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0310-006 (BLCK) s s {LICENSED CONTRACTOR DECLARATION U ,The er by affirm under penalty of perjury that I am licensed under provisions of BUILDING PERMIT PERMIT # F- Chapter 9 (commencing with Section 7000)of Division 3 of the Business and 03104 VALUATION LOT TRACT W Professionals Code,and my License is in full force and effect. 7 / a 30834 License# Lic.Class Exp-Date r� CY Lr) , JOB SITE ` APN w 447893 B MC / 558131/2� ADDRESS gl-��.a A NM:tib - - Z t-- /Date, ��' ��w�Signature of Contractor J"t t ✓ � OWNER CONTRACTOR/DESIGNER/EN (NEER I'— OWNER-BUILDER DECLARATION MAAIC)NF '£A°CC�" UC 8�3YIT�3?©Tl+l7'COI�MT1Gt�3 �. UJ W I hereby affirm under penalty of perjury that I am exempt from the Contractor's 437 S•HW`C 101 M7,219 44-420 VIA M11,SOL ~ U) License Law for the following reason: 301"A.HFA CA 92WIS LAQVIMA CA 92253 Z_ ( ) I, as owner of the property, or my employees with wages as their sole C160)34,5-5521 MIA 4320 compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professionals Code). USE OF PERMIT A,rl.f1310$a�;13T�1AQt1111 f� ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals OWKIRAI.,.BUJIMIG 441001,401•TE.R Y AVL.SUIT;203.6. Code).: .S,313 FT.ENTRY CkIATE•'IOWER AND 82S LIN FEET OF ENTRY OATZ LO CNJ () I am exempt under Section B&P.C.for this reason WALLS. PE:(i!t!iIT DOES NOT MCI UDE RENIA,11�F1? R,OF F'3.?RIMUE1'Ct WALLS CNJ Date Signature of Owner O rn &.PLUMB1110. 2001 COLU1•~5, Z WORKER'S COMPENSATION DECLARATION uo Q Cr I hereby affirm under penalty of perjury one of the following declarations: O O 1 have and will maintain a certificate of consent to self-insure for workers' V,A.L.'lINH013 101000,00 LS X w !L- • compensation, as provided for by Section 3700 of the Labor Code, for the 6 F'•WALL $15.00 LF O � Q performance of the work for which this permit is issued. Cal Q (� (!)` I have and will maintain workers'compensation insurance,as required by O U Q S66tion 3700 of the Labor Code, for the performance of the work for which this *Il LO H permit is issued. My workers' compensation insurance carrier & policy no. are: v z Carrier ob 5) 9TA'1'E J+IjW1.i Policy No. 46.10825.03 ESTA!IATED C'oYr OF COc" S"TItL1C`.'I3ON 90,62SAX) J (This section need not be completed if the permit valuation is for$100.00 or less). PLAN CHFCK FRE 101.000-439.318 53$9.33 ( ) I certify that in the performance of the work for which this permit.is issued, C014STRUCTION FC9• 101-0€10.418-0100 $5995.00 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if should become STRONG MO',tKYN PEE-RESID 101-000^241-000 $4.06 3 subject to the workers'compensation provisionsrof Secfionf3700 of the Labor 1tL1;C7'Itll'AL 1611 101.-000-420-000 $37.25 Code, I shall forthwith comply with those provisions r Date: -Applicant- Warning: 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 �-F��''COYJB'Sk�.ijTC1Tr3Yr AND 3�."l�i�f�'kl��'u any permit issued as a result of this applicaton agrees to, &shall, indemnify �,E h1Z• ,I'.AT1�)s'CJ� O,t10, & 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 ,PERM-7'VEM.''s•=K'Now $1,034.66 work is not commenced within 180 days from date of issuance of such n 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 ) 4'1003 + 11111111 IN 71 construction, and hereby authorize representatives of this City to enter upon C 2 IE the above-mentioned property for inspection purposes. RECEIPT DAT1t0ABYDATE FINA ED v INSPE, �TOR Signature (Owner/Agent) / ✓ Date T)" S — 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 V 401-9 F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 2S D Drywall-Int.Lath 6' d Final Final W1116--Y POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings k Main Drain Bond Beam - Approval to Cover Equipment Location Underground Electric Underground Plbg.Test Final I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances = Final COMMENTS: Final �� ��� �_��� � • Utility Notice(Gas) sr1M5 ELECTRICAL APPROVALS Temp.-Power Pole Underground Conduit Rough;Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp"Use of Power Final Utility Notice(Perm) LICENSED CONTRACTOR DECLARATIONBUILDING- PERMIT PERMIT# I hereby affirm under penalty of perjury that I am licensed under provisions of 0310-006 FN— Chapter 9(commencing with Section 7000)of Division 3 of the Business and DATE VALUATION LOT TRACT N W Professionals Code,and my License is in full force and effect. $90,625.00 30834 License# Lic.Class Exp.Date Lr) JOB SITE W r- 447883 B HIC 08/31/2( ADDRESS 81-310 AVENUE 58 APN Z r- Date Signature of Contractor OWNER CONTRACTOR/DESIGNER/EN (NEER o OWNER-BUILDER DECLARATION MADISON F=ATES LLC SOUTH POINT CONSTRUCTION � tp LU Lu U 437 S.H IY 101 ME 2l 9 44-420 VIA DEL SOL a- I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: SOLANABEACH CA 92075 . LA QUINTA CA 92253 Z_ ( ) I, as owner of the property, or my employees with wages as their sole (760)345-5521 CBL# 4320 compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professionals Code). USE OF PERMIT ANTONIO SANTAMARIA ( ) I, as owner of the property, am exclusively contracting with licensed GENERAL BUILDING 44100 MONTEREY AVE SUITE 201-B contractors to construct the project (Sec. 7044, Business & Professionals Code). 