Loading...
RPL (9606-167) + SATT (12392)79655 Mandarina 9606-167 12392 07787 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 6%, 128 C53 10/3096 D a tele t I _1L Signature of Contractor ir _l OWNER -BUILDER DEC RATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 1, 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is4s'st(W.'l(iiVrJ&kers' compensation insurance ca"rrier%•j 856y' no. are: Carrier Policy No. (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 proof Section 3700 of the Labor Code, I hall forthwith comply with- hose provisions. Date: 1 /%_ Applicant f / Warning: Failure to secure W14. 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 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 property for,jnspectionn purposes. / Signature (Owner/Agent) h ' ',"%V Date 1 I,) 'CI BUILDING PERMIT PERMIT9OW167 CONTROL# 3630 DATE a rah VALUATION S7,00.011) LOT . TRACT JOB SITE ADDRESS 79-6'.55 MAN13()HINA APN OWNER CONTRACTOR/DESIGNER/ENGINEER #:t,fN1Y 1111,KSfIA CALIFORNIA E'(DOLS 8t. SPAS 7i7-655 MANWRTNA 41910 BOARDWALK fiA2 LA QUIN1'A CA 92251 PALKI DESERT CA 922tW) !619),140-«000 CBLN 355 USE OF PERMIT lk—KA, ANI VOR S'PA SPA. 0N1.Y 1 y✓ ✓ . I V l w9t't1. i!!w ,tx, l,ry 1'Ett11 IT 14;F SUMMARY I%AN C1IF("K Fi'st's 10i-00(?139-3IH SSIi.!ct► 1X!NS1'RVt 1'IQN l L -H 101-000.413-000 f40-11ANICAL FRE' — KA X. 101.000421-(100 I 1.v0 ELECTRICAL CTRICAL FFEs -- I"( (X 101-(XX1-420-(XX) SIS.tx► '-- I'1AtA4l31NG Fl --F P(x')l. I0149k-119.00() $3;.00 1;0B-'1 F,XL CONMItUC"ITON AND PLAN C RE CK S241.—SO LESS PRET-PAID FLES $o.00 .14 11 PERMIT FEMS OVE NOW 'J JUL O 1 1996 RECEIPT DATE/ / BY 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 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 Pibg. 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 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 Notice (Perm) I 4 P.O. BOX 1504 Building 78-105 79-655 Mandarina LA QUINTACCALIFORNIA 92253 Address Owner J.N. Peters Co. Mailing Address 3501 Jamboree Road City Zip Tel. Newport Beach, CA 92558 (714)854-2500 Contractor Same Address City lZip State LIC• B-1 310858ILoIty 1503 & Classif. Lic. # Desi gnerOr 9 $erkus Group Add storporate Way T X 714) 251--8262 Zip 92714 Lio # C6885 citirvine, CA LICENSED CsONTRACTOR'S DECLARATION I hereby affir th t.lg licens d under provisions of Chapter 9 (commencing with Section 7000) of Division acih €Business and Professions Code, and my licenS is icS full force ande effect. V . 'el, _, / 1 SIGNATURE ,r r / S, -/ DATE V OWNER -BUILDER DECLARATION I hereby affirm that I ani exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner or property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's ( gmpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy N.O.—Company f opy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant —Date— Mailing ateMailing Address City, State, Zip No. 32392 JILDING: TYPE CONST. OCC. GRP. P. Number 769-490-009 Description Project Description Lot 18 Tract 24890 Phase 1 Duplex Plan 2 ZONE: BY: m. Minimum Setback Distances: } r Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: Sq. Ft. Size 2439 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $194,335.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 792. 16 Const. 972.00 Mech. 62.00 Electrical 158.73 Plumbing 168.03 S.M.I. 19.50 Grading 20.00 Driveway Enc. .00 Infrastructure 4o3O9.11 Arts in Publdc Places . a i 0 TOTAL t .3 REMARKS 711 'yu V . U IjjJ3 / nU ZONE: BY: m. Minimum Setback Distances: } r Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. g UNITS SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) 2ND FL. SQ. FT. p FORMS Y ARD SPKLR SYSTEM POR. SQ. FT. p MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® OTHER APPJEQUIP. DRAINAGE PIPING WALL SQ. FT. ® TEMP. POLE DRINKING FOUNTAIN. SQ. FT. ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES =$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SPARK ARRESTOR SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ac HOUSE SEWER 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 & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. 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 APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL i 4 • V CITY OF LA QUINTA DEPARTMENT OF PLANNING & DEVELOPMENT BUILDING DIVISION -lN 01 Laa t1�11V�A 24-HOUR NOTICE FOR INSPECTIONS 777-7153 INOV3u I; Ownw J.M. Peters Co. Ldp`./� Contra) W Same Pwmk Number 12392 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 79-655 Mandarina Duplex TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK .FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING J PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS-BEEN SIGNED CONCRETE SLAB JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS 8 GAS TEST HEATING & VENT- A/C FIREPLACE BOND BEAM O.K. TO WRAP GROUT ❑ 4' ❑ 8' FRAMING G INSULATION PRE -ROOF COVER NO WORK UNTIL ABOYE HAS B EN SIGNED DRYWALL INTERIOR EXTERIOR LATH POOL PRE PLASTER POOL FENCE 8 GATE SEWER SEPTIC TANK _ G r I NAL UA.7 I Lb l HEATING - A/C ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING 4188 Building Address 79-655 ftadarina ce4.t t 4 4 QUM& P.O. BOX 1504 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 JH Peters Mailing Address12526 h Bluff PRO City I Zip ITel. Contractor Zip I Tel. State Lic.I City & Classif. Lie. # Designer Address Tel. CityI Zip I State I /E Lic. # fI LICENSED CONTRACTOR'S DECLARATION I hereby of itrrpp t t ' en ed under provisions of Chapter 9 (commencing with Section 7000) of Divi idn 3 bf El and Professions Code, and my license is in full force and effect. ; i OWNER•BUILDER DECLARATION I hereby affirm hat I m exempt from the Contractor's License Law for the following -son: (Sec. 7031. ,Bus ass and Professions Code: Any city or county which requires a 1.1-1, to cons uct, a er, improve, demolish, or repair any structure, prior to its fssuance also requires the ap licant /or such permit to lila a signetl statement that he is licensed pursuant to the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ Division 3 0/ the Business and Pro/essions Code, or that. he is exempt therefrom, and the basis for the allegetl exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty o/not more than live hundred dollars ($500J. ❑ 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner o/ property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered /or sale. 11, however, the building orImprovement is sold within one year o/ completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) PolNo. Company opy is filed with the city. ❑Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 the permit Is for one hundred dollars ($100) valuation or less.) I certify that in the performance of Ing 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. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. )ILDING: TYPE CONST. OCC. GRP. P. Number Citrus Course 07787 Legal Description Tract 24896-2 PlAf! Project Description I ot is Sq. Ft. No. No. Dw. Size 21631 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. fi Const. 947-,50 Mech. Electrical 125 9 Plumbing I Sri CA S.M.I. Grading Driveway Enc. Infrastructure ft TOTAL 1 6.3i1d_A'R 1 / .+- ./tet_/ ew REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CCNSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT: ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. FT. SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax.valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ®c BATH TUB FINAL INSP. SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL • SQ.FT.GAR ® 3/ac HOUSE SEWER VENTILATION �7 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 & AIR COND. SOLAR - SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING • REMARKS: VENTILATION �7 "' S it-�-i FIRE ZONE ROOFING :� n _ _L��a►-� . _ y� l�/r✓z c t-CXO FIREPLACE SPARK ARRESTOR �/_�� �! /d?39 GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL