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9601-151 (SATT)y. LICENSED CONTRACTOR DECLARATION I herie?by 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. 674UrFI a3 '1_7 License # % . f Uc. Class `� Exp. Dale/ Date Sig natureof Contractor 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 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 secti9njq",d[4t&e completed if the permit valuatiolp_is 100$4•.90.00 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 to the workers' compensation pro cions of Section 3700 of the Labor Code, I+a�shsll forthwith comply with thoseprovisions Date: e .% e. Applicant � x 1/ 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 Alsult of this �a�¢pp►icon;agr� to, & shall, indemnify & hold harmless the City -of IndiarrWelis,fitis officeragents 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 insp66ton purposes: t j 1Z Signature (owner/Age ` Y "i Dats,1/`1':� - ALC 'BUILDING PERMIT PERM'Te,_1 DATE 1111196 VALUATION-5J4*.%JW1 41lJ LOT % TRACT - JOB SITE ADDRESS p'4 11'%' A xe�E�1� LA.i� rik }. APN lb�i9-38S� 000 OWNER CONTRACTOR SPARKS 'ON t (iGI?QN :1).DStP.UNDE\rl.LOP�MI"Wrl LP I(i; ��� �,srcN I3R11;CsF,PID;vQ. P.O. BO 171b LA QQINTA CA .42253 LA QAAWA. CGA 92253. (61.9)`7714941 081.0 2996 DESIGNERIENGINEER P A2EK-MkNl:ELL, INC. 23672ZFSIIZ'II:I DR. USE OFPERMIT97.T4tC%,F;4Ziil7,'� .Ak\ti RA.NCHOLA�QU}7li�vICA y.y} t FEE DESCRIPTION FEES CM10M ICUCTION 1,967.00 LF POTWEYP.A110 r 240.00 ASF CkAi21400CA ORT .' 417.00 SE E,'%T3Mt4TED CAST LDiF.CONST]ftUC Y ION 165,1:$1.50 PE1t1V,[7T FEE SUMMARY � PLAN C%fL?S.`X, FEE, 8713,98, t':UNS`CRUC`iION FEE 101.-000-418-000 fat©.5n .t ECIdAMCAL IZ"I~ EX-MRICAL .FEIE• 101-WO.420.000 $.I4 L:29 1't,Iiil RING rRE 101 -1119 4nHn)(n3 11 "1 .00 nor► ai wivv iv '014 E - iw iis. iruv0 �nai A �-uw Id V. `!b IlNrlv£<. STRI UC"ETURE1"kL-' 22 -i -M-443-342 $1644.79 ARMIN PLTBLIC.PLACU -1RaM 701-000-2,55-000 $1.62.96 SUB;fCC)`iAL CONS'7'RUC11.0N;ANU'1'i:AN CHECK LESS PRE—PAID TEES x+0.00 D "�'T L PIERIMIT .F EES DUE NON%' $5,795.04 FEB. 141996 i ' stir • •, RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD t OPERATION I DATE I INSPECTOR OPERATION I DATE I 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 OX 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. Smgke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: - �oTa� a _ _ CITY OF LA QUINTA Bl1G &SAFETY DEPARTMENT r 1�' 777-7012 �• ,INSPECTION REQUEST LINE T814 m-7153 .D,RT DEVELOPMENT LP Owner-9;�+� .ten �,.._�,.FR_ Contractor 9601-151 Permit Number POST ON JOB IN CONSPICUOUS PLACE INSPECTORMU T I I&PQ E SPACES JOB ADDRESS SFA LOT 2 PLAN B TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE U&S BEE IGNED CONCRETE SLAB JOISTS & GIRDERS EL CTRICAL GROUND WORK O NOT POUR CONCRETE UNTIL LL ABOVE HAS IfEEN 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 INSULATION — PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGN DRYWALL INTERIOR EXTERIOR LATH — 2— POOL POOL PRE PLASTER POCII ENCE & GATE ,SEWER)SEPTIC TANK FINALS I-INAL CTAS I t51 HF,i�iT1N(; - A/C HV41St NUMtitH5 I .In.'ACr)MPI FTFn ABOVE APPROVALS DO NOT INCLUDE RIGHT TO 1/95 TURN ON UTILITIES OR OCCUPY BUILDING