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0008-118 (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 Ex ate 6 B /31/2( Date �� Signature of Con actor 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). ( ) I, as owner of the.property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) 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 STATE FUND Policy No. 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 come subject to the workers' compensation laws of C rnia, and agr a that 'f I should become subject to a orkers' compe ation p isions f Section 3700 of a r Code, I / f rt yith comply ith those pVis' . Date: r ,` Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby ize repr a atives.o this City to enter u on the above-mentioned prop rty fo insp ction urpo s. Signature (Owner/Agent) Date it �� BUILDING PERMIT, PERMIT# DATE VALUATION LOT 000$-118 TRACT Il 01 0 $2821106.00 85 29457.1 JOB SIT APN ADDRESS49-110 VISTA ESTRELLA 649-100-009 OWNER CONTRACTOR / DESIGNER / ENGINEER TD DESERT DEVELOPMENT SPARKS CONSTRUCTION PO BOX 1716 79-295 RANCHO LA QUINTADR. ' LA QUINTA CA 92253 LA QUINTA CA 92253 (760)771-1941 CBL4 2996 USE OF PERMIT SINGLE • FAMILY DWELLING SFD- LOT:85 PLAN:MIR - 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 GARAGE/CARPORT (SF) 13,582.80 ESMIATED COST OF CONSTRUCTION 282,106.00 PERMIT FEE SUMMARY CONSTRUCTION FEE 101-000-418-000 $1,280.00 -T.1 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 t -• PLUMBING FEE 101-000-419-000 $202.25 STRONG MOTION FEE - RESID 101-000-241-000 $28.21 GRADING FEE 101-000-423-000 $20.00 -'— C .1 ...'' DEVELOPER IMPACT FEE ART IN PUBLIC PLACES - RESIL 701-000-255-000 $205.27 SUB -TOTAL CONSTRUCTION AND PLAN CHECK $4,271.50 LESS PRE -PAID FEES $0,00. TOTAL PERMIT FEES DTIE NOW $4;27150 RECEIPT DATEBY DATE FINALED INSPECTOR (nr I, U 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 6'7'074 1;4 '`,,�}, rrf i171�2/2S J�� F4p Date f� � �>�r"a Signature of Contractor r OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's ° License Law for the following reason: ( ) 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). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals 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. ( ) 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 STATEFi1NID Policy No. 045-000`!338 (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, and.agree Fi3t�f I should become subject to the workers' compe fsation provisions of Section 3700 of thhe,Lab`r Code, I shall forthwith comply with those provisions. ,� Date: ' / �a1 �% Applicant\ - ,r ", 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 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 purpo`s`es`.- Signature (Owner/Agent) % tom' i Date BUILDING PERMITPERMIT# DATE VALUATION LOT .TRACT 85 29457=1 JOB SITE •� g�p �g,�p�y�qY A ADDRESS 49-v Vdt��8y6i 5ersll ter er<fA.t@R APN A(� y p��p 6'f9400"iJ�d7 OWNER ' Y CONTRACTOR / DESIGNER / ENGINEER ID D '.�RTDE'il'MOPL TY' SPAS CONSIR'CTar:'I`.jON PO BOX 1716 79.295 RAN CTYQ1AQUIWADR, Lit QTJWTA CA 92253 LA Qi.TL%I?A CA 92253 (760)771.1941. CBLft 2991; - USE OF PERMIT SFDS LOT:95 PLAXMIR - la;t1.'MIT DOES NOT 11BC LUDZ fitbCiCbYAL LS OR.' r P00h 750A PLAN CHECK R:Lt' WUCTION FOR MULTIPLE f0SU NCE OF SHARE PLA13. TYYE,' CUSTOM CONSTR;U,01`1014 3,34&00 OF PORC R(PATIC 1 S O;UO SF G&ViDEIC.ARPO T (SP) W313D COa�FY-O CONSTRU�sr110--N .• �,106.00 .• •. 9q��yy q�y. �yE�yg �[" ERS1vJ.Sl, Jp 9E S R Crtu1`.1t4►OTIwN ft►.?' 101.000.418!-000 $1,230,00 PLAN CHECK FEZ 1 41-000-439-318 $264.23 MECHANICAL FEE 101.000.421.000 S10-10 9LECTRICA, LFFF, 101.00"20-000 }'Lt1DtSBi3dC FEEC�140C?tt-419•Ut3t9207,23 # t STRONC1 MOTION PER < PASID 101-000-241.000 si} tryilpy.�A�1 Itil -00©-473,000 $20.00 rt1'tr�cy,�Fp�t�T,�ip] 6 �n�s t, tp Q ]DEVELOPER LO ER StF` PAC f 1 E—P � $1,9O!.00 - ;< r11 ART 114 PUBLIC PLACks - Ri.'8.tr 701.0t1p�255.0t3Ci $203,27 .� . SUB-S'OTAL C~o lar7.L1'CTlMAM PX.;B+,AI' CIiECIC $4,211.50 1EM FRE-PALD N% $0.00 IOTA L. PMAfff 1rN s DUE N 4 150 V RECEIPT • DATE { By ' "' ak;,. DATE FINALED INSPECIP I if t,,, Ili , INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade/�� Return Air Steel Roof Deck _ �// _ Combustion Air Exhaust Fans O.K to Wrap F.A.U. Framing�5' Insulation Fireplace P.L. p �' 06-�,/ —�� v—� Compressor Vents Grills Fireplace T.O. - - Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final _ POOLS - SPAS BLOCKWALL APPROVALS 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 _ y 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 / / Appliances Final COMMENTS: 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)