9601-078 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
Section
,r7000) of Division 3 of the Business and Professionals Code, and my
sense is in full force and effect. 674074 }3 7/31/95
License # ! Lic. Class Exp. Date
Date 4 , , /x7 jSignatureofC;,ontractor ., ;~1 L - --
-.- 4 - /
OWNER -BUILDER DECLAR*hON
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 theL 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 sectjcn,qe�dinot p completed if the permit valuatiop q 99 y,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 provisions of Section 3700 of the Labor
Code, I shall forttiw' comply with those provision
Date: /A t7_/49 Applicant s...
I ✓ if � � f
Warning: Failure to secure Workers' Compensation �n'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 oft IndiarL(!V,_ ells�,! 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 hereby authorize representatives ofAhis City to enter uponAhe
above-mentioned property fore inspection purpo S�
Signature (Owr*/Agsnt) T�; �` Date
���,/t,'-r' .ter. �=�' f -9''`•
v'r.(
ALCM—
•A� <- ;BUILDING PERMIT
PERMIT 4601.073
DATE 111. / b'
VALUATION 41 J,116..: iE
LOT 11
TRACT !
{
r
JOB SITE ADDRESS 7�41i9a VIA SAN C.LARA
APN 649-40&010
OWNER
CONTRACTOR
SP,A.RK.S CONSTRU(°T.CON
T.D. LP
1.01AVALSTON 13RIMIM RD NO.
P.O. BOX" 1716
LA QU1N'1A CA 922-53
11A. Q J[N'1'ti. r-; /i, _ 92 3
(019)7'71-194.1 C:4 Y;# 2996
t6.10774 ` �.9=t
DESIGNEPJENGINEER
P.V1KMrWr 11,91C..
23672 S[ITCHMDR.
USE OF PERMITJ.1i+iliL.l. l`AAfl LY liir EL,L'o.;i' G
Y AVV VADriNV f% it 47AV4 PH 1 A " 17 i
R.ANCH0 LA.QUINTA
PAL&C10 P1.,A142
FEE DESCRIPTION
FEES
k:17` TO41 C;ONSTRU(.1 014 3,822.00 Ll;'
PORCE PATIO 180,00 8F
GARA00CA,TWORT 066.00 Sit
I
{.
ESTIMATED COST OF CONSTRUCTION
313,181,40
PERN1.11T FEE" SUMMARY
y y Q
PMAN C-MCK EFF 101-000-4.39-331:~3 $1, l.35.3r3
CONSTRUCTION .t'M 101-000-41 M00 S1.323.50
MECHANICAL TQM 101-OW421-000 $131-00
EI,FC1`RJCAL FEE 101-090-420-000 $227,0.9
4y?:.4. HOING. VER, lot C)OO-419-(?f3C1 $205.00
ST Orta NIC x.10114 .Ff-T3 - RES.I l7 1.00-000441.00 $ 3.t -12
C3l�A�z'z�t�.1�.►�� 1G.1-i�n'i-42�-Ot�u 5��1.vi1
1WRAS1R1JC'1,'11:i2,L• ME 22,5-000-443,342 $610110.00
PRIrCISB- PL Aw 1014)00--44:1- i45 V51.00
- ART IN PUBLIC P1,,ACTS R:.RE-Sit- 70.1-0004255.0130 SS3'2,95
E
---� ' _ ^ L.CONSTRU(.'TION AN PLAN CHECK
LESS PRE -PAID FEES
D.
S9;"r03.1i3
, . A.00
JAN 2 2 1996
$9,703.1.6
r
By-------
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
6PERATION
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
4
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
•: i?mp. Use of Power
Utility Notice (Perm)
COMMENTS:
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
,82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date . 1/22/96 APN # 649-400-010
No, 14061 _ Jurisdiction , La Quinta
Owner Name T. D. Desert Development : Permit #
No. 79095 Street Via San Clara Log #
City La Quinta Zip 92253 Study Area 123
Tract # 27952-1 Lot # •10 Square Footage 3822 r
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 Occupancy for
this square footage in this proposed .project may now be issued.
Fees Paid By T.D. Desert Development _ Telephone 71 194.1
Name on the check
By Dolores A. BallesterosVV
�
Superintendent }�� �'t- _'.
Fee. collected /exempted by Pauline Pearson, Payment Received $6,573.`84
Check No. 7663
Signature 2 11 �?1
S �OwLA L01Yx_
Collector. Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original -Building Dept./Applicant 'Copy - Apolicant/Receipt Copy - Accounting ,
I
C111`VT ,OF LA QUINTA
�1 CAG & SAFETY DEPARTMENT
` 777-7012
t&0
JaN TION REQUEST LINE
-,,` 777-7153
Owner T.D. DESERT DEVELOPMENT
Contractor SPARKS CONSTRUCTION
9601-078
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
79-095 VIA SAN CLARA
JOB ADDRESS
SFD LOT 10 AN 2
TYPE OF INSPECTION DATE _ INSP.
FOUNDATION & SETBACK 0
FOOTING STEEL
MAIN GROUND SYSTEM
.GROUND PLUMBING
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 L Z
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION -
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIORL
jor �-,--EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
FINAL GAS TEST
HEATING - A/C
HOPSF N[IMRFRS
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
1/95 TURN ON UTILITIES OR OCCUPY BUILDING