Loading...
RER (9710-156)LICENSED CONTRACTOR DECLARATION ' I hereby affirm under penalty of perjury that I am licensed under provisions of HChapter 9 (commencing,with Section 7000) of Division 3 of the Business and ,NLLI Professionals_ Code, and my License is in full force and effect. O =-) ch License # Lic,Class Exp. Date r-- d LU A Z r— Date 4 Signature of Contractor"^ J U S .'': 'OWNER=BUILDER DECLARATION'-. W w I hereby affirm under penalty of perjury that I am exempt from the Contractor's CL License Law for the following reason: ` :• • �. ; Z ' (") I,'as owner of the property, or my employees with -wades as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). • t, V, "; (. ) I, as owner of the property, am exclusively contracting, with licensed contractors to construct the project Sec. 7044; Business.&' Professionals > Code). : , •- ' O I am exempt under Section B&P C' for this reason ' N Date':,Signature of Owner ' .v a Q a WORKER'S COMPENSATION DECLARATION'- ` o �, I hereby affirm under penalty•of perjury one of the. following declarations: p y(,) 1 have and will maintain a certificate of consent to self -insure for workers' X1.11. L compensation, as provided for by Section 3700 of the Labor Code, for the O � J performance of the work for which this permit is issued. " ' • ' m- Q C) ( )' I have and will maintain workers' compensation insurance, as required by O•U Q Se tion 3700 of the Labor Code, for the performance of the'work for which this . r1 U permit is issued. My workers' compensation insurance carrier &policy no. .are: It- Carrier Policy No. n r Q (This section neednot &i completed if the permit valuation Is for $100 00 or less). J O I certify that in the performance of the work for which this permrt 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 workerscompensation proyisions of Section 3700 of the'Labor 3 Code,'I shall forthwith comply with tthose provisions.. , v Date: 7Applicant 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. ” f 1. Each person,upon whose behalf this application is made & each.person arl,g 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 1.80. days will subject permit to cancellation. ,K .tiF 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 autfiorize representatives of this City to enter upon I /the above-mentioned property for,ins�pection purposes.' ` ,Signature (Owner/Agent) �`1 =`` `n`-- Date­-`/-")­ PERMIT ate /-") BUILDING PERMIT PERM'T# CONTROL#, 1017 1% i 0A TRACT DATE xx+ // yyyy rry. VALUATION , C�+pp yy /Iai�gpQ�� ` `.� LOT . .' HS,LYV♦711.�I7T. JOB SITE ADDRESS µf- �� .� � � t x. , .' . ' r ` APN _ 761-451'0,17 OWNER CONTRACTOR/DESIGNER/ENGINEER VS4 NatNN12'gr *V 11-3QCtN1M- "'1'' A C'OULAf.AN RUI3. DRR' . 57301 ItIffit.041-M, M25 PRARIE OR LA Ql N fA , r�A 91-012.53 :{f"�i1.��.:�3'yy(A-ItiXI, CA t ... xr92260 i��nl7��f4J^�•i�v7 ��71dir� USE OF PERMIT )�DD,RREPLXCE, WIND09.", W, Er�gA 09"t' 1141,I'� fNo 1yk00M, - s VALUATION' 211"'00.100 J1.01" .3.I.�.�.Pi lfWE0(DO.M"O CI :NitiY•,NR M, f'4�:B ION +e 16,90 111 PERMIT FEE .1;Uh1fi1.AkV P.L.Akivt;tf KIKRI!, I01-000-4:34�413 rc;,iv.�'r;:{;rd�rnnf t:9a€; 3f1}-f}�±S>"�.13t.��t3t► �'�'��.ntt ;'i 2ONC; flit:;".t 4ON I.7i1E, .+l.=SID?i 3.01.000.24..1 00 9f, t'i1ji,CO L,NiLE MP{IDp $37345 10.00 V �F�l OCT 2 41997 . ; TOTAL Pa.,l.E NOW Ty ��= Lim bRECEIPT DATE X r.y" 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 OX to Wrap F.A.U. Framing Compressor Insulation /sl Vents Fireplace P.L. Grills Fireplace T.O. j 17 Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 7 Final Final wffz6 BLOCKWALL APPROVALS steel POOLS - SPAS . Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground PI . 