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0105-110 (MISC)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. License # Lic. Class Exp. Date iwosio Date X.% 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 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 Date 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 S�'ection 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. : a,MPT (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 agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shell 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 $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. ` 1. Each person upon whose behalf this•application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harm;ess the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Si"gnature~(Owner/Agent) ' `"`� Date /"x J� UILDING PERMIT VALUATION LOT PERMIT# TRACT JOB SITE d..- APN ADDRESS .�, OWNER LA QV`.FNTA, CA 92253 USE OF PERMIT WiXATION CONTRACTOR/DESIGNER/ENGINEER 32,118 10 M -ON 1'.��UMA , .1AQUIWZA. C.A. 92253 {'?60)56481837 CBUP 6453 50.00 Ls ErVIUKIT-11D COST OP CORIWAIRM11110N TEMP 4?1d�°TI'U 'IO� '�f;1�ILM fU'1:?9004D-000 ,70 1 _- D a � MAY - 8 2001 CITY OF LA OUINTA FINANCE DEPT UM -TOTAL COWMPT::j'CCUOIRA7' LIM Pps-PAM F`=« ll{,84.b.a!'L PEULiM''l!S$�14!T.:e-0 IME .NON1 RECEIPT I DATE �f j lryf I BY I DATE FINALED I INSPECTOR -NI $200,00 $t?,00 $'. 00M INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION I 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 Wall Insulation Condensate Lines Party Wall 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 113tectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: ta-- (r L r kLld ✓✓ 01/ P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 May 7, 2001 Mr. Jeff Shively Jeff Shively Construction 41'--625 Eclectic Street, F-2 Palm Desert, CA 92260 SUBJECT: MINOR USE PERMIT 2001-287 Dear Mr. Shively: (760) 777-7000 FAX (760) 777-7101 The Community Development Department hereby approves your request to establish a temporary construction trailer at 53-350 Avenida Montezuma pursuant to Section 9.60.250 of the Municipal Code, subject to the following conditions: 1. Mounted on the exterior of the construction trailer door shall be a written notice providing emergency personnel your 24-hour emergency phone number they can call in case problems arise that need your prompt attention (i.e., minimum 1 " high letters). 2. Install one. 2A1OBC fire extinguisher inside the front exit door of the trailer. 3. The applicant will indemnify, defend and hold harmless the City of La Quinta in case of any legal claim or litigation arising out of the City's approval of this project. The City of La Quinta will have the right to select its defense counsel at its sole discretion. 4. The City may elect to add conditions to this application request to mitigate any problems that arise not previously addressed herein. The sales trailer shall be removed by May 7, 2002, unless the Community Development Director grants an extension. G:\WPD0CS\Itrcdi-MUP193 Century.wpd October 12, 1995 Titif 4 4(1V a" 78-495 CALLE TAMPICO — LA OUINTA, CALIFORNIA 92253 - (619) 777-7000 FAX .(619) 777-7101 Ronald & Janet Phelps 53-490 Avenida Montezuma La Quinta, CA 92253 Mr. & Mrs. Phelps: Certified Mail . It has come to the attention of this department that the separate structure located on your property is now or recently has been used as a rental unit in violation of La Quinta Municipal Code Chapter 9.42 which lists allowable and conditional uses of an SR Zone (special residential single family). I have attached a copy of -this chapter with this letter. Upon receipt of this letter, you are requested to cease all rental activity at your Montezuma property as soon as possible. If you have any questions regarding actual allowable uses of your property, please contact the Community Development Department at City Hall. I thank you, in advance, for your cooperation in this matter. Respectfully, Don Whelchel Code Compliance Officer I1 Roger Hirdler Community Safety Manager DW:es Enclosure 53490mon MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253�J