9601-140 (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. 6740'74 ,- �t1 7,, 1
License #,� , e , Lic. Class (Exp.Date r
Date tj 11Y �iSignatureofContractor t l/
— V J
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 sectio n d no a completed if the permit valuatio is to 0O 00 or less).
a�� F:4 P P %ti,au5§90-
O 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 provisions of Section-3700�of the Labor
Code, I sh/all forthwith comply with those provisions.;/.'
Date: d J V_ 19� i'V Applicant a` r O J
Warning: Failure to secure WorkersCompensation {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 woo is performed under or pursuant to
S, any permit issued as a,r'esult�of this ap lYcati! agn!es,tb, & shall, indemnify
& hold harmless the City of4dian-Welts, 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 cancellatiR%
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 ins pectiohTutposes.
(
S' 19 ,nature Owner 's ' f' Date11V1'
/A9�
ALcx
BUILDING PERMIT
PERMIT;01i40
DATE 1�4.iI 6
VALUATION S.146i190.7fi LOT
TRACT '27935
JOB SITE ADDRESSR .,
48• -guar VIA ` .� A,1,MW-tA
APN A
OWNER
CONTRACTOR
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i !.t?! Nk�ALSTO"A1 BRI'DO ; IM tiff,
P.U, .fox 17 16 `..
ISA QUINI-A CA 72253
LA CA. 92253
? (619)771-1941. 1 8L0 "299
($19)771.1941
DESIGNER/ENGINEER
�}}Lt?):r�:F{..- w7�.PmT[ fD�Ft:L,
29ri,1UR�TCHER.D..R-
t� n�1, 7 ry ( / �
USE OFPERMITJ(tJ a ,13 7:'dlA11L�° f�17EA.C1:190
RANI: 40 LA. QUI.Nrtl
C,A51TA&DUPL'.EX PLAN A. l
FEE DESCRIPTION
FEES
CUSIrOrvi-C€)NS11R.UCITICYN-V725XX11.C'
1;0RCWPA11.0 2c1r,,�xf sr
GARA.CQ&C.'ARPOtZT 4467.00 Sr
L.STTiii6.ATED CO'S*T OF COi ISt.a'BdlCf'WN
144,190.70
VER��'tI`+��tyyt�+-��Er�+C(���;i�?+i���)�'aIAIARV .
t :y } },D dr ,
P1,FkN CW1 X T 1 10,1 0-439-3 8 M1 .a7
CONSTRUCTION17M 10.1-000-4.18- $3t;4.G0
kvir-.01.AMCAL FIM 101-000-4:214)00 M-50
'ELECTRICAL FIM 101 -MO -420 -ODD 8133:22
S'1.(.A TNGFEE i0?-fl�tf! 41.9-f)QO.. S15-5.00
`IM,4`0 MXOTION:FRE - R1 SID 100.4100-241-000 S1G.t42
GRADING M lt7l-i)OG-�i23-iiQ() ��tr,�Qf
1NN".RAS'XRU(t 'iIRJE FEE 22.5-000-443-342 $3,229.44
ART YN KjOLIC P1,ACNci �'t illr. 701-000-•255-fit)f1 g:t.I.SAiS
• I.
SUB -TOTAL C0145TRUCn0N AND PLAN C14ECK
s5,2m5.5
USS PRE -PAID FEES
90.00
'L
T PERMIT FEES DUE NOW
�5�2Ufi,S�
4k a FEB 14
1996
RECEIPT
DATE BV b* .fit
DATE FINAkXD
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 Voitage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
1
, 0730
a
5 s
_ CITY OF LA QUINTA•
+aBUILDING & SAFETY DEPARTMENT T
777-7012
INSPECTION RE94§E AE
777=41 53 81619
Owner T.D. DESERT DEVELOPMMLU DEVELOPnFp?
Contractor SPARKS CONSTRUCTION".
960.1-140
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
.48-200 VIA VALLARTX
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 GROUND WORK
/ , . 7,
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 j
GROUT ❑ 4' ❑ 8'
FRAMING - y
INSULATION
PRE -ROOF
r' ic i � ;%S -;--COVER NO WORK UNTIL A OVE HAS BE91N SIGNED
DRYWALL INTERIOR L �.
EXTERIOR LATH Com- G
POOL PRE PLASTER /
ENCE & GATE
SEWE SEPTIC TANK
-
FINALS
ELECTRICAL '
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
1/95 TURP: ON UTILITIES OR OCCUPY BUILDING