SFD (0106-055)51540 Avenida Martinez
0106-055
LICENSED CONTRACTOR DECLARATION
Thereby 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
Date' % ` Signature of Contractor * - ((-ri/ G
OWNER -BUILDER ECLARATION
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 Linder 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. is issued. My workers' compensation insurance carrier & policy no. are:
Carver Policy No.
R. Mfirvff RMS CO A49MM102
(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 shall forthwith comply with those provisions.
/Date: : i, Applicant i
...Y,. e,
Warning: Failure to secure Wgrk rs• Compensation coverage is unlawful and
shall subject an employer to criNnaf 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 representatiGes of"this City to enter upon ;
the above-mentioned prdperty for inspection pur, oses.
/Signature (Owner/Agent)
BUILDING PERMIT PERMITk
DATE VALUATION LOT ( } ,-(' TRACT
7AS170 22 131-'x 1 '13
JOB SITE
APN
ADDRESS firr,, yy /y q •p A q/p ry yp 7 r
11-s640 AYhi3.V.{d. 6A h- i:- RQ76F.Sdf:.b:l.1A".uZ.
j S p p e1
f 7.1-142— llti i
77.1-142-Mi
OWNER
CONTRACTOR / DESIGNER / EN INEER
BUMONTOHOMONS
JOE QCT C34:ONMOCTtM
4 2-W0 COP Q_X 'DEBT F7M 120
78.545 a s' T`A1eUC3HTL ANE
PA 114 DIMEW t CA 92211
RMS 4 TD A:CaVMES CA 922.201
(760)360"6118 CM1. 3002.
USE OF PERMIT
3F0 — .PERMIT''DOES NOTNCLUI)E.IrWC:KWAL POOL O1i: T?1UV7,WA Y
A
PPILOACHMS' 3P>'.,,A19CRECK FF9 REDUCTflON FOR. MULTIPLE 1'k7 min o).?
SAME PLAINI TYPE
TRACT COWS'i':RUCTION SP
A
l+fr►1I.Ci os €L I'IC)J.O(i Gid
0APIA011211CA si'Oi1.'T .305.04
MTmlY'Y.htP,n4aC •R.' COST Off °r. -017s RuaJ.RY.fm
97,455.20
("ONS`I''RUCT3C N FEE 101-:000,418•000 $630, R;
PWII CKEICiiC
ME DIRPORIT 4180 , 00
X49C HANICA.L.?)EE U6150
F.LIW`.I"IiX.. , PEE $114,37
PLL9PAB1140 F89 101-000.4.19.000 =;; $130.00
S`1'#1,d ;ai4, MC1VON f U - .P iO 101.000=241-000 lom
€„"+RA- DrNo KE, 101-000-423-000 $20.00
DEVRLOPTA IMPACT WE S11007100
PRIIEVWB P3.AN 101 -000-.441-3 3.5 $100.00
MfTR L':°T1.ON' MT.) PUIX C R
$3,110,47
;QLX.19S PRE -RM 141M3
4250,00
AUG 2 2 2001
C Or. LA A
IF NANC DEPT.
RECEIPT
DATE
By.
DATE INALE
INSP OR
G t
ZZ f,
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
_ G
Exhaust Fans
0, K. to Wrap —
_
/Z _
F.A.U.
Framing
Insulation/-
%% -
b i
Compressor
Vents
Fireplace P.L.
_
!
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
3 -2 l - O 2L s
Final
$ (I C1Ji
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
f
ice[ t 9;10-k S_`
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
(moi . O 1 4S7
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) ej&e,
'{ 30-0y
P.O. BOX 1504 APPLICATION ONLY
Building[0-495[0-UD CALLS TAMPICO
Address d of P f/f ;) ut .7— LA QUINTA, CALIFORNIA 92253
Owner
5 L! r L.. D "i l" (•( 7r) Iiz I '<Z-0 r,/ a
Mailing
Address 7 7 J
City Zip Tel.
Pkt I s - ; 1—/ -s.. I f 3 yra - ./ -7y R
Address
City Zip
State Lic.
& Classif. y -7.3
Arch., Engr.,
Designer SicPf'xl
Tel
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number
Legal Description 6""'
Project Description 5 ^-
Lic. # 3 Uo Sq. Ft.
Size
New f/_
Address Tel.
4.,,r- . u ' o,P ti c r.' .57E -7 3 vG - 3 ? (_ c,
City
lJ Zips State
1 a a (, C. , Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of theBusiness an Prof/essions Code, and my license is in full force and
1.
S GNATUR ! 1 DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors 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 thealleged 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).
f: 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 II'
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.)
17 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
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.)
Policy No. JC T!(r ')•-- Cc'L
ompany . /i/ -c 7CjrJ i(/N 77ba✓l?4 ,u
r.
,k Copy is filed with the city. ❑ Certified copy is hereby furnished.
dcj
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.)
Ii
that in the performance of the word A9 which this permit is issued, I shall not
employ any person in an rn' nner.so as to be om subje t to t e Workers' Compensation
Laws of_Qalifo nia.
NOTICEI TO APPOCANT. It. a erm&king this Certificate f Exemption you should become
subject to the Workers' ComOeWation 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 it 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 aQplicant Date
Mailing Address
City, State, Zip
No. / No. Dw.
Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
mated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc. Uni
Infrastructure
TOTAL
REMARKS
AMOUNT
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:
WHITE = FINANCE YELLOW = APPLICANT
PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 8/20/01 APN# 773-142-003
No. 22395 Jurisdiction Palm Desert
Owner NameBuilding Horizons Permit #0106-055
No. 51-540 Street Avenida Martinez Log #
City La Quinta zip 92253 Study Area
Tract # BLK 113 Lot # 22 Square Footage 1599
Type of Development Single Family Residence No. of Units 1
Comments
@ City of La Quinta, verified new address (formerly known as 52-140 Martinez).
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 1,599 or $ 0.00 the property listed above and that building
y'
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
i w
Fees Paid By Exempt - Coign Franklin Telephone 760-360-6118
Name on the check j-
By Dr. Doris Wilson
Superintendent
Fee collected /exe pted by Annette Barlow Exempt
Signature
w Check No.
$0.00
NOTICE: 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
above 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
collect them on the District('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
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RC DISTRICT - PLANNING REVIEW FORM
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove
Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine:
1) that the proposed house design does not duplicate the same architectural style of any
house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for
Master Design Guidelines. If the applicant does need. to file a Master Design Guideline, please
transmitted this information to the Building and Safety Department as part of your correction
list. Please attach additional explanations as necessary.
APPLICANT BUILDING HORIZONS
SITE ADDRESS 51-540 Avenida Martinez
APN 773 _ 142 _ 003 CASE NO.: 2001-503
LEGAL: LOT 22 BLOCK 113 UNIT S.C.@V.L.Q.
CHECK AND APPROVED BY: Frpa Raker DATE:
Inform the assigned Building plan checker upon your assignment to this case. The CDD
Executive Secretary maintains a log book to track applications and assign case numbers.
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Verify legal and APN information
Consistent with MDG on file (as
applicable
APT
nED OMMUNITYOEVE OPM. NTO DEPT
E
MDG filing required (5 filings since
9/3/98)
EX
CA
MIT
E NO. _
Architectural variety within 200 feet of
the surrounding area:
Colors
Materials
Architectural design features
Other Requirements:
I
P.O. Box 1504
78-495 CALLS TAMPICO (760) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101.
A. -
May 24, 2001 I -
Mr. Joe Sitko
Building Horizons
42-600 Cook Street, .Suite 120
Palm Desert, CA 92211
SUBJECT:,MINOR USE PERMIT 2001-2911
Dear Mr. Sitko:
The Community Development* D_epartment hereby approves your request to establish
a construction storage bin at-51,-5_4.0_.A-v_enid_a Martinez pursuant to Section 9.60.210
of the Municipal Code, subject to the following conditions:
1. Mounted on the exterior of the storage bin shall be a written notice providing
emergency personnel your 24-hour emergency phone number they can call in
case problems arise thatneed your prompt attention (i.e., minimum 1 " high
letters).
2. Install one 2A1 OBC fire extinguisher inside the front exit door of the trailer.
3. The City may elect to add conditions to this application request to mitigate any
problems that arise not previously addressed herein in addition to those stated
herein and in the attached letter.
4. The applicant agrees to indemnify, defend, and hold harmless the City of La
Quinta in the event of any legal claim or litigation arising out of the City's
approval of this permit. The City of La Quinta shall have the right to select its
defense counsel in its sole discretion.
5. The trailer shall be removed within 12 months or May 24, 2002, unless the
Community Development Director grants an extension.
G:\WPDOCS\ItrApprvl TUP 250.wpd
This decision may be appealed to the Planning Commission provided the necessary
paperwork and filing fee of $175.00 are filed with this office within 15 days.
If you have any questions, please contact me at 760-777-7125.
Sincerely,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
CHRISTINE DI IORIO
Planning Manager
CDI:bjs
Attachments
c: %Building and Safety Director, Code Compliance Department, & Counter
7echnici01.
Public Works Director
Fire Department
G:\WPDOCS\ItrApprvl TUP 250.wpd
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vimuf4iiY DEVELOPMENT
/DEPAR W, :;
PY' v DATE
EXHIBIT
d
CASE RIO.fit
I
I
DO
mg r 41(17I
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24, State of California, in the building at
C6— Ave Martinez, La Quinta, CA_ r
CEILINGS:
TYPE: BLOWN IN MANUFACTURER: Certainteed THICKNESS: R-38
WALLS:
TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-13
GENERAL CONTRACTOR: BUILDING HORIZONS LICENSE*
, 1 1
BY: 064&(N 65Si7i /j/I TITLE: PG ( 2 f% f
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
BY: TITLE: OFFICE MANAGER DATE: 05/21/2002
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24, State of California, in the building located at
51-540 Ave Martinez, La Quinta, CA
CEILINGS:
TYPE: BLOWN IN MANUFACTURER: Certainteed THICKNESS: R-38
WALLS:
TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-13
GENERAL CONTRACTOR: BUILDING HORIZONS LICENSE # 3- aC6
BY:
oho('
. ;5/! avn TITLE: L M
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
BY: TITLE: OFFICE MANAGER DATE: 05/21/2002
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification:
Occupancy Group:
Single Family Dwelling
51-540 Avenida Martinez
R-3 Type of Construction: RL
Owner of Building: Building Horizons
Building Official
Bldg. Permit No.: 0106-055
Land Use Zone: RC
Address: 42-600 Cook Street Ste #120
City: Palm Desert, CA., 92211
By: Daniel P. Crawford Jr.
Date: 5/31/02
POST IN A CONSPICUOUS PLACE