0008-096 (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 # Lic. Class " Exp. Date
674074 8
Date ,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, 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). i
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.
( ) 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 5'Pd4.T13 FUND Policy No. 046 4i al
(This section need not be completed if the permit valuation is for $100.00 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 ma;;. Innerso as to become subject to the
workers' compensation laws of California, and gree that if I should'become
subject to the workers' compensation provision i of Section 3700 ofth Labor
'Code, I shall fAhwith comply with'those provisions. '
Date: Applicant/
Warning: Failure to secure WOrkeYS Compensation coverage is unlawfuland
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 hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent),.. �"' i ".Date��
v
BUILDING" PERMIT PERMIT#
96
DATE VALUATION ��ry�r,`�n' yJ�[��� LOT q�}0ON-� TRACT 29457-1
���yyq 66�g
f 1` 1i%.O21106 l7) 63 2945 i- 1
i r
JOB SITE /
APN
ADDRESS 4s-iU vim H►�'C rmA
e�4 ll?i1-S
OWNER
CONTRACTOR/DESIGNER/EN INEER
` ) DESwrDM.LoP2di NT
9P.ARKS C0NST"1Z1:1'CXT0N
PO BOX 1716
792:95 RANC`90 ISA QMNT.A DR
LA9.QjJW'A CA 92253
JL,AQUINTA to 92253
(760)771.1941 OUR 2996
USE OF PERMIT
W0J� " FAWZY fUZ7UITUIM0
SND- LDT:62 PL AN:Mlk a. PEWIT 19OES NOT INCLUi7N BL.00KWA.LLS OR
POOLr. 73% PLAN CHFCK FSE REDUCTIOX FOR: MULTIPLE ISSUA?aCK OF
SMF, PIAN T YPT,
CUSTOM C040TRUCTION :048,00 V
PORC JUMP 10 580.00 SF
,13ARAGUCARP012T (U) 13,582.80
E911IV11!ATED COSI' or CONST°,iai7C. ION
�A2,id?�i.t7�3
JP2;%md'FEE saJmbuki'
C0148TRUCTIQN FE 101.000.418.000 $1 nolvi
PLAN CHFCK FEF, 101-000-439-,318 2264.23
A+ IF..CII.ANICAI. PU 101.000.421*000 $149.50
MECTRICA.1. FEE 101 -0b"20-000 $215.04
:r
PLUMBIN11 Fa - 101000=419.000 3202,M
STROdC1 MOTION ME - RF,SID 7.01-000.241-000
,
�' `
GR,ADINO F1"F 101,060.423,-000 320.00
_ .•
DEVELOPER IMPACT FEI.
ART IN PUBLIC PDGF.$ - R981E 701 «000.255.000 $203.27
SM-` arAL WNW :R•U'M— 0ki'.AND Pi.€ N CIM.'r,
54,777.50
LESS .PT�i•PATD T7M9
$0.00
TOTAL 1'E W. , r IS DIRE BOW
-,271:%0
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
+���/
Underground Ducts
Forms & Footings
"tel
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
j`—
Exhaust Fans
OX to Wrap
_
F.A.U.
Framing
Compressor
Compressor
Insulation�—
—Ol
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall -Int. Lath
C�
( 2
Final
Final
POO S - PAS
BLOCKWAI,IL APPROVALS
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
Z-,
l
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral']
�T7�
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
CPMMENTS:
Final
Utility Notice (Gas)
i
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring :
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles�,3C/�'/
_
G.F.I.
— 7"
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Certificate of Occupancy 0jZ
City of La Quinta
Building and Safety'Department
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: 48-670 VISTA ESTRELLA
Use Classification: SFD Bldg. Permit No.: 0008-096
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TD DESERT DEVELOPMENT
Building Official
Address: P.O. BOX 1716
City: LA QUINTA, CA 92253
By: GARY HARTMAN
Date: 07-13-01
POST IN A CONSPICUOUS PLACE