0111-241 (SFD).
R D
LICENSED CONTRACTOECLARATION.
I hereby affirm under penalty of perjury that; I:am licensed under provisions of
Chapter 9 (commencing with Section 7000) of biv'ision 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
!�yy Z+ yy�r S yry
Date s^ f Signature of Contractdr f
OWNER-BUILDERMECLARATION '
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). f
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:
(.) -1 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,( ) 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.
OTATE FUND
(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,
[.shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California -and agree that if I sbou Id become
subject to the worl(ers' compensaton provisions of Section 3700,of.•the Labor
Code, I shall forthwith comply;,with those provisions.
DatedZ Applicant
Warn ng: Failure to secure o ker§''Compensat on coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,00&; 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-.fokh '.on .=his
application. tY
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 inspectit'urp0
es
Signature (Owner/Agent) f� Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0111-241 TRACT
/Z 4 /ol 74
JOB SITE ' ~'"�
APN
ADDRESS *.,aV MWEA it.,,�YRYLiLA
i�S° S114M-00 7
OWNER
CONTRACTOR / DESIGNER / ENGINEER
11..)7 ROPU `r D.M1 T1 DV1A :W
.'PA S C'OMERU(MON
PQ V7X°: 1716
79-x.595 RANCM LA Q 71MA DRQ
LA QUNTA CA 92253
LA QWNTA. CA 92253
(160)771..1941 CTiR 11996
y
USE OF PERMIT
R1'd'YLt,�''
Lr�t}T 74 .ir:4i��. Pt�N,��a'.tC�gnY1T Wife NOT 114C�LUOT±'.f t.00iK:'�;�iLi
t01) qF 1Ei�1.y,A��N
D'f4��.�.4 SPA OR D AYY EWA I SaX'.Y'R4iACH � ,
C;Cr]N>Pf&t CTION 1,9203. UP
POPWIMVID 255.00 2.17
"RAOMCARIPORT .47D.00 3?
EMD COST OF c(MMUC17C�
TpMJi
.A:.1r.l. 111YiR1.A6.
OONS, RUCT V14 "OU 101-000-418.000 S1,133,op
PLAN (:HRM FEE 101-000-430-318 $232.24
--
h i.pc,`MC&L ilW11? le i -QC 4-�12l��iJC9i? �kf,�. (4
PLUNDIR0 TM111%, )01-000-419-0 00 V75.76
=N iV o -L no rpm . izzsm 1101-000- 241-000
ORA INO t99 101-000-49.'1-000 WWO
DEV'ELOPY,R. WPfkCT M*W $1,907.0
UB
MIS
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92A.Kk
DEC 06
MORA UIKAI
RECEIPT ;f
BY
DATE FINAL
INSP
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
r _
Underground Ducts
Forms & Footings
Slab Grade
c - Q - Z
�r=� - Z �j
Ducts
Return Air
Steel
Combustion Air
Roof Deck
d c
Exhaust Fans
O.K. to Wrap
=����
F.A.U.
Framing
Insulation
_ _
�- �� —0Z
Compressor
Vents
Fireplace P.L.
_
Grills
_
Fireplace T.O.
_
Fans & Controls
Party Wall Insulation
_ _ _
Condensate Lines
Party Wall Firewall
_
Exterior Lath
—
Drywall - Int. Lath
Final
� QZ
Final
%/_� ��. ✓��
POOLS -'SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines /�
_
y=L�
Heater Final
Water Piping
62-
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
S/ �� - �!
Encapsulation
Gas Piping
Gas Test
a
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
�j--
ELECTRICAL APPROVALS
Temp. Power Pole
-.
Underground Conduit
Rough Wiring
S
Low Voltage Wiring
Fixtures
Main Service
_
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
_
Temp. Use of Power
Final
_ QZ
Utility Notice (Perm)
VC(ertificate of. Occupancy
..Cit y 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:
r BUILDING ADDRESS: 49-270 Vista Estrella
Use Classification: S,F.R.. Bldg. Permit No.: 0111-241'
Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: R -L
Owner of Building: T.D. DESERT DEVELOPMENT Address: PO BOX 1716
City: LA QUINTA CA.92253
By: GARY SHOWALTER
Dater 11-18-02
Building Official
l� - POST IN A CONSPICUOUS PLACE