SFD (9801-130)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
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.
Se(.) I have and will maintain workers' compensation insurance, as required by
ction 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.
. LATE FUNIL) 446 4)3- 00069 23
(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 pFO isions.
Date: ? • ' . r v Applicant
Warning: Failure to secure Workers' C mpensation 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 puPp ses.
VSlgnature (Owner/Agent)~ L. ,/ 4J" Date Zen;
BUILDINGPERMIT PERMIT` CONTROL#
DATE VALUATION .•�Q� LOT I TRACT g•
Jj/
JOB SITE
APN
ADDRESS bC .1 �►xc��tj>� r! �� t3r�i)ii�i>�
769-142-6413
OWNER
CONTRACTOR/DESIGNER/ENGINEER
11101Nfll�1 i11`.4.1,€ I AtNP fI°!)t"OAIf;,INIC
;tIIM111 t3;l;ItA.I-PAINIT-T)COW,INC
;04`13 it10UN'IAIN SIbUXJWS RD
30-145 NIOUti•iA N IHAI)t, WS KI)
1.1 1 f UIN l"A CA 142251
LA (,�ta1N'I)1. VA alb 5,A
{,.'tiq)S&I- 18,19 C.'F#t.tf it). I
PRO
USE OF PERMIT
SI L1
Z6 C kN!=*X1 F RARk
St % AlkkINIi t: f 1. s N1.3 t 1ANCYLU )JE BLOCK WA%.L 011 POA_ AttT IN
1'U&I%-' 11dt AC'J S C,RW)IT QY `s225 72 PFR &410AslalL:N'.f UT) 14 ('! 1-MA4 AN 1117
� J
01°i'V1l (,(:VPs,1V N 1' Y),Nlyf.
8_ 5j,00 NF MAR
' 19 98
f°CiltC'I)al'�ii%<l S.`ltkol3ti'
�1ARACiNi`A&'P .)It T3,=lzsf� j)i} Si
CITY OF
LA QUINT►
h
�qi 11a., Xift C�wr R ��((
gg�� 6�,,�+ 9 rrYpf� ll �� ��i ` CON -VI,
3:.>Y �'f i��dd" IFFD CONT 01i, 1,�ON—VI'J.•�.14n\» _��ON
R �f cjJI:
- R��tl4'ID
Pii'A ill JiVE Self<lM4%RY
.»iS'fRLt("CiCrNF 1()1 (1#>t�- 1i3-(FUt► �ti�,t3.(xt
Pl,A,N f"f' FOK FFF 1101 liltl-4 11, ;13 Stit��t ?
IE. [iI::J'031;' tQI-000.4393IS 5250.00
{�{ a {Z\,i{�TA]tl i� t'o`i: 11 fl11-i5ft(�i-� i v.ritzf) �,^Fi11)Yi
•
M<;1"1:1c>?I r f; , .,111"Sr1F 10) -000-241,OU9 $Ifr.(f3
cikA-01V44(i (01_-(It)ti-423-(?(h) � tl,crtl
11vFR W1 l'kt tf"I LIWt * HiE 2,' 5,"-413-342 =.1 02
ART ;,1114 IA( 11-31 ,P3_AeFS - I,tFitr- I.00fl-`51-(1Q(1 T,rS7!
,1111'x' 1;3 t�7131.It� lyf�ilC"'.1�:► - 1111;:51;' ''�()1 �d3Q(? �25��1()Q :u?w�.", 2
"rJOMAND MAN C111"'(7v
RECEIPT
DATE
By
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
I INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
1
Underground Ducts
Forms & Footings
- -
Ducts
Slab Grade
_
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
_
- Z
O.K. to Wrap
_
F.A.U.
_
Framing
L
Compressor
Insulation
Vents
Fireplace P'.L.
_
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall- Int. Lath
l
/LA/%O Qom,
G/
Final
-
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
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
- (L
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 j
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) ��Z�
COMMENTS:
�'1,,..,,'...-�„�it't'��"�lT'�`_'R"�'r ��'w,py'k•qtr'+'•.a;,�:�%.ftS�Q`illai�r�+�'^�,u'J'yi';rfn�.�$9,.•t"�1'yr&ii:SIL:�+i�sy`kf.�:w*.7�+;tv`>:�`
gS01 1--3o
• w/F"s,Joco Pec1'Ta;� 1(224
P.O. BOX 1504 PPLIC TION ON
Building�,� r 78-495 CALLE TAMPICO
Address So o q.< y 1 U11I4A/ J I bo -is LA QUINTA, CALIFORNIA 92253
'ler
/14,A,Isze:r C as,,e�r
ling
gess SayyS" 4'7Oj/.v�gr 6fAAow; IPri.
&AJ d zip
Contractor I
City Zip Tel..
.aww uv. vny
& Classif. G� �99 Lic. #
Arch., Engr.,
Designer
Address Tel.
City I Zip State I
Lic. #
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
Thereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031. S.Susiness and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to'fts 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).
17 1, 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 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.)
1'I 1, 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 contractor(s) licensed pursuant to the Contractor's License Law.)
1-1 1 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
1 Copy is filed with the city. ❑ Certified copy is hereby furnished.
i
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed iI the permit is for one hundred dollars (S100) valuation
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.
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
1 hereby 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. r
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 Date
Mailing Address
City,* State, Zip
BUILDING: TYPE•CONST. OCC. GRP.
