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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
57777,6 lei _ X0950119!
�Da` to Signature of Contractor J _
'r All
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.
(,Q I have and will maintain workers' compensation insurance, as required by
Sec 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.
STA1 11178) 01531110-99
(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 io the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.,.
/ate: -� Applicant 7_7'
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.
S'g� ---_ re (Owner/Agent) ` bate r7
DATE
JOB SITE
ADDRESS
OWNER
BUILDING PERMIT
VALUATION S78,65RA4► LOT
MOUNTAIN S IFF LANE
A.1:C'!f!E A111UNIA .t
81-9y)0 MOUNTAIN VIEW LANE
LA QUINTA CA
USE OF PERMIT
RJRS!b. ,N AAL ADM' OK
PERMIT #
"o7 -04S
APN
TRACT
767-480-014
CONTRACTOR/DESIGNER/ENGINEER
39725 GARAND #C,
92253 PALM DESEWF CA 92211
(760)7%45-9711 CBIA 700
ADD1 CION 01, tiLWT HAUS% & 290 8Y. PA110 COWR
ADDIT1GN
1.3FA00 ar
280.W Sty
U
V'S fMI TED COST Ole CONSTRUC" HON,
I'Eitl4UT FEE SUNIMARV
PLAN CitECK FE. -F 101-000-434-3IR 5341.-,5
t`r1tV':IRf1("T10NwF1j 1()140)_41R.f)flli sus N1
INCTMILN3CAL C 1X
UECr3 ICAL HA-:
PLUNl131NO PIX.
Sl'1VC1N0 tittY ('W VVIZ -1' vmn
01R1\J)fN0 F17.1'
101 000 421-!300 $19 00
101 -CM -420-000 S7u.titl
101-000-419-(100 S1f;.tx►
10144X) -7A 1 AMO 57 87
10 1 0011423 .000 $ 20 otI
0
RZ'INI-TC)TAI.C'()n14i'Iti.fcTi(.►N AND MAN C1J CK $1,(Y)d9"
LESS PRE, PAID IBES $000
1'OTAi, PERIM FERE 0UP, NOW $1,094.92
RECEIPT DATE BY' DATE FINALED INSPECTOR
f1 4
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
O.K to Wrap
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
POOLS - SPAS
BLOCKWALL APPROVALS
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:
C .
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)
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that'l 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 fulf'force`and effect.
License # Lic. Class Exp. Date
577!'tD kS t :l9I�3t1i 1
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.
( ) 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.
Cri"AIr" YTYT.R4 ito*M AA
•SI N.7. ti. 1•e 11V:J tri JU lv l}sY
(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 provisions.
Date: 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.
Signature (Owner/Agent) Date
BUILDING PERMIT PERMIT
DATE 07/2JI1,409VALUATION S7g,65& LOT TRACT
S ITE
ADDRESS 81.-i 1(bQf, UN iF%I1'�'�'+1ITA �..r NF,
APNJOB
OWNER
CONTRACTOR/DESIGNER/ENGINEER
'01/A1'1nfktiA1
Ai
?+i�rti l �].f0 -41010
81,tl!?ii RiOUNb'.t IN VIEW L.ANL
397 5 <aktiAND 4.t%
l.A. QUIN FA i.'.0. Y2'253
PSA ,M :Esmer cii, V2211
l�t5tll rd _t#711 {Til 14
USE OF PERMIT
14LESi1l9kN1IAL!. Obfi i*
PoiCllW."Ai to ;,SO_00 Sill
'"C"'roks IYO."grYA'3vlr^X.
a�,.ann�ast'►anysa.v..+� +✓s rt;.w�tt.r+sglir�„xxlra�
"a eC.�{i aN6
+o�ga.a.
PLAN Cf—&.MMai 1011 ftilJAV- 19 $354.25
i `(1Af 'd'fYt 16" I'S(�T.t :fd%1F 101.4'iM-•4 3 R -M) $50" 00
MlrCIM041CAL FFUZ 1.01- WO...z2 )-000
L-Lik:i1'U,CAL SAX it7i•(33} —42( 4KI $7fD.8id
fsLiTRlB(NO FM 1311,-0 GO.41,9-WO 348,00:
RM-)''NIC4 M N'10114 RV ,. R !td.1, t l Y) sAi(1S"}-` 411-{361,1 $7 87
OTZADINCFET, MOO
401F1 1YIX'E1.t, 41N�: ¢ Ci" {i@"i 1NI Bl it i F'1 •'�1A1 f 'b1re
$1,(1 4 97
LEISSIS111111-Pi►�a�.+ F11,11 -11S .
Tli W
W.CAL PERMIT iN'.@:WS DUE NOW
$1,094.
RECEIPT
DATE
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
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
77 44
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�Z/�— '
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
Gas Piping
PLUMBING APPROVALS.