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 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) COMMENTS: i -of La QUInta ty j Building 8i Safety Division,--, . "P.O. Box 1504 v .:.....::::::...: Perrnfc # 78-495. Calle Tampico, : ...:...::.:..::::: ..... ::........:::.::.::'>:::: Y La Quints, CA 92253 'BuildingPermit Application -and Tracking,Sheet Project, Address: O. Owner's Name: A. P; Number: Address",r v . e Legal Description:.. r City,ST'Zip:- ntractor:.Tele Aw uCoP hone: ^. Address: ((� �� e Project.De"scnpUon:: f G` w. Ciry.ST, Zip: 5C--f/ ! � De _ I hone: Te e P © M u s State Lic. # . ' City Lic. #: J Arch: Engr.. Designer: Address:' [[ �" J City, ST. Zip: Telephone: e Construction Occu anc :YPe: State Lic. ProJectnPa circle one : New Add At r Repair IN= ' Name of Contact Person: Ui �� 5 Sq. Ft:: #Stones: #Units: .' Telephone # of Contact Person: 77q -o �a 9 Estimated Value of Project: CONSTRUCTION ESTIMATE NO• ELECTRICAL FEES NO. PLUMBING FEES .ST FL. Su FT , $ 2ND FL, SO. FT. ,1; POR. 50. FT GAR SO FT SAR P j0. FT Z WALL SO Fr sZ 50 CT, a ESTIMATED CONSTRUCTION VALUATION S UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM 1 BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to De �,seu a$ property :ax +a!uation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.0 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. q c BATH TUB SO. FT. 0 c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT, RESID 0 1 % c SEWAGE DISPOSAL SO.FT.GAR @ 4c HOUSE SEWER REMARKS 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 A AIR GOND. 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 APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING au. Yd LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIOWSOUND FINISH GRADING FINAL INSPECTION CERT. OCC, FENCE FINAL Ina�cv � vn a wYnw � V wi��n/ � IwW GARDEN WALL FINAL - AUG "-97 MON 2: z'_ LPM M0,N1 ALKH,.C1R011j h-6 61-9 .776 5111 ♦ ! r� 4 f� PGA WEST II RESIDENTIAL ASSOCIATION, 'INC, . P.O. BOX 12$2, LA QUINTA, CA 92253 (619),7761-5100 FAX. (619) 776-5111' July 31, 1997 George & Nancy Burnett P. O. Box 364 Lake Arrowhead CA 92352 RE: PGA WEST If Residential Association Architectural Variance Request / 57 301 Merron Dear Mr. & Mrs. Burnett: The Architectural Committee for PGA WEST If Residential Association has reviewed your plans submitted for a remodel at the above -referenced residence. We are pleased to inform you that the Committee has approved said plans. The Committees approval in - no way attests to the structural integrity of the plans. Approval Is Contingent of the City of La Quinta inspecting the plans and approving that structural engineering requirements are met. Thank you for your submittal and should you have any questions regarding the above comments, please do not hesitate to contact me at (760) 776-5100. Sincerely, PGA WEST 11 RESIDENTIAL ASSOCIATION For the -Architectural Committee BY: John J. Monahan, Assistant Association Manager cc: Don Troy, Architectural Chair Allen Coleman Builders John Monahan, Assistant Manager Unit File TT iii;- 4-77 lY1C!ti 7 1: Jhit ��(_lit :i G �-_.;� -r.1 lt�.. C,,], Tz ( ` PGA WEST II RESIDENTIAL ASSOCIATION, INC. P.O. BOX 12$2, LA QULhITA, CA 92253 WEST (619)'776-5100 FAX (619) 776-5111 July 31, 1997 George & Nancy Burnett P. O. Box 364 Lake Arrowhead CA 92352 RE: PGA WEST II Residential Association Architectural Variance Request / 57 301 Merlon Dear Mr. & Mrs. Burnett: The Architectural Committee for PGA WEST II Residential Association has reviewed your plans submitted for a remodel at the above -referenced residence. We are pleased to inform you that the Committee has approved said plans. The Committees approval in _ no way attests to the structural integrity of the plans. Approval is contingent of the City _ of La Quinta inspecting the plans and approving that structural, engineering requirements are met. Thank you for your submittal and should you have any questions regarding the above comments, please -do not hesitate to contact me at (760) 776-5100. Sincerely,, PGA WEST 11 RESIDENTIAL ASSOCIATION For_ the Architectural Committee John J. Monahan, Assistant Association Manager cc: Don Troy, Architectural Chair Allen Coleman Builders John Monahan, Assistant Manager Unit File ce 0 44 P.O. BOX 1504 in78-105Addrdess57-301 Nee ion LA QUINTACCALIFORNIA 92253 Owner ` Sunri se Ccapany Add�ess42-600 