SFD (0201-240)52691 Avenida Martinez
0201-240
'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
Date?3 Signature of Contractor A
f OWNER -BUILDER DECLARATION
(thereby 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&RCCAor 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:
Carrier VATS FUND Policy No. 229-01 UNIT 400463
(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.
Daie: 2 Applicant --Li
t lC.. F
r
Warning: Failure to secure Workers Compensation coverages unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest,and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at -
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
thea ode mentioned property fornspec fon purpoYs.
1 7 y ..
Si nature (Owner/Agent) ! d Y i r &.Date 4 9/ or
. BUILDING'PERMIT PERMIT#
DATE VALUATION LOT Q.'<t"S TRACT
j r
yy K.
11 1x1. ,l 44
JOB SITE ' `
AP INEER
ADDRESS r'l i$ Itov.Aw*AW .FrAiB (XaG,i
OWNER
CONTRACTOR/DESIGNER/EN
5690 ! MC=3014 ST
PJNl,3vf T31± Sx' ItT CA 9'2261
`1'C 'f . AL CA. 92274
!C160)399-1200 MU'A 1954
•
USE OF PERMIT
6M - PI:11WI3' DOES k10T MMUDE 131.G1ut ':DtAL1, POOL Oh L,'DAt !" `EWAY
APPROACH. 99 COM
TRACT G 'C NS'LTi'UCTION I.M4.00 $
PORC HIPA`i`iO X10.00 SF
GARAO.1SICAft O T 513,00 F
5 P'r. ,W? OOD F 'i l cr 200.00 L?
j /g p t 'Y+p , y Q-+ /' y ' y T 'y'y •p /. Q + , 67
. IR ; + 1
AiV C•i, 7l..SJA1J G. i S is'. l {.x4.7.1.94 .iG C'L,V. 111.114 Z`F
i•Aw :y4Ti'1;Y1P
PEP-Mr ' 17W SUMMARY:
C 'Ol' 5TRUC1110N ME 10141,00.416.000
PLJ .t4 CHHCX FL%e . 101-0,00.7.4.49-318 $491.$6
PEP; } 1y!-WO-421dg-• g000
yN}3Ey C HPA..1.41 / ..TAL :: @t /U.2.00
F!YeLr\:+TRICAL rIZE 101. -000 -420 -ate 1:E0 . 0
Pdh' VI IA.'D` D FEE 101-00 41 "00 $7.1 ri.1,5
STItOM 3iC 'iIOVf i EE,.-1 C;;3M' 1101-t10(- 1.000 stsa
(3h'.%i, ING E 1' 3'j -0007423-000 52610
1;DEVE' .,OPER IMPACTM.6' $1,9t1' ,00
1 RECIst +LIK14 101 _600-441 :.34S $100.00
,Y(>f •T( ( yy j'(^
• (' /' . p jq ( [ a'p'p( spry'
SUB
i t,d.i: affi 4.r W 7 .1 R,/3.1rl±.i l l b: i AND 1` .M'7.7.1J CHECK
q 7 7 AIS
$ ,3-72,. •J-2
— ' 1 EYP^% -Pim X
4250.UC
,15.12
PIMU' "T EM4. 71.T. :.Y' NOW
$3,124A2
tis 20 2002
t-MOFLAQUO A `}
RECEIPT
DATE //
BY
D E FINALED
INSPECTOR
9 r - . =---_. N/ 7., e r
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
4
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
3 7,Z4p y
Exhaust Fans
O.K. to Wrap
02-
F.A.U.
Framing
- . O Z
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_
7L 17
Final
Final p Y
BLOCKWALL A PROVALS
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
0. L
Heater Final
Water Piping
_
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
_ _ _
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole , O 2 (o
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) r -/ •O
COMMENTS:
rte,,. A\7y11G'ilry'.'t.1Lj ,T— Y'
of
o 1
. 11I1112-101112-10r"'PJ4A4,.4_ 4e//
VV
• 0 4 "
P.O. BOX 1504 APPLICATION ONLY
Building ? 78-495 CALLE TAMPICO
Address ' f[ fj - LA OUINTA, CALIFORNIA 92253
Owner L% M
tw BUILDING: TYPE'CONST,_ C- GRP.
