Loading...
9601-137 (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. G7407v 13 :�'" if97 License # r , � Lic. Class i'"1 Expr.Date _ ..,..� Date Signature of Contractor OWNER -BUILDER DECLARATION t 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 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 gad� n t.b completed if the permit valuation, is.fo $00.00 or less). () I ceitifk attinte performance of the work for whichft�i�is�`pe mit 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 th'e workers' compensation provisions of ion 3700 of the Labor Code, I shall forthv� ith comply with thosens. X/}pr - isio Date: 0 ,/ 4, /7Aonlicant j , - f I 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 fesult of this Plicc�llion/agr - s to, & shall, indemnify & hold harmless the City.,,. -Indian- Its '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 issuanceof 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 purposes Signature (Owner/Agent) !� -�. Date2l 11K1; , ALC MF.::::. BUILDING PERMIT PERM'T' DATE IM17/96 VALUATION $146,190.70 LOT 2 TRACT 27835 JOB SITE ADDRESS APN 44-110 VI A V A.LL AiltTA 649-390-002 �+.q ` y't +y, �7.i 7y S_NI RKSy iCONSTeti£1y^C���r+pIC3�y��r.•.�.. i..O.I? SERrf3ilStI'..i��ii�.rY9f:.��fi L 101 ivr�i.tr.J�l�liR . iiJ.i�dPf38�A11`O.. 14.0. BOX.* 1.7.1 Ll1l Qua" CA 01253 LA QUINTA CA 921.53 CBL# 2996 (61:0)771-1941 DESIGNERIENGINEER i' tom"AREK-CRA.NDE L. INC. USE OF Pmm LINC'IL.% .E:A�41L.Y ,,Vl' ,t\CF11:D 2367213IRT(WR DR. RANCHOLA;I)UINTA CASI'I'A§1.%T.P .F_1,' PL AN A I FEE DESCRIPTION FEES PORCINPATIO 200.00 SF C;Al2A0rJCJUU10RT 467.00 SF SU.L.-TOTAL CON STRUMON A.N PL.EAN.CI•IECK LESS PRE -PAID PEES D a TOTAL, PERAM' FEES DUE NO 146;590.70 $5,,205,55 :0.00 ss,205.55 RECEIPT I DATE IBV (DATE FINALED I INSPECTOR I t ESTIMATED COST OF CONSTRUCTION PERM",' 1!♦ ICE NETtNUM ARY K AN C RE GX .1.1.7, 101-f.100-433 i1 Pr $664.29 CO'N3T1tU CTIC3N FFM- 101 -WO -4.18-000 $804.00 - WRICRANICAI: RSE 10 1 -04o-421-(30() 568.50 FLEC71RICA1.FEE 101-000420-4)010 420-4)01o� ;si3s: 1�1 e1 fli ilill?c; 001-000 101"000^41.9.0V V . -STONG MOTION kT-1? - RES.0 100-000.241�0()0 $14.62 GItADING FFE 101-000.4?3-006 $20.00. INFT4..AS°t'R(JCrFURE'FEF' 225-000-443-342 $3,229,44' .SRT IN PIJBL"IC PLACES - F.ESM 701--000-.2.55-000 •1 VISAS SU.L.-TOTAL CON STRUMON A.N PL.EAN.CI•IECK LESS PRE -PAID PEES D a TOTAL, PERAM' FEES DUE NO 146;590.70 $5,,205,55 :0.00 ss,205.55 RECEIPT I DATE IBV (DATE FINALED I INSPECTOR I 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 Pibg. 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: llqq ,l a 7- P lt- a s _ s CITY OF LA QUINTA hero,. BUILDING & SAFETY DEPARTMENT 43,�iTA 777-7012 ' - INSPECTION REQUEST LINE 7 FE916`I 77-7153 � -DESERT DEVELOPMENT PARKS CONSTRUCTION Contractor 9601-137 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 B E"IGJNED CONCRETE SLAB JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SI NED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST 427 HEATING & VENT - A/C FIREPLACE ROOF ! BOND BEAM O.K. TO WRAP - GROUT ❑ 4' ❑ 8' FRAMING C INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR EXTERIOR LATH POOL PRE PLASTER FENCE & GATE SEW R SEPTIC TANK FI ELECTRICAL PLUMBING FINAL GAS TEST HEATING - A/C HOUS'- NUMBERS JOB COMPLETED TEMP, POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO 1,95 TURN ON UTILITIES OR OCCUPY BUILDING