113 SQ.FT. ENTRY GATE TOWER AND 825 LIN FEET OF ENTRY GATE Ul) () I am exempt under Section a&P.C.for this reason WALLS. PERMIT DOES NOT INCLUDE REMAINDER OF PERIMETER WALLS Date Signature O O rn gnaure oOwner &PLUMBING. 2001 CODES. a Q WORKER'S COMPENSATION DECLARATION o 2 Z I hereby affirm under penalty of perjury one of the following declarations: .T H O ( ) I have and will maintain a certificate of consent to self-insure for workers' VALUATION 70,000.00 LS X W �= compensation, as provided for by Section 3700 of the Labor Code, for the 6 FT.WALL 825.00 LF O J Q performance of the work for which this permit is issued. C0 Q CJ ( ) I have and will maintain workers'compensation insurance,as required by p U Q Section 3700 of the Labor Code, for the performance of the work for which this Il 0) Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier STATE FUND Policy No. 46-10835-03 ESTIlVIATED COST OF CONSTRUC 0111 90,625.00 r- O PERMPT FEE SUND4"Y J (This section need not be completed if the permit valuation is for$100.00 or less). PLAN CHECK FEE 101-000-439-318 $389.35 ( ) I certify that in the performance of the work for which this permit is issued, CONSTRUCTION FEE 101-000-418-000 $599.00 I shall not employ any person in any manner so as to become subject to the STRONG MOTION FEE-RESID 101-000-241-000 $9.06 workers' compensation laws of California, and agree that if I should become ELECTRICAL FEE 101-000-420-000 $37.21 3 subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. 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 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 SUB-TOTAL CONSTRUCTION AND PLAN CHECK $1,034.66 whose request and for whose benefit work is performed under or pursuant to LESS PgE.pAIDS $0.00 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 TOTAL PERWr FEES DUE NOW $1,034.66 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 72IIIIIIIIIIIIIIIIIIIIIIIII construction, and hereby authorize representatives of this City to enter upon. IE the above-mentioned property for inspection purposes. RECEIPT DATE BY DATE FINALED INSPECTOR Signature (Owner/Agent) Date Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning .;. Beaumont .;. Calimesa Canyon Lake Coachella Dessert Hot Springs Indian Wells 4 - Indio Lake Elsinore La Quinta Moreno Valley Palm Desert 46 Perris 4c - Rancho Mirage o� San Jacinto 4 - Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, District 4 Marion Ashley District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072 December 3, 2003 I IIIIIII VIII III VIII IIII 70 IE Santamada & Associates 44-100 Monterey Avenue, Ste. 201 B Palm Desert, CA 92260 Re: Non -Structural Building Plan Review LAQ-03-BP-098 / 81-130 Avenue 58, La Quinta Stone Creek Ranch — Entry Tower Fire Department personnel have reviewed and approved the plans you submitted for the above referenced project. Please be advised the following conditions apply as a part of the conditions for the issuance of a building permit. Gate Power Operated drivewa iroad with powered ates . 1) Install Knox key operated switches, series KS -2P with dust cover, mounted per recommended standard of the Knox Company. Plans must be submitted to the Fire Department for approval of mounting location/position and operating standards. Special forms are available from this office for the ordering of the Key Switch. This form must be authorized and signed by this office for the correctly coded system to be purchased. Utility Room Structure 2) Install a portable fire extinguisher per Title 19, but not less than 2A1 OBC in rating. Contact certified extinguisher company for proper placement of equipment. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Sincerely, FRANK KAWASAKI Chief Fire Department Planner By Walter Brandes Fire Safety Specialist Cc: City of La Quinta — Building Dept. H:wFawP o•t u, QL*ft1PR0JEOTSWd by PCUAo-03-BP4 9.doc EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE 82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 8638886 • Fax (760) 863-7072