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�- LICENSED CONTRACTOR DECLARATION
eby affirm that I am licensed under provisions of Chapter 9 (commencing with
on 7000) of Division 3 of the Business and Professionals Code, and my
se is in full force and effect.
se # ti Lic. Class•..... Exp. Date
ALCM
BUILDING
PERMIT
PERMITS k'�
.9areeilwrs
DATE 3! $/96
VALUATION $4.941.3t
LOT
TRACT
JOB SITE ADDRESS
5,-296 ,VENIDA ALVARADO
APN '
711-2411-014
OWNER
e
A r mEt •r in .&, ner-ry t rear.(
l'IVA..L+LrL•tka t.� AJC.! 4 A LAJI L"Ld
54296 AVENIDA ALVARA O
LA ( U[ 4'4:4 CA 92251
CONTRACTOR
f
OWNER/BUILDER •
i"ill:#
Signature of Contractor
- _
' OWNER -BUILDER DECLARATION
eby affirm that I am exempt from. the Contractor's License Law for the
ring reason.,'
1, as owner of the property, or my employees with wages as their sole
sensation, will do the work, and the structure is not intended or offered for
(Sec. 7044, Business & Professionals Code).
I, as owner of the property, am exclusively contracting with licensed
actors to construct the project (Sec. 7044; Business & Professionals Code).
am exempt under Section /B&P.C. for this reason
�6/ L` 4/766 -
T
DESIGNERIENGINEER
`
USE OF PERMIT?
ADDITION
,
BATHROOM ADDITION
A iI, {d Signature of Owner/ - // //,,d.. --T./.
. - ( ,; ..-.--i,,,,- -- - 11,..."
WORKER'S COMPENSATION DECLARATION
?by affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
pensation, as provided for by Section 3700 of the Labor Code, for the
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
3700 of the Labor Code, for the performance of the work for which this ,
is issued. My workers' compensation insurance carrier & policy no. are:
er Policy No.•
FEE DESCRIPTION
FEES
ADDrrIoN
E',5tTI1V$ttiTED
PERMIT 1 FETESUMMARY
PLAN CHECK FEE
CONSTRUCTION FEE
MECHANICAL
ELECTRIC /NI. FTI
PLUMBING FEE
GRADING FEE
S 1'Q 4( MOTION iii - IZES at "
SUB -TOTAL CONSTRUCTION
f __
1/
�y t
Q
J�
199c MAR
�. ( 11
• / U
'„ Y
91.00 SF
.
COST OF CONSTRUCTION
101-400.430-318 $46.80
101.-000-418-000 $72.00
t
101-000- 421-000
101-000.4,20-000 $18.19
_
301-(1UCi-4f y-i3U0 >�33,00
10I-000-123`000 $20.00
101-000-241- 000 $.50
AND PLAN CI-I.EC.K
•LESS IRE -PAID FEES
r "'EES DUE 'NOW
if ERM I'� 16'
1---11111111t11178
•
4,94E301
$190.49
$0.00
$190.49
IE
section need not be completed if the permit valuation is for $100.00 or less).
/certify that in the performance of the work for which this permit is issued,
not employ any person in any manner so as to become subject to the
compensation laws of California, and agree that if (,,should become
ect to the workers' com ensation rovisions of Section 3700 of the Labor
p P
e, I sheOfforthwith comply with those provisions. e
e% , / forth,
Applicant f` !,'.. �(_.� l
f �.r . .�. -« ..,,• ,i /
ming: Failure to secure Workers' Compensation coverage`" is unlawful and shall
sot an employer to criminal penalties and civil fines up to $100,000, in
to the cost of compensation, damages as provided for in Section 3706
e Labor Code, interest and attorney's fees.
DRTANT Application is hereby made to the Director of Building and Safety
permit subject to the conditions and restrictions set forth on his application.
Each person upon whose behalf this application is made & each person at
request and for whose benefit work is performed under or pursuant to
y permit issued as a result of this application agrees to, & shall, indemnify
hold harmless the City of Indian Wells, its officers, agents and employees.
Any permit issued as a result of this application becomes null and void if
is not commenced within 180 days from date of issuance of such
or cessation of work for 180 days will subject permit to cancellation.
that I have read this application and state that the above information is
ect. I agree to comply with all City, and State laws relating to the building
truction, and hereby authorize representatives of this City to enter upon the
/43 -mentioned property for in p'ection purposes. ✓
j �� f /�#
ature (Owner/Agent) I /,/G_..i! -4.) /11- / Date & /// %/
RECEIPT
DATE.,
BY DATERNALED `F
Je A-6'; 5
INSPECTOR
«" ,/ /,1/' '
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
$'
Underground Ducts
Forms & Footings
/,
Ducts
Slab Grade
t/
Return Air
Steel
'\
Combustion Air
Roof Deck -
Exhaust Fans
0.K to Wrap
F.A.U.
Framing
Compressor
Insulation
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
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
7//74
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
1s2)lL eot r!✓
i/' iyr
,
Final
rr
1.
