- PLAN B'
TYPE OF INSPECTION DATE INSP. I
FOUNDATION & SETBACK I
FOOTING STEEL x
MAIN GROUND SYSTEM
GROUND PLUMBING f
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SAGNED g
CONCRETE SLAB
JOISTS & GIRDERS k
ELECTRICAL GROUND WORK•
h
DO NOT POUR CONCRETE UNTIL ALL ABOVE HA'3 BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF - r
BOND BEAM I
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING •"
INSULATION
PRE -ROOF
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO I
1/95 TURN ON UTILITIES OR OCCUPY BUILDING
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
-�/
POOL PRE PLASTER
i
POOL,FENCE & GATE
EWE SEPTIC TANK
,. �• (�� - I
B
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO I
1/95 TURN ON UTILITIES OR OCCUPY BUILDING