0002-206 (SFD)LICENSED CONTRACTOR .DECLARATION, 4 �•
I`hereby. affirm under penalty of perjury that I am licensed under provisions of
H ` Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
N W Professionals Code and my License is in'full force, and effect.
O M License #c> .,' Lic.Class . 'Exp. Date,,,:11,..;,
cn bisi i4 b llfJJl{lt/t
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LLJ
Z
Z r— Date ' ` Signature of Contractor � ^
Or Y
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J U 1 OWNER -BUILDER DECLARATION
W W I hereby affirm under penalty -of perjury that I am exempt from the Contractor's
� License Law for the following reason: •: ,. •
Z_ ( ) 1, 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).' f
( p 'I, as ,owner of the property, -am,ezclusively*contracting` with licensed
",contractors to construct the project (Sec: 7044,'Business•&,Professionals
Code), t ,:. !' • `
r CO O I am exempt under Section B&PC: for,this reasonLO'
0 N ,,; i Date. + Signature of :Owner
CL Z r WORKER'S COMPENSATION DECLARATION
O I,hereby affirm'under. penalty -ot, perjuryone'ofr•the following declarations:
'U-) F' 0 O I have and,will maintain a certificate of consent to self -insure for workers'
X W.LL compensation, as provided 'for, by "Section 3700 of the, Labor, Code, for rthe
OJ
ri _J performance of the work forwhyich this permit is issued:. ;
Q C) "'.(.'•) I have and will maintain Workers" compensation insurance, as required by
Q U•Q ` {.:Section 3700 of the Labor; Code, for the performance.of the work for which this
qm _ — permit is. issued. My workers compensation i."nsurance carrier & policy no. are:
v Z = _ Carrier STAT rt .E T 43h1t� Policy :No.. 04 0 j32V
E.
Q (This section need not be` completed rf tcb .51
he permit valuation is for $100.00 orless):
certify that in theperformance of the work for which this permit is issued,
1 shall bot 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 tooth workers'`compensation provisions of Section 3700'0. the Labor
Code;,•I shall forthwith complywith those powsions°"
-«
Date: 2"110"U
Applicant
Warning Failure to secure Workers,tCompensation coverage is Unlawful and
s
shall subject an`employer to criminal penalties and. civil fines up to $100,000; in
addition to the cost of compensation, damages as'proJided 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. e` ' .
` 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 applicator, agrees to, & shall, indemnify
& hold harmless the, City of La Quinta, 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.l 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 prope rty'for iFspection purposes
'-• Signature' (Owner/Agent) - �d�Date"
BUILDING. PERMIT PERMIT`+��aZ���
f 60
r'• Z�5l:
VALUATION�rIs11�+` LOT TR CT , !
DATE �/�
s ' f�
JOB SITE 6- YVik VPA 1 AAfI A
APN i ®+8Q1—.9K�t1 aYA..f+
ADDRESS F•'
r
OWNER
CONTRACTOR/DESIGNER/ENGINEER
i 1 3 171]•j� 1 11x1 P tTtApt,Fr
.9-:i. s,c,,.�.sVt lkA tilA 0.
CO A u114 ��•'!/ti Aicvy•qi1('''�'{{"� 7
..,.1 t'YI�A+,, S 1.t�,6.�.9FRU1. -t..4�!N, t .
19-295 RANC LA
L�14 i 1 i�r1'ti: '` CA 9.°L2 3
$.. l Utdd ' � C 253
............
;
USE OF PERMIT },. �:
UNG.[.F, FtAta46LY DWELLING t`
r�r.:•�. 7 ,r :Mr A'\t'iw n —?t ix;. •kms +,•..: n sn�'-�.
wzrcr v7+i+r,Y rw ,.Yr. ..a n 3.