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
12
f
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 7/8/99
No. 19015 Jurisdiction La Quinta
Owner NameArchie Altunian
No, 81-990 Street Mountain View Lane
APN # 767-480-014
City La Quinta
Tract # Lot #
Type of Development - Single Family Residence
Comments
Permit #9907-045
Log #
Zip 92253 Study Area
Square Footage 1,380
No. of Units 1
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:
EXEMPTION.NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
1.93 X `' 1,380 or $ 2,663.40 the property -listed above aiid.Jiiat building
— rr
permits and/or Certificates of Occupancy for this.square footage in this proposed projeet may now;be issued �.
Fees Paid By cc/Eldorado Bank/Stark Construction Co. Tel ephone '.345-9,71,1
Name on the check ! rr
By Dr. Doris Wilson
-Superintendent
Fee collected /exempted by Juanita Green Payment Received $2,663.40
Check No. 108707945.,
Signature
f
OTICE: Pursuant of ssembly Bill 3081 (CHAP 549, STATS. 1996) -this will serve to notify you that the.90-day approVal'peri0d in which you may.pr'otest the fees or other payment id8ntified
bove will begin to run from the date on which the building orih§tallbti0npermit for this project is sssued,or on which.lheyare paid tothe District(s) orto,another public entity authorized to
llect them on the District('s)(s') behalf, whichever is earlier:
s.. t
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
Is
PUBLIC WORKS CLEARANCE LETTER
FOR
CUSTOM HOME LOTS
Dear Builder:
Prior to issuance of a building permit, you will be required to obtain clearance from the
Public Works Department for one, or more, of the following:
1. Verification that rough grading is complete, and the pad elevation certifications
prepared by a licensed surveyor, or engineer, are on file in the Public Works
Department.
2: Verification that infrastructure improvements and other required tract improvements
are complete, or sufficiently advanced to warrant building permit issuance.
3.. Prepare an engineered grading plan that provides for on -lot storm water retention,
and have it checked and approved by the Public Works Department.
• Tract 26524 (Estancias)
• Tract 26769 (Mountain View'Estates)
4. Prepare an engineered grading plan that provides for building pad grading in
accordance with the existing soils report and tract grading plan, and have it
checked and approved by the Public Works Department.
• Tract 28034 (South Valley Estates)
10 M.T�q1E.0 U.
�wi�T �ws� on.1L�
FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT
TRACT:
LOT•
—' j xl�
PUBb'd WORK AUTH RATION DATE
F:IPWDEPTDOCS%FORMSIPW CLEARANCE LETTER.ss
COMMENTS:
i
r LAGUNA DE LA PAZ HOA
DESERT
,-- MANAG EMENT
July 15, 1998
6195648867 P.02
I
John & Mary Oatey
81-990 Mountain View Lane
La Quinta, CA 92253
Re: Architectural Approval — Lot #14
Account No. 53-00014
Dear Mx, and Mr. Oatey
The Board of Directors for the Estates at La Quinta Homeowners Association has
received and reviewed your pians for a Guest House at 81-990 Mountain View Lane,
ARCHITECTURAL REVIEW COMMITTEE
Date Submitted: __� — C Approved V Denied
Conditions of Approval (if any)/or reasons for Denying
Committee Review: Authorized Signature(s)
Date: -7
(Afl bate:
If you require additional information, please feel free to contact me at 760-564-8864.
Sincerely,
Board of Directors
;��" aA� 1-0,AA .
Bonwie Hagerman
Agent for Estates at La Quinta
0142427 Rancho Mirage Lane • Rancho Mirage, California 92270 (760) 862-1202 Fax(760)8G;0-12-10
0 1729 E. Palm Canyon Dr., 4227 • .Palm Springs; Californla 92264 (760) 325-4257 Fax (760) 778 6846
LACUNA DE LA PAZ HOA 6195648867
ASSOCIATION
REQUEST FOR ARCHITECTURAL APPROVAL
Applicant: AL -RL,
Ulf -
Address: A--9 U--h-t L.
Enclose plans (may submit sketch on reverse side of this form)
Brief Description of Request:
Z
Lot: Tract:
P. 03
,1
Approval of this request does not relieve applicant from obtaining the necessary building permits from the gover rhenlal
envies irtvolve,�. ,
Sectioft�-Lof the DecOaration of Restrictions for the G. f{ vires archliectural a'I proval
prior to any construction.
This request should be submitted in duplicate. An approved copy will be returned to the applicant and one copy illbe
retained by the Architectural Review Committee.
THE OWNER IS RESPONSIBLE FOR THE MAINTENANCE AND PROTECTION OF THF'- EXISTING DRAINAGE
PATTERN IN HIS LOT. ANY DAMAGE TO HIS P PER'IY HIS NEIGHBOR'S PROPERTY OR THE COMMON AREA
ARISING FROM ALTERATfON Y HE EXI I F TTERNS WILL BE THE RESPONSIBILITY 0 $Alp
OWNER.
Signature of property owner: pate: •i . cl
ARC ITECTURAL REV
Date Submitted:
Conditions of Approval/or reasons for Disapproval:
COMMITTEE
_Approved --�Dlsapproved
Arch c 1 viso o iitl;e Review: Authorized Signatures: (2 required)
Date: Date:
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