Loading...
9801-001 (AR)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 —'Signature of Contractor + t OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: j ( ) '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 . • 1; ( ) 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 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 Labbr 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 Policy No. a (This section need not be completed if the permit valuation is for $100.00 oriless).• () 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. JDate: Applicant 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. e , Signatr/Agent) Date y = PERMIT #, `CONTROL# ' BUILDING PERMITON DATE,VALUATION LOT TRACT4. 78 JOB SME7 ADDRESS Qk2�l . CVNiais�:t3lI�1 APNUN OWNER > CONTRACTOR/DESIGNER/ENGINEER UERJON 79-920%I. ,, Ifi DRIVE VE .T..A. Q'i ilmi'A • CA, W.2 3 LA Q.U19FA CA, 192253 , i64]'y75.7��43 tuT1T. t, 32112 USE OF PERMIT ii.E`3EI 376 �:F. 0, (ts'I''uoust. �:v�r t;ii .�'CI SN, i;r r 4UAL TO COI'`!�'t`1~lii.fG'f10K.A;t�.7 �?I..�7€viIi(tir�3'Fa: `� i1MOD F'e?:f+l W011K, 6'sEOUN- MU0,1:C TO OF Pt"RIV11111, . •y+� s ,g g �� py • �unl?:i &itYt •A�AIJ O+i LiY BlV1➢R.t'J/te 10NO „'t "'a+rT•�„ o'!q`[W,ti4�V.aTti y.. Pr"Rma �!`.VA' Sium10'AE ly. PL AN V:l;fi"�C"'.r 03M ., . l.fl,!-iDt3(D-43.�31.�+ fitfSE1.� . � COfsMR.UICTIONI�P. 1J1-000-418 ► I N1ECUfAN11GAL F11 . ii18-flt7fl�.21..C)t 1:a.gt) F°— fi L"O'.f`l"�f1�AL 1 '" 10.i-1©df�.ttjF+.lo oo 31TRr)hfQ 1b!OVION, FIFE, RAFI .1 D41) I, C�.4 t-{lf'rt} S2.93 ��+!i(1-..4 M2A )9NG FM3.t�1-fisl(; LL. 4 L� j'�'(c• pc�j. /• }NLY��tt�j ! L �•• /�p,'� a i) • '•f 1.1+%"� V�2 fI LGL`: 4l•S.4tU�rPL AS.3•LM .t�.l ;�.'4 .1"y�u'L�`� Oi '.LSA'. �K Yet^"`• - g+f` �'} sy ,D7 J,•S.F• R!. U "Ph.L:-:PAID FEES SOA. ' TOTAL, !J.0.1 'Un��R, !�'.8',i.L'n1 1)t J1a'I��OW RECEIPT DATE BY ( f DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION 1. DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap -Q �, F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL A ROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines ,(►=tom - _ 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 t t a - Final Utility Notice (Perm) COMMENTS: ' al .......... ...... .... of La'Quintat. 'City 'Building X-X-X-X-X-:-X-X a Safety Division --X-:-X-X-X-X-X- P.O. Box 1504 W_ ............ 78-495 C. alle Tampic'o K,* .......... ...... IaQuinta, CA 92253. Building Permit Application and Trackingckiig heet�.,�- Project - Address: 45 Owner's, Name: A "P. Number: & Address'-.'�J.-' 90- 24_r- Legal'Descriptio'n: C.ity,ST,, Zip: ­ Contractor:TielephAe:, ` . . . . . . . . . . . . E- Lg— Address: eosh \)w Project Description:, City.sf; Zip: Telephone:, State Lic: 4 qity Lic. Arch., Engr., Designer: V- Address: T4 J-1 C, k;�. % 5-710 X, -7 V City, ST, Zip Ak Telephone: ............... x x X .......... .. ............ ................................... C onstruction Type. Occupancy: State Lic: #: ....................................... ............................................. ........................................ _ ...................................... ....... .......................................... ................................................. ................... :-X-X-X-X-:-X:-:, ­.'.'.'.'.'.'.: .......... .......... 'XI: -111111 ... Project type (circle one):, New Add' n' Alter Repair',. Demo Name of Contact Person: "4- Sq.'Ft.: 76 - # Stories: # Units: Telephone # of Contact Person: -7 -7.75 3 Estirnked Value of Project: ................ .................... ....... ........................ .................... ...... . A' A. . . . . .................. ... .................... ... ...... . . ........ X ................. ........... ........... ....................... ... . . . . . . . . . . . ..... pwv ... .... ... .... .... ........ . . . . . . ........ A CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES N0. PLUMBING FEES !ST FL. SO FT .? S 2ND FL. SO. FT. •q POR. SO. FT t8 GAR. SO. FT. .g CAR P SO. FT .4 WALL SO FT .Z SO rT. ;t ESTIMATED CONSTRUCTION VALUATION S UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be usea as ,progeny tax a!uation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVARCOOL HOOD SIGN WASHER(AUTO)t01SH1 APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL. FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. 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. @ c . BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT. B.T.U. SO. FT. RESID r,* 1% c SEWAGE DISPOSAL SO.FT.GAR @ 4c HOUSE SEWER REMARKS GAS PIPING. PERMIT FEE PERMIT FEE PERMIT FEE OBL 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 v FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINA4 OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM ' WATER SYSTEM GRADING cu. yd. = p1uB x>I =$ LUMBER GR. FINAL INSP. ' FRAMING FINAL INSP. ROOFING REMARKS VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSYt UT W W * MIYNA I YNtMIN11 MILS GARDEN WALL FINAL Desert Sands Unified School District ' .. Notice• 82-879 Highway 111 .L • tiIndio, CA 92201 .,. Document Cannot Be Duplicated 619=775-3500 CERTIFICATE OF COMPLIANCE - Date 2/4/98 APN #` 761-560-002 No. 16610 Jurisdiction La Quinta Owner NameGeorge Ladd III Permit # ' No. 80265 Street Merion Log # City La Quinta Zip 92253 Study Area Tract # Lot # Square Footage 376' Type of Development Single Family Residence No. of Units 1 • Comments 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: E y } �. ysa7f t k' EXEMPT This certifies that school facility fees imposed pursuani to Government Code 53080 in the amou ntof�. 0.00 X 376 or $ 0.00 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 f Fees Paid By n/a A Telephone 775-7933 Name on the check By Dr. Doris Wilson Superintendent IJ i Fee collected /exempted by Olivia Aguirre Exempt $0.00 Check No. n/a - Signature I NOTICE: Pursuant of Asse ly 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 Illabove will begin to run fro he 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 • PGA WEST II RESIDENTIAL ASSOCIATION, INC. P.O. BOX 1282, LA QUINTA, CA 92253 (760) 776-5100 FAX(760)776-5111 PGAWEST January 27, 1998 Mr. George Ladd '80-265 Merion La Quinta CA 92253 RE: Architectural Change Request Dear Mr. Ladd: - -- The Architectural Committee of the PGA WEST II Residential Association is please to inform you that it has approved your request for a guest room addition at your home on Merion, with the following conditions: r ' 1. The annual color specified on your landscape plan. calls for the use of 4 inch/quart size pots. The Association utilizes only color pack plants in its annual plantings: The committee also noted that the volume of annual color appears greater than is normally utilized within the Association. The Association will only plant 6.5 flats of colorpack, annual winter color through the landscaping at your home. Any additional color desired will be at your own expense. Please contact me at (760) 776-5100 should you have any questions or concerns. Sincerely; ti John J. Monahan Association Manager CC: Board of Directors