0008-117 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
F- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 w Professionals Code, and my License is in full force and effect.
O ch License # Lic. Class Exp. Date
t-
LLJ
d
67 4 B . /31/2(
oZ ti Date G Signature of Con actor
(D 0.
J1.-
0 OWNER -BUILDER DECLARATION
W W r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
H 0 License Law for the following reason:
U)
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).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
Ce) () I am exempt under Section B&P.C. for this reason
O N Date Signature of Owner
0)a Q WORKER'S COMPENSATION DECLARATION
p Z I hereby affirm under penalty of perjury one of the following declarations:
Ln H O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W u- compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q IJ ( ) I have,and will maintain workers' compensation insurance, as required by
QSection 3700 of the Labor Code, for the performance of the work for which this
U
Ii LO H permit is issued. My workers'. compensation insurance carrier & policy no. are:
,It Z Carrier Policy No.
ob O STATE FUND 046-0007338
(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, manner so as to become subject to the
workers' compensation laws of California, an Be that if I s Id become
3 subject to th w kers' compensation prov' Ions of ectio 00 I
he Labor
Code, I sh fo we comply with those rovisions.
Date: Applicant
Warning: Failure to secure Workers' Compensation 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 fo"r 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 authori epresentatives of this City to ente/up.,,n
the above-mentioned•propert r insp do oses.Signature (Owner/Agent) Date i7
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0008-117 TRACT
$282,106.00 84
29457-1
JOB SITd
APN
ADDRESS 49-090 VISTA ESTRELLA
1
649-100-009
OWNER
CONTRACTOR / DESIGNER / EN INEER
TD DESERT DEVELOPMENT
SPARKS CONSTRUCTION
PO BOTS 1716
79-295 RANCHO LA QU7INTA DR,
LA QUINTA CA 92253
LA QUINTA
CA 92253
(760)771-1941
CB1,4 2996
USE OF PERMIT
SINGLE FAMILY DVI== ATG
SFD- LOT:84 PLAN:M1 - PERMIT DOES NOT INCLUDE BLOCKWALLS OR
POOL, 75% PLAN CHECK FEE REDUCTION FOR MULTIPLE ISSUANCE OF
SAME PLAN TYPE.
CUSTOM CONSTRUCTION 3,348.00 SF .
PORCH/PATIO 580.00 SF
GARAOEICARPORT (SF) 13,582.80
-_....,
ESTRVIATED COST OF CONSTRUCTION
382,10500
PER IlTFEE SiTA4A4ARY
CONSTRUCTION FEE 101-000.418-000 .$11280.00
PLAN CHECK FEE 101-000-439-318 $264.23
MECHANICAL FEE 101-000-421-000 $149,50
ELECTRICAL FEE 101-000-420-000 $215.04
I-
O
PLUMBI14(3 FEE 101.000.419.000 $202,25
--i
STRONO MOTION FEE - RESID 101-000-241-000
ORADING FEE 101.000-423-000 $20.00
DEVELOPER IMPACT FEE. $1,907.00
ART IN PUBLIC PLACES - RESIE 701-000-255-000 $205,27
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$4,271.50
LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE NOW
$4,271.50
RECEIPT
DATE / L Lct,
BY
I
DATE FINALED
INSPECTOR
I
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
Z
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
BLOCKWA
14o
L dPPROVALS
POOLS - SPAS
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
.--� —2
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
ZVI
Pool Cover
Sewer Connection
ellEncapsulation
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
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Certificate.of Occupancy
City of La'Quinta
Buil.ding,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: 49-090 VISTA ESTRELLA
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0008-117
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RM
Owner of Building: T.D. DESERT DEVELOPMENT
Building Official
,,Address:
P.O. BOX 1716
City:
LA QUINTA, CA 92253
By:
GARY HARTMAN
Date:
JANUARY 10, 2002
POST IN A CONSPICUOUS PLACE