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9601-136 (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. nV 7 7!31/97 License # / // Lic. /Cl�ss Exp. Date 1 Date , lki'4K!YISignatureofContractor. „ OWNER -BUILDER DECLARATION I hereby affirm 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 3760 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 valuations for $100.00 or less). () I certj(ygQ n�'i�rperformance of the work for whic'A 4AW'2&it 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 subjectto the workers' compensation provisions of,Sec n 3700 of the Labor Code, I shall forthwith comply with those'provisio14. �R Date: x .Iiy` ; r Applicant Y % v Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT . Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this•app11'M' a ree to, & shall, indemnify , & hold harmless the Qty_of Indtari W., s.lfsfoffi er ; gents and employees. 2. Any permit issued as a -result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation., I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purpos8s.. Signature (Owner/Agent) 1�. LC A"" BUILDING PERMIT PERMIT qy� iA 136 DATE 1/17(96 VALUATION S.i. 1i1.70 LOT 2 TRACT 27835. JOB SITE ADDRESS APN 4"80 VIA VALLARTA 649-380-002 OWNER CONTRACTOR SPARKS C,ONti'1"M.IG"i'iON . 1'.D. DEFT KT DEVELCtP.MEI`!`1' LP 101 WALS"]'tC3P1.BRIDGE ;tib NO. P.©, '13011 716 l:A + U.C.N'IA OA 922. L.A C11:IINTA CA. . W2253 (619V11-:1941 C'BL># 2996 DESIGNERtENGINEER (619)771-1941 Pk, AREK-C12)IMYS.L, INC. 23672 iZ[iLTCi Ik1t DR.. USE OF PERMIT.INt i LF PA[o� li,Y M 1'iA CglF D RAMC 10..) L.A. Q(YI dTA CA 3TAZ31 DLTF'I.E . PLAN A T FEE DESCRIPTION FEES CUSTOM C0NS`l'1•tUCI ION 1,7~5,00 .LF. ,RC14JP tri O 200.00 tr 4A'RA013tCARPORT 467.00 N1:' ESTIMATED COST UI+' CONSTRUCTION 14(090.76 PEI2AHT FEE SUMMARY P(, AN CHRECK N (,WE,' 101-000-43',x-3 ($ $664.29 CONS'rRUC'Tt0'N'JIM-7 101-00041&000 $804.06 HILE,:'TIUCA1, E.I. .101-000-420-000 Si143. ByI.t11U11aiNfJ C?F► :401-000.404,It}0 til 4F�.htJ "TONG MOTION FM - RES.1i, Sttl.62 ORAD11140 Fli 101,000-423-000 t'NFRAdS'1'tt1JG 1'URlaFRE TM -4000-4431-3142 0,229.44 a11?•l� i3 .urtyr,rO vt,A�'1?S R �ylr 7Ul-A0u-25`w_Qn g.�g D ' FEB 1. 4 1qq� .Al, coNS"1'.1tUC'•.C1OP}' ANIS PLAN C +ECK S5,20,. -SS y LESS PRE -PAID EES $0.00 Ry TOTAL k' Ii314��� $�LI�S >U�l , l`�E)N�' $:,Z05.55 .. RECEIPT DATE BY DATE RNALEO INSPECTOR 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 APPROVALS 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 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: O7 -2Z 0_,10 CITY OF LA QUINTA BITING & SAFETY DEPARTMENT `� �' , _ ; t - t �� �,�1 1 �0 777-7012 FEB 16 1� INSPECTION REQUEST LINE 777-7153 Owner -`:b!bgSERT DEVELOPMENT Contractor SPARKS CONSTRUCTION 9601-136 Permit Number POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS SFA PLAN A TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB 7 - ' JOISTS & GIRDERS ELECTRICAL GROUNDWORK %fes �= �✓!� 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 C/-. INSULATION - INSULATION , PRE -ROOF COVER NO WORK UNTIL ABOVE HAS IqMEEN SIGNED DRYWALL INTERIOR - EXTERIOR LATH POOL PRE PLASTER POOL FENCE & GATE (!§EWM SEPTIC TANK FINALS Hto I INU - AJU I I 1-101 PAP NI IMRIZP.q ABOVE APPROVALS DO NOT INCLUDE RIGHT TO + 1/95 TURN ON UTILITIES OR OCCUPY BUILDING