0111-146 (AR)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.
Licenser# Lic. Class Exp. Dater
7 ice, iWa�r��+
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02
atSignature of Contractorll(__,,
-
OWNER -BUILDER - ECLARATI
1hereby 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 isnot 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 am exempt under Section B&P.C'. for this reason
Date Signature of Owner
WORKER'S COMPENSATION nECLARATION
I hefreby 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.
(Vf I have and,will maintain workers' compensation insurance, as required by
eption 3700 of the Labor Code, for the performance of the work for which this
ermit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier 3 ATE, 10)4D a Policy No. e229010023566
(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 a iree that i f.l)should become
subject.tohe workers' compen tion pr igio �of S ctioR,3700 of the Labor
,Code, e � ort with comply wit • '" s� pro i ons.
Date: Applicant • V'r �''
Warning: Failure to secure W� r ers' Compensa ion overage is unlawful and
shall subject an employer to cPiminal 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.
a
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. S,1
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 dertify 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 repfesentativesrof this City to enter upon
the above-mentioned proper or-irisdo pur oses.
Signature (Owner.. �,/'- Dat
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:' :BUILDING PERMIT PERMIT JI
DATE y I VALUATION Q+q ��pry' LOT �`� TRACT
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ADDRESS ,9944Z,•A
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OWNER -
CONTRACTOR /DESIGNER / EN INEER
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RECEIPT
DA}TEBY
DATE FINALED
INSPECTOR
INSPECTION RECORD
r OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings,
_
l�! 6
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
//L
F.A.U.
Framing
Insulation
�/ T 6�
�G ��Qp�
Compressor
Vents
Vents
Fireplace P.L.
_
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall -Int. lath
�(���
L
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
RON .
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
Under -ground 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) .
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 12/4/01 APN# 775-153-023
No. 22728 Jurisdiction La Quinta
owner NameEd & Joyce Hasse -146
Permit
No. 54-949 Street Riviera Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 60
Type of Development Residential Addition No. of Units 1
Comments
60 sq. ft. dinning room addition and remodel master bedroom/bath, living room and
kitchen.
m
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes.. It
has been determined the above-named owner is exempt from paying school fees at this time due to the following reason:
Residential Addition 500 Sq Feet or Less
EXEMPT.
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
0.00 X 60 or $ 0.00 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may,now be issued Va.
Fees Paid By N/A - Keith Brinson Telepibo e 773-5857
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Exempt $0.00
Check No. N/A
Signature
NOTICE: Pursuant of As bly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run frollythe date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the Dishi ('s)(s) behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting \\
N
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PGA WEST
RESIDENTIAL. ASSOCIATION, INC.
December 3, 2001
Edward H. Haase
54-949 Riviera
La Quinta, CA 92253
Dear Mr. and Mrs. Haase:
Mr. Don Adolph, Architectural Committee Chairman, has approved your new plans as submitted
dated October 2001 for your 54-949 Riviera residence. Upon completion please submit the_enclosed
Notice of Completion form to this office. Please be advised that any damage that occurs—to common
area including but not limited to roof, landscaping and electrical shall be the responsibility of the
homeowner.
We reserve the right to make a final inspection of this change to make sure that it matches the
original request. An.approval is based only on the aesthetics of your proposed plan and should not
be taken as any certification as to the construction worthiness or structural integrity of the proposed
change.
We appreciate your cooperation in submitting this request for approval. If I may be of further
assistance, please contact me at the HOA office, (760) 771-1-234 extension 15.
Sincerely,
�//'�l
Ke cGalliard
Operations Manager
cc: Architectural Committee
Enclosure
P.O. Box 1,060, La Quinta, California 92253, Telephone 760-771-1234 FAX 76D-771-5125
WM. NONA * A55OCIATE5 a Division of Fountainhead International
Architecture Planning Land Use Space Planning Interiors
Los Angeles, CA. Palm Desert, CA. Henderson, NV.
CI7Y (_) 73-350 EI Paseo Drive 5uite 206
�� ►1il91''A Palm Desert. CA. 92260
Tel. 760.25 1 .5353
oV 4 9 W"o Fax 760.251 .9602
BUILUIYIICa JejlVo 6hemail: architectnonaC�Daol.com
��Y
October 26, 2001
Keith Duane. Brinson
Brin5on Development
44306 Me5quite Drive
Indian Wells, CA 92210
RE: Haa5e Re5ldence Remodel
54-949 Riviera
La Qulnta, CA
Mr. ,Brm5on:.
A bulldlncg permit was 155ued for the remodel of the referenced project.
When you flr5t contacted me, you said that you were making changes, and that the
changes were minimal. You also stated that you have completed demolition based on
your planned changes, and not the approved plans. I have not had any written Instruction
from my client that Indicates that you have any authority to Instruct me to make changes.
In addition you told me that you wanted to get approvals "a5-you-6jo", and that you
wanted me to prepare these plans. You also Said that the Building official agreed to thl5
procedure.
When I told you that I would not prepare piece -meal plans, you demanded that I supply
you with electronic data on a disk, and that you would make the changes. A5 I told you
on the phone, "you cannot arbitrarily make changes that will impact the safety of the
building."
Based on what you have Indicated to me on the phone, and along with the marked -up
plans that you dropped off at my office, It appears that the building may be unsafe.
It seems to me that you have told different `stories' to the Building Department, the
Structural Engineer, to me, and to my client.
Brinson Development
October 2G,' 2001
Page 2
We normally work with general contractors on issues. of cost savings ,for our clients.,
when the opportunity presents itself as a viable. alternative to the- design drawings.
However, you have blatantly abused your position as a team player in this_project.
It ha5 come to my attention that you have hired someone to make changes to the plans
that we prepared which the City of La Quinta approved.
I also understand that you have called the Structural. Engineer with 5tatement5 that. you
- _-want_him__to work with your new architect.
1 would like to pass on a few expletives that relate to your brash procedures, but.] can't
bring myself down to the level that you occupy.
Your method and attitude is unprecedented.
-Please cease these procedures, and let's see if you can .start. over, and do this project
in a manner that 15 acceptable to industry standards.
Sincerely,'
WM. NONA t, ASSOCIATES
a Divi5ioQ of Fountainhead International
Wiliam Nona, Architect C74 17
WN:5n
CC Ed + Joyce Haase
Bruce Anderson, Structural Engineer
Greg Butler, Building t Safety Manager