Cook Street. Suite 200 City Zip Tel. . Palm Desert 92260 568-2328 Contractor National HDrtgage A Land Address Sam State Lic. I City & Classif. M130 Lic. # 398 Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section effect. ofof bmsion 3 of the Business and Professions Code, and my license is in full force and SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affign that 1 am exempt from the Contractors License Law for the following reason (Sec- 7031.5,Brsfress and Professions Code: Any city or counly which requires a pearl@ to construct, afar, improve, demolish, or repair any structure, prior to its issuance also requires e applicant for such permit to file a signed statement that he is licensed pursuant to the pmvbbns of the Contractors 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 exarptioa Any violation of Section 7031.5 by 'any applicant for a permit subjects Ile applicant to a civilpenally 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 worlt and the structure is not intended or offered for sale. (Sec. 7044, Suisness and Professions Cade: 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, pievided that such irprovements are not intended or offered for sale. If, however, the building or krprovarent is said w8hin one year of completion, the owner -builder will have the burden of prong that he did not build or snprove for the purpose of sale.) ❑ I, as arner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec 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 wih 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 Wf>e affirm that I have a certificate of consent to self -insure, or a certificate of affirm Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Polity No Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (n& section need not be completed If the permit is for one hundred dollars ($100) valuation or less.) 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in arty manner so as to become subject to the Workers' Compensation Laws of Cal-rfornia. Date owner NOTICE TO APPUCANf: d after making this Certificate of Exemption you should become MAjed 10 the Rbrkers' compensation provisions of the Labor Code, you must forthwith comply wih such Provisiions 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, 00 Code.) Lender's Name Lenders 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. 1 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 Addmsa City, State, Zip No. 47252 BUILDING! TYPE CONST. OCC. GRP.- A.P. Number PA Legal Description Tract 24801. Project Description phase SH plan H3A Sq. Ft. 2899 No. No. Dw. Size - Stories Units New ❑ Add ❑- Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $214,923 PERMIT AMOUNT Plan Chk. Dep. A�q Plan Chk. Bal.. 58 � A Const. 11�' • +� Mech. r Electrical _� Plumbing Wil 5�u ~ S.M.I. s * Grading Driveway Enc. -- Infrastru ture !P 5'• � R �a wr t� i r.*4 9 fi n TOTAL Cf • REMARKS i?E} %t TTN iia 7r r1' -?4 r �t1 °� xf•� 10 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 2/28/93 Issued by Date Permit Validated by: - Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. FORMS 14EWER OR ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® �AS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN SO FT ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE Not to be used as property tax valuation INAL INSP. ��- 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 VENTILATION LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB THING — GGG SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3Vic 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 PLUMB _?�() UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS 14EWER OR ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF.L _ �/ l �AS (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. INAL INSP. ��- MING 7-/2 FINAL INSP. ROOFING_ / [ �` v^ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING — GGG MESH INSULATION/SOUND �- FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS ' GARDEN WALL FINAL