Mailing y y3'— by
Address ?.O 3,x 3 S 64- A.P. Number 773 &/ _ oov . 9
.City / /} Zip TeL771-117&
. / - / r -e
Iil f L• Q f dt . L7 %/ - %L 7& Legal Description/ TQ% /cX oe
Contractor Project Description 51
AD/o re ,,U // 11"for
T
City Zip)
State Lic. % /I Z City
& Classif. { Lic. #
Arch., Engr., _.. /
Designer [;7i►! , r( Z
Address f, Tel.1 GJ `
City Zip/ State
/I ., / !/. 1 ::y . , `) ) )r/ t_ Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the BusinessandProfessions Code, and my license is in full force and
effect. k 4✓'_ 1 -
SIGNATURE wl DATE
e.
OWNER -BUILDER DECLARATION
I hereby affirm that I am 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 thathe 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).
I 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 or 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.)
I 1 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 contractors) licensed pursuant to the Contractor's License Law.)
it I 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 th eof. (Sec. 3800, Labor Code.)
Policy No. t> k _+ r 1 0 -Company '^ . "' ✓` "
r7 Copy is filed with the city. O Certified copy is hereb 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, alter making this Certificate or 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
Ihereby 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 applicant ' 1 yL Dated 1 /Z
Mailing Address
City, State, Zip '• + i <' =+ 1 -1
Sq. Ft. y 7 No.
Size Stories
New 2-' Add ❑ Alter ❑
n
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
No. Dw.
Units
Repair ❑ Demolition ❑
AMOUtj;,
;7
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
04 Lw ✓ ,
- PITWOF LA QUINTA
OFrtceo°S /BUII DIN'G:::& SAFETY DEPARTMENT
777-7012
:-3NSPQ ION REQUEST LINE I
tis j r, + "'I 777-7153
finer-MOUNT41MCOVE DEVELOPMENT
Contractor WIEFAAM-RUSSELL ROGERS
Permit Number 0201-240
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 52-691 AVENIDA MARTINEZ
STD - PERMIT DOES NOT INCLUDE BLOCK
WALL, POOL OR DRIVEWAY APPROACH.
98 CODE
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
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 & GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF 7 _
BOND BEAM
O.K. TO WRAP G ] •- )
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
y -
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER i
I POOL FENCE & GATE
SEWE$ SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER f.
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 2/14/02
No. 22946
Owner NameMountain Cove Development
No, 52-691
City La Quinta
Street Avenida Martinez
Tract # BLK 144 Lot #
Type of Development Single Family Residence
Comments
Family Residence 1344 s.f.
APN# 773-301-021
Jurisdiction La Quinta
zip 92253
Permit # 0201-240
Log #
Study Area
Square Footage 1344
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:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
2.05 X 1,344 or $ 2,755.20 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 CC/ Canyon National Bank - Larry Shields Telephone., 760-771-1670
Name on the check
By Dr. Doris Wilson
Superintendent c
Fee collected /exempted by Nicola Wong Payment Received $2,761.35
Check No. 9437
Signature
NOTICE: Pursuant to Assembly Bill 3081 (CHAP 549, STATS. 199) 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 bebin to run from the date on which the building or in lation 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 DistrictCs)(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
Fla
a
RC DISTRICT - PLANNING REVIEW FORM" NOv 2 82001
,..:t I" U1 LAUU1 dA
PLANNING DEPART.,V-:!. 17 i
This form is to be used by CDD staff for review of single family dwelling-g-'in-the-RC-`(-Cove-_.D j D
Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine: j
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. Poi VS AQ-sr2) li/z 8
k
APPLICANT
SITE ADDRESS
WR Rogers/Mt. Cove Development
APN 773 _ 301 _
LEGAL: LOT 8
52-691 Avenida Martinez
021 CASE NO.: 2001-590
CHECK AND APPROVED BY:
BLOCK 144 UNIT
Wally Nesbit
15 S.C.@V.L.Q.
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
vktll7 1,1-vn*-vat 71-2noyj Off ^
Consistent with MDG on file (as
applicable
MDG filing required (5 filings since
9/3/98)
Architectural variety within 200 feet of
the surrounding area:
Colors
Materials
Architectural d - ' 46 s
CO&P2 S 7D 430 Sirs/1.42 TO
Iv- OMj-S
Re
ann ng Com
Other Requirements: E3 City Council
Community 0
Initials
hvnkv-z 2 7a Case No. A Gcl)
7TKO Pte -i S Exhibit
X With Conditioir
mission
IV. Df
pt.
.... ....... ... .,—
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-- 59
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tis
CF 1OF f1
PLAN CHECK CORRECTIONS
December 18, 2001
Mr. Larry Shields
Re: 52-691 Avenida Martinez
Dear Mr. Shields,
TNis c cia+J ► c(►c.e
S P c ► A -L. coReGc iaaS
uQ
Regarding "Plan 1347 LS" by Thomas Hernandez (Design Classics), a single
family dwelling design:
This letter is to inform you that this application is being rejected as an
unacceptable submittal.
"Plans and specifications shall be drawn to scale upon substantial paper or cloth
and shall be of sufficient clarity to indicate the location, nature and extent of the
work proposed and show in detail that it will conform to the provisions of this .
code and all relevant laws, ordinances, rules and regulations." (1998 California
Building Code §106.3.3)
"All persons preparing or being in responsible control of plans, specifications, and
instruments of service for others shall sign those plans, specifications, and
instruments of service and all contracts therefor, and if licensed under this
chapter shall affix a stamp, which complies with subdivision (b), to those plans,
specifications, and instruments of service, as evidence of the person's
responsibility for those documents." (California Business & Professions Code
§5536.1(a))
The plans submitted to this Department are deficient in several ways. Please
note the following deficiencies and remedies:
Plans (or portions thereof) are not drawn to scale. Redraw plans to scale.
The use of incorrect drawings with "nts" notations is not acceptable.
Plans lack required legibility. Redraw plans and reproduce submittal
documents from clean, new originals. The submitted plans are the result of
multiple generation reproductions. Many notes are barely legible.
:
AXE r
F .,®MMUo
Plans lack clarity in the nature of the work proposed. Redraw plans,
eliminating` unused or outdated information. The submitted plans contain
conflicting information regarding wall bracing and anchorage. There is a
shearwall schedule claiming certain shear values for certain conditions. However,
no calculations are provided to justify those valuess. In conflict is a note
indicating the intent to comply with CBC §2320 for Conventional Light Frame
Construction. The shearwall schedule provided does not detail the construction
of Braced Wall Panels and Alternate Braced Wall Panels as prescribed in §2320.
Outdated and unapprovable energy calculations are affixed to page 3 of the
plans. See red marks on plans for these and other areas not in compliance. All
White -Out on plans is unacceptable.
Plans not appropriately signed by preparer. Each page of the plans is
required to be wet -signed by the preparer.
Energy Calculations not signed (page 4 of 12) by Designer or Owner. After
corrected calculations are prepared, Owner or Designer shall fill in appropriate
information and sign both copies.
Please note: This is only a cursory review. Due to the incomplete nature of this
plan set, this application will be treated as a first submittal (anticipated three-
week turnaround) the next time it is submitted. At that time, a comprehensive
review will be performed and additional corrections may be required.
When next submitted, Building Department staff will endeavor to process your
application in a timely manner.
Si erely,
T
Greg BUtIE
Building & Safety Manager
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:
52-691 AVENIDA MARTINEZ
SINGLE FAMILY DWELLING
R-3 Type of Construction:
Owner of Building: MOUNTAIN COVE DEVELOPMENT
ld L
Building Official
Bldg. Permit No.: 0201-240
VN Land Use Zone: RC
City: PALM DESERT, CA 92261
By: RICHARD KIRKLAND
Date: 06-05-02
POST IN A CONSPICUOUS PLACE