SFD (0305-182)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 'o '
f the Business and
Professionals Code, and my License is in full force and effect.
License #a. ,B Lic/.''Class Exp. Date
48 n
0121 20 c3e,�IM tam.,' C-1( 3f 10113
Date f� /I 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
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 STATE FIND Policy No. . JWIV i�t�AD
I
(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 mariner 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 provisionps,,
Date: .t �'. , Applicant a�'
Warning Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application`is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City -of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
Work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
Correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) '`� �+ `'
A ,1'"1 __. ' ` Date �✓'
BUILDING PERMIT PERMIT
DATE - ,EVALUATION. ::�fJ LOT S TRACT _ 1` 207
JOB SITS id �9 �a ate' ( Vis$ � Z Q n �.
APN 7744M-921
ADDR .
OWNER
CONTRACTOR / DESIGNER / ENGINEER
1at'E.(:3t7. Ct') ' ''. ~
0 1 5 11- 1L o 4k' 1
0, BOX 2982
RUITAWAVD, Y
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USE OF PERMIT
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RECEIPT
PATEr -°
BY4
DATE FINALED
INSPEC
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
-p
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
p 3
Exhaust Fans z
O.K to Wrap
- /L -
F.A.U.
Framing
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
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 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
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) /- .p
COMMENTS:
Comments OC #0009701010 in the amount of $3,280.62 received. Remaining balance of $188.32 paid in cash.
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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that 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
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 1,621 S.F. or $3,468.94 have been paid for 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 OC/Wells Fargo - Art Lambrose Check No. 0009701010
Name on the check Telephone 760/578.3584
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGilvrey Payment Recd go.00
$3,468:94 over/Under
Signature �
NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the Districtfs) behalf, whichever is earlier.
NOTICE: This Document NOT. VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt- Copy - Accounting
CERTIFICATE OF. COMPLIANCE
v FIED
Desert Sands Unified School District
47950 Dune Palms
zq�eso
¢ BERMUDA DUNES r
Date
7/28/0`�] 7
yRoad
�
La Quinta, CA 92253
7
Cn RANCHO MIRAGE C7
ti
�+ INDIAN WELLSDESERT
No.
24753
(760) 771-8515 -
�� PALM LA QUINTA �y
cf�QwDlo
L7
0
Owner
DGH Dev. Corp.
APN #
774-062-015
Address
P.O. Box 2982
Jurisdiction
tLa Quinta
City
La Quinta Zip 92253
Permit #
0306-182
Tract #
BLK207
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No. Street
S.F. Lot # No.
Street S.F.
Unit 1 3
53045 Avenida Mendoza 1621 Unit 6
Unit 2
Unit 7
Unit 3
Unit 8 _
Unit 4
Unit 9
Unit 5
Unit 10
Comments OC #0009701010 in the amount of $3,280.62 received. Remaining balance of $188.32 paid in cash.
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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that 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
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 1,621 S.F. or $3,468.94 have been paid for 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 OC/Wells Fargo - Art Lambrose Check No. 0009701010
Name on the check Telephone 760/578.3584
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGilvrey Payment Recd go.00
$3,468:94 over/Under
Signature �
NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the Districtfs) behalf, whichever is earlier.
NOTICE: This Document NOT. VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt- Copy - Accounting
P.O. Box 1504
78=495 CALLE TAMPIco
LA QUINTA, CALIFORNIA 92253
August 22, 2003
Mr. Arthur Lambrose
DGH Development Corporation
51-105 Avenida Villa
La Quinta, CA 92253
SUBJECT: MINOR ADJUSTMENT PERMIT 2003-519
(FRONT YARD SETBACK ENCROACHMENT)
Dear Mr. Lambrose:
(760) 777-7000
FAX (760) 777-7101
Please let this letter stand as notification that the Community Development
Department has reviewed your Minor Adjustment application, 'pursuant to
Section 9.210.040 of the City of La Quinta Zoning Code. Your request for
an encroachment of one foot -five and one-half inches W-5-1/2") /2") into the
required front yard setback of 20 feet in order, to.legalize the residence has
been approved for property located at 53-0.45_ Avenida Mendoza, based on
the following Findings:
FINDINGS:
1. The Minor Adjustment is consistent with the La Quinta General Plan,
in that the request does not alter the approved land use for the
property, or affect land uses on surrounding properties:
2. The Minor Adjustment is consistent with the intent of the La Quinta
Zoning Code, in that the request is for a deviation of no more than
10% of a development standard. Ten percent is the maximum
deviation of any code pursuant to Section 9.210.040 of the Zoning
Code.