Vl-: JI✓� i,\J V'NYd 1a61.1,Y Y Y-.• 1 SCM KJ.4✓.LMVI yYY.i Ai\VL4/LA:.ttae\Jt. } YY ,'1L4U. •rr, h ,
ORJAWI.'75%PI:.A'Ni~'a:?;r2IVi%si;i`14'!�lS�il}t�NCis
or SAW, PLXNrNq--E,
CUSTOM �1xi iti'
Al
ESTIMATED COST OP C;ONSTIRUCTION
1.73,4651.4,JgJ
CON TfRUC3WN FPS' '.'101-000-419_000 M)
z'z-�..ri�"•fiF.OK.?<3� 3tit.(Jf1t,�.��9-�'I� ���"t,.g;3
, ,, .. .• -
if-r:t^TRICALrEH 01 -OW -420-700 1-43A3
-PLtJ�ITINO iu Ii�1-00e - 1 4 1 : $143.25
T
.5 �,}t_C)t�i'F;� �,4(;�`t't�13J 3�� o li�V3F1'i tfJi•�f)f;()-�¢� f}f1Q � �i'I. �T
� m
".4f, 10-000.2 $20, 00
:~
Alf Dr PUBLiC PLACES -)tu, 7(0.000-255-0.0•® S184.14
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KIP-T�'!TAL 4tONS— R iC"E ick ,AND PLAN CHr*4rt ,
,$_.V_ 53
MEW Vin; P AID V.� S
0 01
'' " 00,06"-
.. � �
1, • •,
RECEIPT
DATE' i
BY ' %
DATE FINALEDINSPECTOR!;
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
• �.V
Underground Ducts
Forms & Footings
_
r/
Ducts
Slab Grade
L - -.W
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
pd
F.A.U.
Framing
Cic!
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 .. C .�
BLOCKWALL APPROVALS
Steel
_
POOLS - SPAS
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
7 Gc/
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer LateralPool
Cover
Sewer Connection
��
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final l
Utility Notice (Gas) G
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) *17
COMMENTS:
` 12/15/2000 10:04 7607711841
SPARKS CONSTRUCTION _ PAGE 03
'
!'
CITY OF LA QUINTA
BUILDING &SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
� , s
777-7153
,.
TA ASSERT DEV ELO
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Owner•
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i Contractor SPARKS CONSTRU ON �
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0002-206
i!t
-,-.
Permjit Number
'
POST ON JOB IN CONSPICU ACE
INSPECTOR MUST SIGN ALL ,= L� BLE SPACES'
I ° '
i
78-850 VLA« AN,A, i
JOB ADDRESS
SFD-LOT 60 PLAN V2-3- PERMIT DOES NOT
•
`
INCLUDE BLOCK WALLS OR POOL.
r
TYPE OF OF INSPECTION` DATE INSP.
��`
f "
.
FOUNDATION & SETBACK gyp'
I ' t•
#!•
;+t'.�
i
FOOTING STEEL
tj
MAIN GROUND SYSTEM
i
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GROUND PLUMBING
•
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL A L ABOVE HAS BEEN SIGNED
CONCRETESLA9
JOISTS & GIRDERS
•'
ELECTRICAL GROUND WORK ;
t + `
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
I
ROUGH PLUMBING ti
,
"
ROUGH GAS & GAS TEST
:I
HEATING & VENT -A/C
It'(
FIREPLACE
f
BOND BEAM
i
O.K. TO WRAP - C -'/
GROUT, 0 4' 0 8'
FRAMING i - cz j a'
iil
, '
•
INSULATION<
1
iii
PRE -ROOF
II
'COVER NO WORK UNTIL ABOVE HAS 13EEN SIGNED
i
DRYWALL INTERIOR
+ +
!
EXTERIOR LATHc
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL �. �..� cvo
f
i 1I
PLUMBING—,
' •
FINAL GAS TEST iY
i4'
'.
HEATING" -A/C
i
.HOUSE
NUMBERS
I.
JOBCOMPLETED
TEMP POWER
1 _ ABOVE APPROVALS DO NOT INCLUDE RIGHT 70
,TURN ON UTILITIES OR OCCUPY BUILDING I'�
+