0008-090 (SFD)LICENSED CONTRACTOR DECLARATION' L
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#-Lic. Class Exp. Date
674074 1 t2p
Date %�A/ r a 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
( ) 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).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors, to construct the project (Sec. 7044, Business & Professionals
Code). \£ ,
() l am exempt under Section B&P.C. for this reason
Date ` Signature of Owner
WORKER'S COMPENSATION DECLARATION tf
r
I hereby affirm under, penalty of perjury one of the following declarations:
O r 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
peiformance''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.
STATR FtIN 046-0 OM32 M
(This section need not be completed if the permit valuation is for $100.00 or less).
( i) , f 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 Calif ornia7:and agree thatfif I should become
-subject to the workers' compensation provisionsiof Section 3700 of the Labor
Code, I shall forthwith comply ,with those provisions.,' ft
Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and i
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 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 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 herebyauthorize rePresentatives of this City to'enter upon
the above-mentioned property for Inspection purposes.
Signature Date I -t _r
<< PERMIT#
BUILDING PERMIT.,
Oa r
DATE j VALUATION fi ' LOT TRACT
59
2945 -1
JOB SITE 'I • `J
ADDRESS Q Vi,TA X5TRVAat
APN
649-100-00.9
OWNER
CONTRACTOR/DESIGNER/EN (NEER
):1 `1' ?�1✓'�d J +j N . '3'
Tar
VPAYKS CG�i' f ie ;TT(il�i
'PLD.Boyl.17161
`19.295 RAWHOL?sQURT:1ADR
T A QC7il I'A CA 92253
LA QUW.fA ' .
CA 922$3
k
(766)771,-1941
CBIA 2996
USE OF PERMIT
SFDa LOT:59 PLAN:M3 • PFAMI ` DOES NOTINCLUDY, 0L0VY�`%�`rZ..LI_S ox.
'
P00),
CUSTOM CONSTRUCT ION
PORCH/PATIO SZi 00 SF
0ARAGSfCARPOWf (M y.. 43.91coo
X9r0AA1%DC06r OF CONFrRUCM011
351,399,30
P)MMU Mo W 1 f 1
�`!JA1S11si.1C1`IC�ziI✓ 101.00(1.41^OCKJ '. �e,S2I.5Q
ice:
PLAN CHRi"k YKE 101 -000 -4339 -318 -
MECHANICAL FEE 101,000-421.000 $13640
ELF,CTIUC;A1 VER 101-000-420-000
PLUMBING PGE 101.000.419.060LI
i '�
r: I g
STRONG ]MOTION TEP, • WKSID 101-000.241-000 ' X35:14-.
�
GRADING FRE 101.000-0:1-000 "��t1..#�
�» �" �•` ,�
ART IN PUOUC PLAW - R. U-' 701.000.255-,000 1378.47'
SUB-'1°Ci"1,` L ca0RiS"I`-RTJC'PI•0N AND PLAN CN3 VX .
,. 1546485,25
Li a 1! * 9
JAMS ??R aT'./lEt?
, : MOO
.�
RECEIPT
DATE1
By
�A
D� F L DO
INSPECTOR
I jt Ji' 1
!:
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set BacksiZ
Forms & Footings
��
Underground Ducts
Ducts
Slab Grade
Steel
f_
f�
Return Air
Combustion Air
Roof Deck
,p
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
3 _ / 22�
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_ ��tt _ _
Final G�
BLOCKWALL APPROVALS
Final
POO .-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
_
—zZ GAJ
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
/ l'Z
/
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
C MMENTS:
�P-�o
�=
Final
Utility Notice (Gas)
ELECTRI AL 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 j
Utility Notice (Perm)
SPECIAL INSPECTION SERVICE
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax . (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY �/%®Xy
O POST TENSIONED CONCRETE O ASPHALT O OTHER
O REINFORCED MASONRY O FIRE PROOFING
JOB LOCATION +0_
I�JC 'K T
59 C) VSa es I /a BQ A �, w'`�
`� {ri
REPORT SEQUENCE NO.