A.P. Number 760- ;2 d Q 1
L I 'TR ,?SY2 9
Legal Description � +`
Prnipc,t npccrintinn S'Fb rI �n/V
Sq. Ft. �6�5 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Stab I AS SO- 280 II1JDIA1,S rA kP
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
I 0 1998
ZONE: BY:LA 01
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
- ♦ 1
Desert Sands Unified School District
'Notice: w 82-879 Highway,.l1l
Indio, CA 92201 "
Document Cannot Be Duplicated
619-7t.-3500' '
- CERTIFICATE OF.COMPLIANCE
Date 2/17/98 APN # 769-542-001
No. ., 16649 Jurisdiction La Quinta -
~ Owner NameMinistrelli Construction Permit #
No: 50-045 Street ',Mountain Shadows, Log # .,
CityLa Quinta Zip 92253 Study Area
777
Tract # Lot # Square.Footage 1
Type of Development Single Family Residence No. of Units •
Comments
2895 square beet.
VISED 2/24/98 CHANGE IN STREET ADDRESS FROM 50-455�TO 50-045
MOUNTAIN SHADOWS
At the -present time, the Desert "Sands Unified School District does',not collect fees on garages/carports, covered
patios/walkways, residential additions undery
r 500 square feet, detached accessostructures 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 Mitigation Agreement" in the amount of
628.00 X 1 ` or.$ 628.00 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
Fees Paid By Cashier's Check/First Community Bank' y,Telephone '564,^1849
Name on the check
By Dr. Doris Wilson:.
l
Superintendent
11. -
Fee collected&/e'xptedd " Ellen ting Payment Received ' ` ` ,:;1628.00 +
CheckNo. 077157.
Signature '
TICE:. Pursuant of Assembly 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
we will begin to run from the date on which the building or installation permit for this project is sssued oronwhich they are paid to the Distrid(s) or to another public entity authorized to
act them on the District('s)(s') behalf; whichever is earlier. I �'
v 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
f
1
MAR -16-98 MON 11:53 ESI FME INC FAX NO. 714261.8506 P.01
ESI/FME, Inc.
STRUCTURAL ENGINEERS & CONSULTANTS
MEMO LETTER -�
MEMO LETTER NO.: 98-3-13
PROJECT "Painted Cove - Plan 7C" - PCLQ1 DATE MARCH 13,199
LOCATION: La Quinta, California PROJECT NO 194-6225-88
DEVELOPER: MINISTRELLI CONSTRUCTION CLIENT NO SBG 124-0100
FILE NO : 6225MO24
ARCHITECT BBG ARCHITECTS, INC. SHEET NO : 1 OF 1
REGARDING: 1) PLAN 7C -W/ RV GARAGE: REVISIONS DUE TO ROOF TRUSS REVIEW OF
OF ROOF TRUSSES MANUFACTURED BY SPATES FABRICATORS.
ITEM
1 The following revisions are required due to roof truss review of roof trusses
manufactured by Spates Fabricators for Plan 7, elevation C with RV Garage on
Lot 1:
a. Provide Simpson H1 at ends of trusses T24 and T52 at 'rear elevation only
due to uplift (6 places, total) ;
b. Provide Simpson H1 at end of truss T47 in front of Wet Bar only due to uplift;
c. Strap the bottom chords of.trusses T58 to T60 together with Simpson ST6224;
d. Roof truss T60 now supports trusses T4's; therefore, 4x12 beam can be omitted.
Other structural information orrthe framing plan remain the same,
Thank you for bringing this matter to our attention. If you have any questions,
please do not hesitate to give us a call.
ISSUED BY: COPIES TO:
E S I J F M E INC. (3) MINISTRELLI CONSTRUCTION
STRUCTURAL ENGINEERS Attn: Ken Schmale
(1) BBG ARCHITECTS, INC.
BY: Attn: Ed Yetko
Danny Matsumoto, C.E.
for ESI/FME, INC.
1921 EAST CARNEGIE AVENUE, SUITE 3J • SANTA ANA, CALIFORNIA 92705 (714) 261.1811 FAX.(714) 261-8506
PROJECT
Structural calculations on "Painted Cove" for
MINISTRELLI CONSTRUCTION to be built in La Quinta, CA.
PLAN 711C11/ LOT 1
FLAT ROOF W/ RV GARAGE
1994 UBC
Date
December 12, 1997,
Revisions
Client:
BBG ARCHITECTS, INC.
Client Job No.
BBG r124-0612
Shipped DEC 91g�� Job, No.
194-6225-78
1921 EAST CARNEG/E AVENUE, ST. U SANTA ANA, CALIFORNIA 92705-0055
Ph:. (71.4) 261-1811 ° Fax ( 714) 261-8506
E S I F M E n c S heet 0.
STRUCTURAL ENGINEERS Date 12-12-97
JN. 194-6225-78
"Painted Cove" MINISTRELLI DEVELOPMENT
La Quinta California
PLAN 7"C"
h1 I
9661 5e :o5 e fnr
ESI/FME., Inc.
STRUCTURAL ENGINEERS
"Painted Cove" / MINISTRELLI DEVELOPMENT
Palm Desert, California
A A N 7'[r[[
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STRUCTURAL ENGINEERS Date 12-12-97
JN. 194-6225-78
"Painted Cove" / MINISTRELLI DEVELOPMENT t
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La Quinta , California PLAN T"C"
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STRUCTURAL ENGINEERS Date:<
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"Painted Cove" I MINISTRELLI DEVELOPMENT -
194Z225--Z&l
Palm Desert, California
P L A N 711011
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