9907-082 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury 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.
License # yLyic. Class Exp. Date
674074 0tl31 T�
Aa e � f ' Signature of Contractor ' ' '
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, asowner 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 1
Code).
O 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. ;
O} 1 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'.
CarrierPolicy No.
t
' `� 1'Ai.`G; ��I�+7#,�.. • 036�04ff75)n
(This section need not be completed if.the •permit valuation is for $100.00 or less).
O I certify that in.the performance of the work for which this permit is issued,
1 shall'.not employ any person, in any manner so as to become subject to the
workers: compensation laws -of California,, and agree hat) if I should become '
Subject to the workers' compensation'provisli�onns�of Section 3700 of the Labor
Code, -1-6,h- all forth ith comply with those prfivis'an's. '
ate: / ' aApplicant
Warning: Failure to -secure Works'-Gemp nsation coverage Is unla/ul and
shall subject an employer to criminal penalties and civil fines up to $1 QO,000,. iri
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. r
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 applicaton 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 applicatiorrbecomes null,voidif;
work is not commenced within 180 days, from,date of issuance ofsuch}
permit, or cessation of work for 180. days wi11 subject permit to cancellation.
I certify that l have read this application and state that the above info matro1�1.n is
correct. I agree to comply with all City, and "State laws relating to the building qrt
construction, and hereby authorize reps sentatives of this City to enter upon l
the above-mentioned pproperty for inspection p�i�lrposes.
�gnature (Owner/Agent)- Date /7
��. - ,
BUILDING PERMIT . PERMIT# r'
DATE / VALUATIONp y o LOT _ { TRACT 251.54 yy ;
V�
JOBSITEG
ADDRESS '%S,+ J IVIA VENTA A
APN
646-331-011
OWNER
CONTRACTOR/DESIGNER/ENGINEER
TTS DESERT ;DEVE:Y..C).t'MENTSFA�ItS
4 CONISTRUCI SON
80. x714
79495 zaAtvCHO LA QUfN A DR.
:i A QLf(N'1',A CA 92,253
LA 1QUIN1.'A CA 0,1253
(760)774-1941 CBL:.4 2996
USE OF PERMIT
SFI.) -.LOT 31 PLAN VIM -: P.CR14JX'T`DORS'NOT "1NaAJDG BLOCi:.'WJV.L
OPI f;OOL..7s0/o.PLAN 0;N:.CK >i; 1 RE UCTfONFORMUIATIPLE.
1SSUA.Mh f)R Sl#MS PLAI4 PX
CUSTOM CC NSTRUCT.Pvi4 ,. :1.038.00 SF '
(JARAGFJCiW,()it,'T" ,i►±7 Sly '.
''RBA FM CMf. f3+' CONSTRUCTION,73,2:
'.�.���ts��•'y
S 0[X)00t c
my.�r/��Ti7�7:N-�.�#1��' 101-'0(X)4184000
Cffrc .'. tO,k-000!1439-318 WPM..
a IECEIANI1;,%9, FE.8 ,cfa $53.50.
ELECTRIC Ail 1 X11 101-000-420-000 $134,559
t,tft� f�rf�f'kl; I0-i1f10-X19<t100 #X00
siR-0-Na. mcn r.)N FEE- RX P.) 10140-24:11-400
GRA DING FM- !01»13#)0��1�3 d3iSfl X20.00 •
)WI2ASi'itfTGTL `IRE. 225-09.0-443-3112 ;s s
ART IN PUBLIC PLACE,9 - f FSS 701 -WO -25: 000
W?i =lOIAL C0'_N:8TRTJC0W AND PJAi0,H6CK
$5X4 139
-
LESS PW-PM1ID.FEES
$0110 • .
r, f Y `r MAI,, YE RiV ff FIVES D UE NOW
��,,5'�2.3!➢
RECEIPTDATE
BYjiiiiyyyy
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
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
j.
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
Fina,
Uti'fdy Notice (Perm)
COMMENTS:
,
I'.1�MF LA QUINTA
LD•ING &SAFETY DEPARTMENT ;
"OF `. _ 1777-7012 Y y
f' , f '�• � 1, �. it 4 QQ -•". - I•- 1
�. 2"�9PECTION REQUEST LINE, `
777-7153 F
Owner TaRFSERT DEVELOPMENT"
07)
�� • i Contractor_` "SPARKS CONSTRUCTION
Permit Number `
9907-082
5`Y „ POST ON JOB. IN CONSPICUOUS PLACE
_ \, .,• _ y � ..INSPECTOR MUST SIGN ALL APPLICABLE SPACES ..
L ,.x`7896� VAIVEN
TANAJOB ADDRESS'
-SFD - LOT 31-PLAN VIA ---PERMIT DOES
,.Y
NOT INCLUDE BLOCK WALL'OR POOL.
TYPE OF INSPECTION DATE INSP.
FOUNDATION 8 SETBACK
FOOTING STEEL ,
MAIN GROUND SYSTEM
6. GROUND PLUMBING
PRE-GUNITE
kms. _ ' • S .1 _ T C. ' ;
DO NOT POUR CONCRETE UNTIL ALL'ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS -'
•,,.. -;� _ r. i 4 •ELECTRICAL GROUND WORK
e'.17/ DO NOT POUR CONCRETE UNTIL ALL' ABOVE-HAS BEEN SIGNED
f ROUGH ELECTRIC -
' , �� ?r` t, ROUGH PLUMBING
ROUGH GAS &GAS TEST Z -16e-
.7
HEATING BVENT -A/C', I;
r ''� ,r FIREPLACE
ROOF
BOND BEAM a
O.K. TO WRAP'-.
GROUT ❑ 4' ❑ .8 �F'
- tr FRAMING (/ '
1 y, . 4 r `,, INSULATION -,� • G'
PRE-ROOF, to
COVER NO WORK UNTIL'ABOVE HAS BEEN SIGNED
• ,*.. i 'a" f k ± �'� f. �' i. •+ DRYWALL INTERIOR ' �22
y EXTERIOR LATH
r
POOL PRE PLASTER
-
POOL FENCE & GATE
Jf ., Vit• ! :r -•Sa', SEWER SEPTIC TANK
l +° 4W 'FINALS
• _x-
' PLUMBING ` • __ _ - �.. :,, �.,,;,,, ,,.�i„ .. ,•„z
FINAL GAS TEST' '� '/ Gt+ • i•
y r r ��'=" '*• - - - - '
HEATING-A/C
HOUSE NUMBERS•
r`JOB COMPLETED j
TEMP POWER'
•
, i r r ��' • , - . , '. -. ( i ..
r
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO rrs
TURN ON UTILITIES OR OCCUPY BUILDING