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AR (0107-234)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. Dat A . qf 15 10 rr Date Signature of Contractor +�� WILDER 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 a_ m 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 � dc' ion 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. (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 g and agree that if I should become subject to the orkers' compensate grodisioV of,,� ction 3700 f the Labor Code, I with comply witds"e pr�' lob t Date: f r-� "� Applicant / Warning:-Failtire- to-secure-Worketg-Co "pensation'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 ' i the building construction, and hereby-aythorize representatives of this City to enter upon the above-mentioned property/f'br}r inspection p rposes. f Signature (Owner/Agent)� Date 161 BUILDING PERMIT PERMIT# DATE VALUATION LOTTRACT JOB SITE APN ADDRESS �m OWNER CONTRACTOR/DESIGNER/ENGINEER 16683 WRION LA t"PINTA CA 92253 USE OF PERMIT BUF31 1 W1 S C®14S'd4RUC1'X0J; L& QuftnA. CA 92253 (760)?75,--?933 C:.1y€..�t 3212 2&1.S.F. 'MT10 CONEf'EILSION & 199 SW, W9W Pr`i.T1C) CUSTOM PATIO t°f;,l0flERVION 264,00 SIR PO :f; H901'? ZO 108.00 5? X9XMAff. D Chit' Quid' K:i NSTR iMO51.`d 1ti.1AV CHECK FEF $1,400 C01.4S°f`i UC 9 ION M4 E f 01 _00.0•x.1£1.000 $71urj, VE.(:HAN11v;A1.IFFS :1011.000-421.000 129,50 Et:.4'r"R"MCA):, YZE 101 ••6 00.420-wo 01,80 z - a , qUG 1 X20 cirl.o 01 TOTAL rE.RWrIrE:4MMNOW M17,27 RECEIPT DATYt ��/ ` 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 ! T). Return Air SteelCombustion Roof Deck9��/�/ Air Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation _ �y d� ; Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath _ _ Final BLOCKWALL APPROVALS Final 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 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) Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 8/13/01 No. 22370 Owner NameMr. and Mrs. Jeff Arnett No, 56-685 City La Quinta Street Merion APN # 761-461-087 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Tract # Lot # Square Footage 264 Type of Development Residential Addition No. of Units 1 Comments sq. ft. addition to single family residence 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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of I , . 0.00 X 264 or $ 0.00 the property listed above and that Wilding rI *,�ti 7 permits and/or Certificates of Occupancy for this square footage in this proposed project may r_ow-be issued ir y Fees Paid By N/A - Bob Edwards Telepb ne 775-7933 Name on the check `�` `• %+ �'' By Dr. Doris Wilson ;;.Z Superintendent Fee collected /exempted by Juanita Green Exempt $0.00 ,t.1 Check No. N/A Signature NOTICE: Pursuant otb9sembly Bill 3081 (CHAP 549, STATS. 1990) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to ru om the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting 1�� Building 0 t 6�,C&ty,,, o 4 " / / P.O. BOX 1504 APPLICATION ONLY 76 .LQS � � LA QUINTAC rCALIFORNIA 92253 4 MOS. _�)WF Mailing Address 6,6 -b.* S city ^tW:& IZip &Z5_?. ITeI. I Con Iaress -7 of _ 9 2 p I�1 Tel. 775-79 & Classif.b$¢ 357 N Arch., Engr., _ _ Designer A -Z I ' %s� a� ZipO State ✓tel Lic. q LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Susiness 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). L: 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 ere not intended or offered for sale. If, however, the building or improvement 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 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 properly who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I'] 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 thereof. (Sec. 3800, Labor Code.) Policy No. Company n Copy 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.) Icertify 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. 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 1hereby 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 a0plicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST. / OCC. GRP. A.P. Number -7 6 / 7Ub 1 0 5�2 Legal Description Project Description Sq. Ft. 4 Size 06CJSto Storm No. Dw. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. X Mech. Electrical �--- Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL 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 1' Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION FROM : MONARCH FAX NO. : 7607765112 Apr. 26 2001 01:47PM P1 -UA#A PGAWIEST. April 26, 2001 Mr. & Mrs. Jeff. Arnett 685 Chester Avc. San Marino, CA 9 1108-13 19 PGA WEST 11 RESIDENTIAL ASSOC:IAI'ION.INC. P.O. BOX 1282, LA QUINTA, CA 92253 (760) 776-5100 FAX (760) 776-5111 Reference: 56-685 Marion. La Quinta, CA 92253 Architectural Change Request for Dining Room Expansion and Additional Landscaping Dear Mr. & Mrs. Arnett: The Architectural Committee has received your revised plans adding the adjacent neighbors' property and tuts unanimously approved your application for a doling room expenasion. Review by the Committee is only for general conformance with the architectural guidelines. It is the responsibility of the owner to fully understand and conform to the architoctural guidelines criteria whether or not all deficiencies are noted during review. it is also the owner's full responsibility to field.verify all existing conditions. The Committee's decision with regard to project design will be final. Plcasc refer to the Architectural Rules for all required submittals. The Landscape Committee advises that the Japanese Boxwoods have been doing great in the shade, but browning in direct sun. You may, therefore, watt to substitute another shrub from the Association's approved plant palette. It is required by the Association that you obtain a 90 -day warranty on shnrbs and a one-year warranty on trees. Please contact Raphael Villareal, supervisor for Valley Gar&ning Service at 760/399-1944 and Carol Faller, the Association Manager, prior to any irrigation modifications associated with this change. Upon completion of changes, please contact Carol Fuller. Damage to the landscaping, Le., shrubs, trees, flowers and turf is the responsibility of the contractor. The landscaping mist be brought back to its original condition when the project is completed. Approvals given by the Architectural Committee arc good for only six months from the date on the approval letter. After that time a new application must be submitted. Upon completion of your project, please complete and return The Notice of Completion of Architectura? Change. If you have any additional questions or concerns, please do not hesitate to contact Carol Fuller, Association Manager, at 7G0/776-5100, Ext. 20. C'ncen:ly, FGA WEST ll RESIDENTIAL ASSOCIATION For the Architectural Committee Far the Landscape Committee C.:lol Puller t.ssociation Manager cc: Board of Directors Unit File REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE RUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE O ASPHALT O REINFORCED MASONRY O FIRE PROOFING O Sq f 94THER 77�� '(4 JOB LOC 1 REPORT SEQUENCE NO. TVP 0 S UCTURE �'�� _ �� / ^UV�/�1`/ PERMIT N0. D Q � DAV OF WEEK MATERIAL DESCRIPTION ^ ARCHI ECT ITOR^7 HRS. CHARGED ENGINEER r� ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL SUB W 0TESSTEa, CONTRACTOR CONTRACTOR W e.( t. N N vKS G4-Lla P, i "I 1r; av-, R ej o S Wu.� tNG Coate- � �-1F.P. Wa't,o w b o t -" S (e. hx �� SC 3�0 —yea P • Cc.�z-b5 (� �r'� b w� G(��e �1�tc.p.a��. - o A..T- iv ttQILj COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. a� 81 URE OF REGISTERED SPECTOR IG A o f .-Me"o QTS DATE qFREPORT REGISTER NUMBFR =101111 NMI nommmR. mm NMI 111SWER1 llimmommm Im MillRESIONEsom NMI� a ommism NMI mommomommams mommoomm woommmmmmsmi momommommillill Mill momommmmms 110 ME moommmaml mm ME 0101001101101=1 mm ME WEEMINSINSAINER MINE mmmmmmmmmi - mamommmmmimi mml mommosommaml WINE ME 11ENMI m REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE ❑ REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY ❑ ASPHALT ❑ FIRE PROOFING ❑ cam` y - ❑ OTHER i JOB LOCATI T q :ro�5 Mr4Rtor�Q u REPORT SEOUENCE NO. TVPJ:AFTURE JJ PERMIT N0. O^ _ ^ ^ O� DAV OF WEEK MAERIAL DESCRIPTION ARCH T_ I T R HRS. CHARGED ENGI EER ASSISTANTS HRS. CHARGED INSPECTION GENERAL w DATE CONTRALTORI& O& SUB CONTRACTOR ask" S c whoma' ox COPY SENT TO CLIENT O -11 CONTINUED ON NEXT PAGE D PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. i SIGN TUE Of REGISTERED INSPECTOR :3�1, DATE 0 REPORk REGISTER NUMBFR INLAND- INSPECTIONS & CONSULTING PMB-283 •231 E. Alessandro Blvd., No A * Werslde, CA 92508 (909) 776.198.1 • FAX ('909) 776-1982• REMSTLRBD INSPECT'OR'S DAILY REPORT Page = of Z Typo of Inspewon: ..� _� Job No.: 12____g3_T� CERTIFICATION OF COMPLIANCE I hereby oar% that I have Insported, to the beet of my knawladpe. all of 0* above mpwW work Woes othauwiss noted. I have found this work to comply with ft approved plans. speoftWions, and applicable sadiorw of the gavel butldln9 laws. signature of FWatered Inspector INLAND INSPECTIONS & CONSULTING 231 E Alessandro Blvd., No. A-283 — Riverside, CA 92508 (909) 776-1981 fax (909) 776-1982 ULTRASONIC TESTING Te►..e,ty �.�P, REPORT nate: g- L 3-0 / Job No.: iZg3 TA Invoice No.: Report No.: Reviewed By: Project: APAeYfv- kes"Je d' Code: AWS D1..1 Fabricator, ps c,) Technician: W, C 10.rk ASNT Level: II Welding Process: FtAre✓ Surface: Equipment: gp"-7£j• Probea: [ ]Normal [X]Angle [X]Hlgh Energy [ ]Normal Energy Calibration: DQSound Path f 113rolected Distance Counlant; r ion r 1Gnnaa rviPeate. r M.1we-arina r inth— Item Identification Decibel Reading • �lr� KIM IM -----MUA EMMIMMINIMIMMINIMM :.• Its .. ©.■■.,-■.-----■..■ m � � LLQ u ©■....-,■-----�� �I -♦ lt\ ©■...■-,■-----.■■■ IN IN IN .M ----------REMARKS: - �Af I � i