3. Approval and execution of the Minor Adjustment is not detrimental to
the. public health,- safety and general welfare, 'nor injurious or
incompatible with other properties and land uses in the vicinity. The
adjustment has no impact on health and safety issues, and will not
affect physical land use characteristics in the vicinity.
P\Martin\MAP 03-519.wpd ��
4. Processing and approving the Minor Adjustment is Categorically
Exempt with regard to the requirements of the California
Environmental Quality Act (CEQA), pursuant to CEQA Guidelines
Section 15305(x). No further environmental analysis is required.
Please be advised that this approval relates only to the allowance in a
reduction of the front yard setbacks as stated above.. This approval does not
imply any entitlement or approval of a building permit for any. structure(s)
shown on the plans on file. All other setback provisions and development
standards of the La Quinta Zoning Code are applicable and shall be adhered
to in preparing plans for the Building Department.
Should you have any questions or need additional information, please
contact me at your earliest convenience at (760) 777-7068.
Sincerely,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
MARTIN MAGANA
Associate Planner
c:' Building & Safety Department
P\Martin\MAP 03-519.wpd
„99,
13 November 2003
The City of La Quinta
Department of Building and Safety
78.49.5 Calle Tampico
La Quinta, CA 92253
Project: A Single Family Residence for:
D G H Construction
53-045 Avenida Mendoza
La Quinta, California
Regarding: Project Observation and Field Revisions
ROLES D. GROUND
Architecture, Interiors, Space and Land Planning
Structural Calculations
To Whom it May Concern,
On 11 and 13 November 2003 1 visited the noted project site to perform code required structural
observations. At the time I noted only minor blocking, nailing and strapping issues that were
resolved at the time of my second visit.
Therefore, I hereby state that the project's structure is in substantial conformance with the
structural design intent as represented in the construction documents.
If you have any further questions regarding this project please do not hesitate in contacting me.
Sincerely,
Architect
74854 Velie Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340-3528 ❑ Facsimile: (760) 340-3728
^ ; CHARLES D. GARLAND
cn" r
. Architecture, Interiors, Space and Land Planning
Structural Calculations
10 June 2003'
The City of La.Quinta
Department of Building and Safety
78-495 Calle Tampico
La Quinta, 'CA 92253
Project: A Single Family Residence for:
D G H Construction, Inc. at:
53-160 Avenida Martinez,A
53-140 Avenida Martinez,
53-065 Avenida Mendoza and '
_ 53-n45 Avenida Mendoza
La Quinta, California
Regarding: Truss Calculations
To Whom it May Concern,
I have been supplied with the revised truss calculations prepared by Trussworks of Thermal and
Palm Desert, California for the projects noted above. Upon review of the revised truss calculation
packages, and in light of the structural design documents, I find them to be in . substantial
conformance with the structural design intent as documented in the structural calculations
1 prepared . by my firm for the noted project. Please note that due to the revision of the structural
calculations the drag truss loads of 5,200 lbs, at shear wall lines "F" and "G", are satisfactory
loads now.
If you have any questions or comments regarding these issues or any other issue please do not
hesitate in con cting my firm.
Sinc rely, ��S�E�D'�C
i
I O/M/20g
� may, •-
Charles D. Garland T 9�OFCAi-1f���\P
Architect
s 74-854 Velie Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340-3528 ❑ Facsimile: '(760) 340.3728
• •
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This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of "issuance, this structure was in compliance with the
'
provisions of the Building Code .and the various ordinances of the City regulating building
construction and/or use.
xR
BUILDING ADDRESS: 53-045 AVENIDA MENDOZA
Use classification: SFD Building Permit -No.: 0306-182
I
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RC
I Owner of Building: DGH DEVELOPMENT CORP Address: 78-921 RUNAWAY BAY
City, ST, ZIP: BERMUDA DUNES CA
I
By: KIRK KIRKLAND
r+
/L Date: 1-27-2004
Building Official
.POST IN A CONSPICUOUS PLACE 4
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