COMMENTS:
19114 -it frL f�7Z, /T EZCT S'D&-P 4-5
VW 5)' U' �2Ervn 't L N/ii-
cn V}' • OQot ir fraVV Rev,- $
elerevow mene ty*v ONGe-
'Temp.
41wk isoteO
y
6I`�(40
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
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) '
619-777-7153
LICENSED CONTRACTOR DECLARATION
I hereby affirm 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
Date SignatureofContractor
OWNER -BUILDER DECLARATION
I hereby affirm 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).
( ) I am exempt under Section •, B&P.C. for this reason
t, Date ,� Signatureof Owner •.r z
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 Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
(,);•1 certify that in the performance of the work for which this permit is issued,
I shell not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I.should become
subject to the workers' compensation .provisions of Section/3700 of the Labor
Code, I sha)f foqhwith comply with those provisions. 1.,
Date: -41'/ . L Applicant ! ° ,�•1• • .
Warning: Failure to secure Workers' Compensation coverage iunlawful 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 application agrees to, & shall, indemnify
& hold harmless the City of Indian Wells, 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.
1 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 thia City to enter upon the
above-mentioned property for inspection purposes. i •'
Signature (Owner/Agent) 61 ' ! 1' Dale "5!J/
j•
i //
ALC 1
BUILDING PERMIT
I PEHMI Ii
9441.1-01 S
DATE
31 ;W%
VALUATION
$4,941.3'0
LOT
TRACT
JOS SITE ADDRESS
OWNER
ti�-; GID .a 9 S• 1431.4 .iF,\ :+,ia iWs
t 1f? 1:'1 1 L', r, teh i'1'\' i , fin.";
!\Ii.\�..1 ...14d •... 4)1..1 . l ,.4... ... c..,
5,12u .\VENti.)A
i.,AykJ NTA.i.'.!•1
APN
CONTRACTOR
w.tr-4:•rniut.ii OAT
1'141.12
USE OF PERMIT
!1LJ1)1.I iCJ1
DESIGNERIENGINEER
101'1'111:f )[ •i'i Al 21=i'I.il 11,4
FEE DESCRIPTION
FEES
1 !1v :,I•
('1':1) i::6 ;U:i
�'ritiil!�4..1le;
!: l 11111;•1-f'
i /;V:;i•Ci<1.,� ."i'i: •id L' 1.1'1: c V i OUi.i- 11 %+ 001;
1.)121.
ki.i?t.:•I'I<ti'!`:!. i l:1. 1114 •iii):'• -1 .''.i 121 /+;
!'Lill�ltaP:' i J i;l{ li)I •iiElli..I!';.t2U,2
11)1-0!00• I..'. -iii il•
,. i'l h•li,�,'.IV 111.1.11'l.l; .:i:: X11,? ilr1, c�i;';2•,'il•'1Ut1
3
•Il{11 L 11.21 1 I1;!:' "1 It .11`:41 Si2..ii. '. Il i'.t. i:.
:r' ' :: I •i•:I'-i':til.% I. it;n
fit..
RECEIPT
:gyp j!
DATE••...,.•,
4,1)4 ,J l
(iu
N1911.49
Mi�i iiitl���1111 of
IE
BY
DATE FlNALED
INS
PECTOR
11110111111111 02
INSPECTION RECORD
c
roo
Q
OPERATION
DATE
INSPECTOR
OPERATION
DATEINSPt_
vo
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Ccmbustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
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
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
7,/147
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 Nctice (Perm) .
1111111119111111111 03
IE
Notice:
Document Cannot Be Duplicated
Date 3/8/96
No. 14213
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Owner Name Aurellio & Betty Lopez
Jurisdiction
No 54-296
City La Quinta
Tract #
Street Avenida Alvarado
Type of Development
Comments
Lot #
Residential Addition
Zip CA
APN #
Permit #
Log #
Study Area 111
Square Footage 91
No. of Units 1
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: •
EXEMPT
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 0.00 x 91 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.
Fees Paid By Aurellio Lopez (no fee paid)
Name on the check
By Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Mitch Moldenhauer Exempt
Check No. 0
Signature
Telephone 619-564-4765
$0.00
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
r7'
�c�fiTica:e ot, CamDiiance: Residential
(Page 1 OT 2) CF -1R
40/9L, ,2�GGL
oject Title v' D X _ 3 %
A
4 ZGQ wit/ AA— -L j144D o
oject Address
• OU.//.4 Tom • (L 11-(3
ocurnentation Author
3mpliance Melhodc adage °int System or Computer)
iENERAL INFORMATION
-otal Conditioned Floor Area:
3uilding Type:
:heck one or more)
=root Orientation: 21 0°1
•
\lumber of Dwelling Units:
=loor Construction Type:
564,47Gs'
Telephone
Climate Zone
Date k Atie � /c/4G
Building Permit a
Plan Check i Date
Field Check i Date
cntorcoment Agency use Only
q.( tt2
:Single Family
Mufti -Family
North / East / Sout
(Input onentatlon in degr
Addition
Existing -Plus -Addition
/ All Orientations
d cirde one.)
3UILDING SHELL INSULATION
Construction
Insulation Assembly .