TYPE OF STURE
RUCT
PERMIT.N40.
DATE
DAY OF WEEK
MATERIAL DESCRIPTIONp
lul $ O k) �`� E #
ARCHITECT
INSP CTOR
HRS. CHARGED
ENGINEER -
ASSISTANTS
HRS. CHARGED
INSPECTION GENERAL SUB �
DATE CONTRACTOR CONTRACTOR •-/ i d w e I
E=, A, ,r S�8 A L-� 4. t2-� ►�Ci 1^%i �. 1 Z�c �,� nn,p_ N -`_
T, p.A o w s u r oX. - e7 AL
Arf -146&s bRushgid - 81o�,oq cIE,4A/e- 0P, +8
DX. l j�l ! eC,10Al
zr�Dov o .ew f' v
•
COPY SENT TO CLIENT ❑
CONTINUED ON NEXT PAGE ❑
PAGE OF /
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
SIGNATURE OF REGISTERED SPECTOR
DATE OF REPORT REGISTER NUMBER
P�
Certificate of Occupancy
City of La Quinta-
w FF =4
Building and Safety Dep*artment �o�ti4
This Certificate issued pursuant to -the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 48-.590 VISTA ESTRELLA
~ Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0008-090
.Occupancy Group: R-3 Type of Construction: VN Land Use Zone: 'RL
Owner
of Building: T.D. DESERT DEVELOPMENT Address:.. P.O. BOX 1716
City: LA QUINTA, CA 92253
By: GARY HARTMAN
Date: JUNE 4, 2001
Building Official II
TING & VENT -
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 0
FRAMING
INSULATION
PRE-FIOOF
COVER NO
DRYWALL INTERIi
EXTERIOR LATH
POOL PRE PLASTI
POOL FENCE & G1
SEWER SEPTIC TA
ELECTRICAL
PLUMBING
FINAL GAS TEST
TING - A/C
r:: SSE NUMBERi
JOB COMPLETED
TEMP POWER
UNTIL ABOVE HAS B
ABOVE #PROVALS DO NOT INCLUDE RIGHT TO
TURN fN UTILITIES OR OCCUPY BUILDING
Z0 39dd NOIiondlSNOO SA8VdS T08ZZLL09L G5:0Z Z00Z/0059 '
ip
CITY OF LA QUINTA
.
e9 9
ILDING & SAFETY DEPARTMENT
gal°F
777-701 Z
INSPECTION REQUEST LINE
777-7153
TA I
ESERT DEVELOP
ee,"- ca o7"Contractor
Owner
SP
CONSTRUCT
. d/7 L� y
7�i 747iS
!
Permit Nu mber
POST ON
0008090
08 IN CO
v
INSPECTOR MUST
SIGN ACL' APPLTCA SPACES
48-590 VISTA ESTRELLA
/
J08 ADDRESS
SFD-9
ERMIT DOES NOT
i
INCLUDE I
ILOCKWALLS OR. POOL
i
TYPE OF INSP =ON DATE INSP.
FOUNDATION S
CK
Q
rV r7l('
i
I
FOOTING STEEL
p 0 r3
MAIN GROUND SY
EM
GROUND PLUMBIN
- �-
PRE-GUNITE
{
DO NOT POUR CONCRETE
UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUl
ID WORK
L .�OT POUR CO
CRETE UNTIL ALL ABOVE HAS SEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
TING & VENT -
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 0
FRAMING
INSULATION
PRE-FIOOF
COVER NO
DRYWALL INTERIi
EXTERIOR LATH
POOL PRE PLASTI
POOL FENCE & G1
SEWER SEPTIC TA
ELECTRICAL
PLUMBING
FINAL GAS TEST
TING - A/C
r:: SSE NUMBERi
JOB COMPLETED
TEMP POWER
UNTIL ABOVE HAS B
ABOVE #PROVALS DO NOT INCLUDE RIGHT TO
TURN fN UTILITIES OR OCCUPY BUILDING
Z0 39dd NOIiondlSNOO SA8VdS T08ZZLL09L G5:0Z Z00Z/0059 '