9601-088 (SFD)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. 6514074• B ,,� "' 11 J
License #// Lic. Class Date ..
Date,, -9'1.7 ' E f I s Signature of Contractor Y° ..! \
l
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).
O 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
1 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 sectj9n�Qe�dfrtbg completed if the permit valuatio0s.100.00 or less).
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 shall%forthw' comply with, those provi Is ons:-- --- "
Date: 61 .Applicant ' t; - � �_ ,...� .
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 application agrees to, & shall, indemnify
& hold harmless the City of Indian Wells, 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 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'herebi authorize representatives of this City to enter upon the
above-mentioned property for inspection purpose}s.
/9th, %�� i...e•^�' . - � I /
Signature (Owner/Agent) , l ` - ' f� Date2, �
ALC i
BUILDING PERMIT-,
PERMIT i
'
DATE 111, 1,10
VALUATION � '6 31 ,1183,E 41.1 LOT wD
TRACT 'L'lyaz-
JOB SITE ADDRESS79450 Ik�F1iv C1.i
APN�-5�1�=��tjl �.
OWNER
'.CONTRACTOR
SPA 1tKS CORN IIt,1y1'L""('l�it.7*jty+7ly.
01 WALSTONT.,B STi 4+Ja�iil:
P.O. d � 1:x16
i LA QUiid"1`A - .A
1.A, ("w?i, IN'TA :C.A. 9W.3 .:
(61.9)77.1,4941 MU ,,%16 .
(619)771-1941
DESIGNERIENGINEER
°P":aall.Rf-CR.I�?dDEl 1.,
2.1672 BR�v.l:4.r-'.1.'�ER DR,
USE OF PERMIT li'tiiUL s_A.A9,ILY V , }-L+1.. NO
RANCHO ],t1.11t.)IN'l'A
v
FEE DESCRIPTION
FEES
cu'S3'om CONS`('ftt7c,"i7UN 3,822.0011F.-
,822.00L1F18000
A.
180.00SF
GARAGE/CARPORT .. [ 666,00 SF
ES IMATFA) COST OF CONSTRUCTION
313,.131.40 '
1')(<IRAW _1F'.E17a SBFMMARV
PLAN CHECK 1: EF 4.01-Q0-439-3113 $1,1.35.30
CONSTRUCTION r-1,13 1:01-000-418-000
;M]WH LAICAL F1sR $137,00
F�t,EG"TRf.CAt; ice. 101-000-420,000 $227.09
t?IaJ 1Nis� 101-000419-0M . $206.00
't'.1 oNr,MO- : ON Fa.-1ZESED IN -060-241-600 13132
�.
GRADING FEE 101-000-4237060 $20,0.0
1NF'RAS1°R C'1` -REFitf 225-000-443�•342 i;£lttO,C►t3
PRECI[SR PLAN 101-0003 44.1445 $x5.00
°IRT .'I'N,PL' LMC PI ACF.S - RESIC 701-000-255.000 $532.95
SUB -TOTAL CONSMu�°?'TO N AND PLAN CHEC
$9,703.16 '
rA3, PRE -PAID FEES
FFB 2 lggs
Q,
RECEIPT
DATE `"
BY:
DATE FINALED
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 I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines 9k,
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:
}
Desert Sands Unified School District
Notice: 82-879 Highway 111
Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
CERTIFICATE OF COMPLIANCE
Date 2/13/96 APN # 649-400-020
No. 14161 Jurisdiction La Quinta
Owner Name T.D. Desert Development Permit #
No. 79050 Street Via San Clara Lag #
City La Quinta Zip 92253 Study Area 123
Tract # 27952-1 Lot # 20 Square Footage 3822
Type of Development Single Family Residence No. of Units 1
Comments
At the, present time, the Desert Sands Unified School District does not collect fees on garages/carports,
covered'patios/walkways, residential additions under 500 square feet, detached accessory"structures or
replacement mobilehomes. It has been determined, the above-named owner is exempt from paying
school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This, certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.72 x 3,822 or $ 6,573.84
the property listed above and that building permits and/or Certificates of,O ccup*,cy tfor
this square footage in this proposed project may now be issued.
�0 ~ry�rs J
Fees•Paid By T. D. Desert Development ; Telene X771-IS41
Name on the check'
iv S.
By Dolores A. Ballesteros ,
Superintendent
Fee collected /exempted by Pauline Pearson Payment Received $6,573.84
Check No. 7881
Signature 1t {�i a ann r ca
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
f 1
a .
s _ CITY OF LA QUINTA
Ego; - .; SUILDiNG 11 SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-7153
Owner
Contractor SPARKS CONSTRUCTION
Permit Number
9601-088
POST ON JOB IN CONSPICUOUS. PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-050 VIA SAN CLARA
SFD LOT 26 PLAN 2
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING 1770
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED,,
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST -
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP t-? 13
GROUT ❑ ,4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR —
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
01 ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
1/95 TURN ON UTILITIES OR OCCUPY BUILDING
EXISTING RESIDENCE
(UNCUANGED)
REMOVE EXISTING DOOR WINDOWS 4 WALL
fIO4 SQ . FT.
TOTAL GL, AREA). R
E
PL
A
CE
U
/
NEW 15I X SI FOLD IN T MPEREDG ASS
D00 S*rST M (55 50. FT. TOTAL L. AREA). ).
EXISTING COVERED AO l OVERALL fsn CLEAR OVER �$ SOLAR,BAN
I
60L OW -E. U -VALUE = .31 F_ 162.44
----------._. ----
-
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a
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= 1Yi (E)
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EXISTING
-- (E) DECK RESIDENCE
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SCALE: /q _ - I -On � -AREA OF I1'�IPRO� MENT
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INSTALL NEW AC 6
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INSTALL, NEW 51/ X AM
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STA A. SI OF M. _ 1 R P E DE B
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AUG 26
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EXISTING ROOF LINES
V-0" T.O. CSL. DR. Sl'ST_EM�
FF 011
CITY O LA WINTA
BUILDING & SAFETY DEPT.
FOR CONSTRUCTION
DATE BY
--&=
( C
M vr^& f
PROGRESSIVE DESIGN CONCEPTS
• Architectural Design
• Residential and Commercial
• Planning and Development
78-115 Calle Estado, Ste. 2105
La Quinta, CA 92253
Office (760) 664-4707 Fax (760) 5644955
www.swconcepts.com