R -Value U -Value
;,omponent
rype
Wall
Wall
Roof
Root
Floor
Floor
Slab Edge
Raised Floor (circle one or both)
Location/Comments
. (attic, to garage, typical, etc.)
1.-(3$
FENESTRATION
Fenestration Area
Orientation (st
Front ( )
Front ( )
Lett (
Left (
Rear (E )
Rear ( )
Right ( )
Right ( )
Skylight
Skylight
t
THERMAL MASS
Type/Covering
(slab/exposed. tile. etc.)
Fenestration
U -value
Devices
Interior Exterior
Overhang Framing Type
(roller blind.,etc.) (shadescreen, etc.) !ves/no) (metal/wood/yin I)
Area Thickness
Isf) (inches)
Pik 3
Revised January 1992
Location/Description (kitchen. batn. etc.)
Certificate of Compliance: Residential
(Page 2 of 2) CF -1 R
Project Title
Date
HVAC SYSTEMS
Note: Input hydroa c or combined
Heating Equipment
Type (furnace, heat
pump'. etc.)
hydrornc data
Minimum
Efficiency
(AFUE/HSPF)
Cooling Equipment
Type (air conditioner,
heat pump. evao. cooling)
under Water Heating Systems, except Design Hearing Load.
Distribution .
Type and.. Duct or
Location Piping Thermostat
(ducts/attic. etc.) R -Value Type
Minimum
Efficiency
(SEER)
Duct
Location
(attic, etc.)
Duct
R -Value
WATER HEATING SYSTEMS
Water Heater
Type
Distribution
Type
Thermostat Configuration
Type
(soli, or package)
Energy
Rated t Tank • Factor or
Number Input (kW Capacity Recovery Standby(
in System or Btu/hr) (gallons) Efficiency Loss %)
External,
Tank
Insulation
R -Value
1. For small gas storage (rated input s 75.000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor.
For large gas storage water hatters (rated input 2 75,000 Btu/fir), list Rated Input, Recovery Efficiency and Standby Loss.
For Instantaneous gas water heaters, fist Rated Input and Recovery Efficiency.
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6, of
the California Code of Regulations, and the administrative regulations to Implement them. This certificate has been signed by the
individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple
orientations, any shading feature that is varied is indicated in the Special Features/Remarks section.
Designer or Owner (per Business & Profession, Code) .Documentation Author
Name:
Tide/Firm:
Address:
Telephone:
Lic.*:
600S -,Z /r'-U.€6j , a
3/7
Av/,c//vim /7L/A-AU
.4Qv«l7/9 l'/1- Qz5-�.�
6/q� S-314 476
/d/c
(signature)'
Enforcement Agency
Name:
Tide:
Agency:
Telephone:
(date)
(Signature/stamp) (date)
Revised January 1992
Name:
Tide/Firm:
Address:
1 / 0,4 Z, Al. v
,c.), /303. 3/
S4 2 Aet/6,v/ pig/// _O
L,9 �v//.✓ T� r 0, .1.3
Telephone: 4 /y 5Z 4 6 i
(signature) (date)
V s : a,: �-- • r,. ,-• ;' ,,._ ., �`~t� y: � rpt' ��+1" ''f y '�ti:� %lka~'• . ��`7'1�'"^�l't""r�'ry�t"�7.1'br• s.ny:.:'h--t` �i
•
4 4 aditrad
78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253
TELEPHONE (619) 564-2246 FAX (619) 564-5617
OWNER /BUILDER: INFORMATION •
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Stare
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are -aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-105 Calle Estado
La Quinta, CA 92253
(619) 564-2246
FAX: (619) 564-5617
(oe',&a( /
OWNER'S SIGNATURE/'DATE
PROPERTY ADDRESS
PERMIT NUMBER(s)
44ut4a
78-495 CALLE TAMPICO — LA OUINTA, CALIFORNIA 92253 - (760) 777-7000
FAX (760) 777-7101
TDD (760) 777-1227
December 10, 1997
Aurellio & Betty Lopez
54-296 Avenida Alvarado
La Quinta, CA., 92253
RE: Addition Permit 9603-018 @ 54-296 Avenida Alvarado
Dear Mr. & Mrs. Lopez
The purpose of this letter is to inform you that your Addition Permit #9603-018, for the project
at 54-296 Avenida Alvarado, has expired. In accordance with 1994 UBC section 106.4.4, no
further work may be performed until a new has been issued.
Please contact Daniel P. Crawford Jr., Building Inspector I, at (760) 777-7012 to obtain any
information you need regarding a new permit and/or any required inspections. Should you
choose not to complete the project, we would then have to pursue any or all of the following
actions:
1) Abatement of the project through the City Attorney's Office and Code Compliance Division.
2) Notice of non -conforming structure placed upon property profile.
3) Action filed with Contractor State License Board. Optional if Owner/Builder.
Please contact us at your earliest convenience prior to 10 working days to resolve this issue, and
for any questions you may have.
Sincerely,
Mark Harold
Building,& Safety Manager
Daniel P. Crawfofd Jr.
Building Inspector I
cc: file
dpc
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253