SFD (0310-285)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:
(y,) 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
O I,am exempt under Section , B&P.C. for this reason
,,,Date Signature of Owner d,
+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.
(This section need not be completed if the permit valuation is for $100.00 or less).
iI certify that in the performance of the work for which this permit is issued,
I §hall not employ any person in any manner so AF-fo•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. ti %
, te: % Applicant—
Warning:
Warning: Failure fo 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 tl a building
construction, and hereby authorize representatives of this City to enter upon
.the above-mentioned property for inspection purposes. ,
Signature, (Owner/Agent) is ut -^5' - Date . '
BUILDING PERMIT PERMITN
DATE/�;� VALUATION
" LJ f;5114,
LOT
2.20 7
TRACT r
:�I x 3 t StiV:
JOB SITE
ADDRESS
APN
fyJ,_C,4.J if."p'pl ffj)A Na�V�.��.I�.�.}
OWNER
CONTRACTOR / DESIGNER / EN INFER a
JAWM & PnVP ! S.(k 19AWCJMZ
51.896 CtiN43140 C:ORTO
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C'OAC MIX A. CA ` '7 f s 6
USE OF PERMIT
Mi'3'OLuM&LY D1rS377:.,I:.S.TN13'
IfiY►„a7�: ;ipC7 PZRMIT I OES*TOT
IN LU68 BLOCK ' AJA,, POO.LISAIA
OR DP.1VMPVF APPROACH
TRACT CONOW TR.UC T IMI 11877.00 FI'
POR::I I)JI t.'IO
Z99.00 IV
CIAR.o-'►.MUC:A3x. "FIT
09,00!3f;
FXiZMr.r M. 90AMEARY
1<
YU DOOSIT
101 i,00a0e;41 � 4250100
KLEC'1 RIC AL 1 L
$122.98
PI.,UNSINO M
Y t)1-i;Ot1 t 9 i(30 Ibi .
STRONG MOTIO)i FFE - ICCIM
1 Ca-CIC��,��,1 s�Qtltl $11,4
CIRAf R40 &E
101-0004423AW900 $m.fyj
DWELOPER IMPACT FEE
r , $3,406.00
'101-000.1
PRE.t�. iSIP Rich!
� 345 $100.00
PLM CI` ECK F&
101.0 )Cai .0e $1449,90
CONS-rR.I3S TION IOZE
1S9Y-fl0(l`�I1� '-000 �59� Ii0
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y
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UMS PIM-PALD FUMS
• 250.00
PR 0 5 2004 AL leWERMU MRS 1jCfIE NOW
�I, /49M
CITY OF LA QWNTA
FINANCE DEPT.
n
RECEIPT
DATE. + •�✓1
BY/' —'
DAT FINALED
PE -
:,Q
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:
PEA .4P(�G r2.g..T X41 f %iw.ftr Rr
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
1
Final
Utility Notice (Perm)
Date
3/5/04
No.
25580
Owner
Javier & Feresa Sanchez
Address
51896 Camino Corto
City
Coachella Zip 92236
Tract #
Type
Single Family Residence
Lot #
Unit 1 7
Unit 2
Unit 3
Unit 4
Unit 5
Comments
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
No. Street
51645 Avenida Navarro
S.F.
1877 Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
4���lF1EDS,CyO
z cSs �UU� o
Q BERMUDA DUNES r
rn RANCHO MIRAGE
NJ INDIAN WELLS
PALM DESERT y
LAQUINTA
OINDIO yr'1
O
APN # 773-144-019
Jurisdiction La Quinta
Permit # 0310-285
Study Area
No. of Units 1
Lot # No. Street
S.F.
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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that 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
Education Code Section 17620 and Government Code 65995 Et Seq
in the amount of $2.14 X 1,877 S.F. or $4,016.78 have been paid for 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 CC/Downey Savings - Javier Sanchez Check No. 03610107134
Name on the check Telephone 760/398-2134
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGilvrey
/% _
Signature
W
Payment Recd
$4,016.78
$0.00
Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), thikw Reserve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
r Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
Certiflcate_�.of Occupancy
s - f��ft�iGV
Icesr eim 4
�w
OF i. Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance. with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 51-645 AVENIDA NAVARRO
Use classification: SFD Building Permit No.- 0310-285
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: JAVIER SANCHEZ Address: 51-896 CAMINO CORTO
City, ST, ZIP: COACHELLA CA 92236
By: KIRK KIRKLAND
Date: 7-1-2005
Building Official
` POST IN A CONSPICUOUS PLACE
0
CITY -OF LA QUINTA
'Z[4f
BUILDING SAFETY DEPARTMENT -
777 -70124 J`.
INSPECTION hE&J4
717;-.;7.1
W E
Owner R SANC
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Contractor U ER
--OWNER/B
Permit Number 0310-7285.
ROST ON JQ13lN:lb0NSPIC000S-,-0LACE
INSPEQT0R-:MUST SIGN ALL,AF5PLICABLE,SPACES.
JOB-ADDRESSAVE. NAYARRO�..
1877S.F-.ISFIDPER1V1-11",�7joES*NOTINCL E
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BLOCK- WALL; P-06ij9PAR--,bkI ii �
VEWAY
APPROACH.
TYPE OFANSPECTib J
DATE
INSP.
TEMPORARY POWER-,
SETBACKS
U/G PLUMBING,/WASTE.„,
U/G. ELECTRICAL /GROUNDING
FOOTINGS./;STIEEL..
CONCRET,6SLA B
DO NOT .POUR CONCRETE UNTIL ABOVE SIGNED
ROOF NAIL -kL-R
P-,.-...
.0 -TO WRAP
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'FBA1111,1111111111111111 G, COMBINAT. ION
ROLJGH,,EL0CTAIC�.
ROUGH "PLUMBING...
ROUG'MECHANI AL
K.
"INSULATION'..
T_. _71 7_1zi—,
�COVER':NOMORK UNTIL ABDVE�SIG:NEDi
INTERIOR.-GYP`BD.DRYWALL
EXTERIOR. LATH:`
LASTEST
SEPTIC ABANDONMENT:.
SWER CONNECTION
C GREASE INTLRCE-
MASONRYANS PECTi9iQ
FOOTINGS STEEL
BOND
FEATURE INSPECTIONS..
PRE-GUNITE [SETBACKS
.U/G%.PLUMBING
U/G-.GAS
U/G ELECTRICAL',.
..PRE-PLASTERQ
JAR AmM
-A B RRIERS
.
FINAL INSPECTIONS
TEMR USE NFNT'Pe)WF:P 1 --2, _-Z-
lwm
r LU IVI t5 I 1'4.0
MECHANICAL
PUBLIC WOR K& DEPARTMENT.
-COMMUNITY DEVELOPMENT- DE'T'...
FINAL /JnB COMPLETED
ABOV 4
RIGHT TO
TUR SING
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