9701-103 (AR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Charter 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 Signature of Contractor
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
,dotnpensation, 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& :�f6his so
VDate - 5 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:
Gamer Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
I.�I certify that in the performance of the work for which this permit is issued,
all 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' compensdfion provisions of Section 3700 of the Labor
Code, I shall forthw' comply v�/. Whbse proviions.. ,
ate:. w i _ Applicant i [441 ons..
%�
�..
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. F
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 propert�r inspection purposes.
Ignature (Owner/Agent_ Date
BPERMIT# CONTROL#
BUILDING PERMIT
97111-1113 46 54
DATE VALUATION S7,6Z6 .iIt) LOT TRACT
JOB SITE
ADDRESS 53-296 AVIUSI )A h ONTMUMA
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
Ffillr,N F sc.If1 11 M- 1Cii
OWNER / WILDER
+3216 AVE il!(zNi'i?LDMA
LA Q4JINTA UA 022Sz
MIN
USE OF PERMIT
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FN''I f1CATEM CO3VY OF C'OtVti'I'1ttT110IN
7,626.0111
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1101,{100-'12 1-0m s21 tltl
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T'f:l's l'tlltl Ff:i.+
S000
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1 s Yi-A L 111';RM1'I' !%F3 % C)i W INOW
$305.62
RECEIPT
DATE
B1'
DATE FINALED
INSPECTOR
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
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
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
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
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)
COMMENTS:
Project Address: • �3 -� � � ��� %t,{9 � ,rj. AOwner's Name: t uac- it
xt-tC� iv A. P. P. Number: Address: 5--3 ,'7-9 6 ,,4- V o.
Legal Description: City,ST, Zip: �—
Contractor:
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Address:_5— Z0/ (,e. Project Description:,
City.ST, Zip: �:� l> f1-✓T`� /��
Tel h n
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P
State Lic. # : City Lic. #:
e
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
N0. PLUMBING FEES
'ST FL. SO FT , E
2ND FL. SO. FT
POR. 50. FT
GAR SO. FT.
CAR P SO. FT 4
WALL SO FT ,Z
50 cT.
ESTIMATED CONSTRUCTION VALUATION S
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to to useo as ;roceny :as va!uanon
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)tDISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOU1P.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE. TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. 4.c
BATH TUB
SO. FT. � c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID rs T!a a
SEWAGE DISPOSAL
SO.FT.GAR *y 4c
HOUSE SEWER
REMAILKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO: FEE .
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING A AIR GOND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.Q UNIT
COLL AREA
SLAB GRADE
ROUGH PLUMB,
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOU1P.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. Yd-
= plua xf
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMAILKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIOWSOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC,
FENCE FINAL
GARDEN WALL FINAL
..J - -S.
Notice:
Document Cannot Be Duplicated
Date 1/28/97
No. 15216
Owner Name Eugene Scheftner
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Jurisdiction
No. 53296 Street Avenida Montezuma
City La Quinta zip '92253
Tract # Lot #
APN # 774-033-029
La Quinta
Permit #
Log #
Study Area 111
Square Footage 186
Type of Development Residential Addition No. of Units 1
Comments
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 186 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 n/a
♦
' . ; �Telephune 564=4-292
Name on the check
By Dr. Carol McGrew
}'
Administrator in Charge
C� , �. : '�•�
Fee collected /exempted by Pauline Pearson
Exempt ; , )V00—
r
Check No. n/a
Signature
40TICE: Pursuant of Assembly 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
rbove will begin to run from the 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
bllect them on the Districl('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
f
a
.r
Scheftner Residence
53-296 Avenida Montezuma .
Requirements for Approval of Converted Patio
December 10, 1996
Provide verification of continuous footing under all exterior walls.
Verify 1/2" anchor bolts at 6' 0" on center and within 12" of corners.
Provide electrical outlets per NEC 210-52 in addition.
Provide means of maintaining 70 degrees at three feet above floor level. (Heating duct or
wall unit that ^meets CEC requirements.) .
Provide smoke detectors in residence per UBC for additions.
Verify minimum R-11 insulation in walls and R-19 insulation in ceiling.
Provide tempered glass adjacent to sliding glass door.
Verify no propane run to barbeque, or verify materials and installation.
Provide school fees exemption letter for added square footage.
Remove unpermitted, uninspected lattice covers in setback areas.
Obtain permits for lattice work that is not in setback areas, if they meet City Requirements
After the above items (construction and removals of lattice) are addressed, we will issue a
permit and accept the construction.
4
��tizy
4(4j
4
78-495 CALLS TAMPICO — LA OUINTA, CALIFORNIA 92253 - (619) 777-7000
,..
FAX (619) 777-7101
November 5, 1996
Mr. Eugene Scheftner
P.O. Box 1368
La Quinta, Ca. 92253
Re: Converted Patio at 53-296 Avenida Montezuma
Dear Mr. Scheftner:
Please accept this letter as a follow up to the visit by Danny Crawford and myself to your
property; located at 53-296 Avenida Montezuma, on Monday, November 5, 1996.
The Department of Building and Safety records for your property indicate your single family
dwelling, (including garage and patio) pool and spa, propane tank, and miscellaneous fencing all
obtained, inspected and approved during 1986. In 1988 a permit was issued for the installation of
a satellite dish and a permit (#04208) to screen in a cooler and patio work. The estimated value
given on this permit was $200.00, to screen a cooler and patio work. It is permit number 04208 .
that this letter will address.
The site visit to your propertywas specifically to see the extent of the patio work performed. The
"patio" is today a completed television room, completely enclosed, and the space is conditioned
by a swamp cooler. The permit card does not reflect any inspections performed during the course
of this improvement. While the work done appears to be professional in nature, our records
indicate that none of this work has been accepted by the City. If you have any documentation
regarding this project, we would be pleased to review them to resolve this matter. Without such
documentation, the following items must be addressed;
There are lattice covered patios located in side and/or rear setback areas. The current zoning
ordinance for La Quinta prohibits "any yard structure less than five feet from any rear property
line". This new ordinance is less restrictive than the previous ordinance in that the distance has
been decreased by five feet. The trellis' were'not permitted or inspected to meet City standards. .
The trellis work must be removed from setback areas unless accepted by the Community
Development Department, and the structures must comply with the City's structural requirements.
5 ' .
MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 ;'. ,
.4
A brick barbeque has been built against the back wall of the property in the setback area. While
the building department has no issue with the location of the barbeque, we would wish to verify
the materials andinstallation of any gas piping to that location.
The enclosure of the patio is the most difficult to accept as built, due to the lack of information
about the construction without benefit of any inspection. There are two courses we can take to
resolve this situation. One, treat the enclosure as an addition and obtain a permit, pay all
applicable fees and provide for the verification of compliance for portions of the construction; Or
to return the patio to its original condition.
To obtain a building permit we would require a school fee exemption letter, and applicable fees
for the addition, which would be $298.46. The elements of construction we would need to verify
are foundation depth under exterior walls, any shear elements in exterior walls, insulation
installed, and any electrical added. A heating duct must be added to the room and the glass
adjacent to the sliding glass door must be changed to tempered glass. Electrical outlets must be
placed per the requirements of Article 210-51 of the National Electric Code, and a review of the
energy elements required in 1988 would also need to be reviewed against what is currently in
place.
We look forward to assisting you in any way during the permitting process if you wish to continue
with the project.
Sincerely,
h"&--
Mark(Harold.
Building and Safety Manager
cc: Tom Hartung, Director of Building and Safety
i
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