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SFD (9911-172)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). Xi a 9 1 (,)/I am e emounder Section B&P.C. fonth''s-reason ►Date I� UV 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. (This section need not be completed/if the permit valuation is for $100.00 or less). (fig I certify that in the performance of thetwork 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 Callfornia,l and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor C de, Ir I�forthwith comply with thoWprovisions---------- ,,Date: 4J Applicant "k'jlI.IR .�-, 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 ithis application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of wq"rk 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 authorizefr'epresentatives of this City to enter upon the/above-mentioned property for'in's ection purposes f /� ✓Signature (Owner/Agent) "1 / Date BUILDING PERMIT PERMIT# DATE VALUATION 13.1 LOT TRACT ' P JOB S 3.-775/.l 8ya�14�� ii ADDRESS APN *771, 183-0,43 OWNER CONTRACTOR / DESIGNER / ENGINEER ` ff��� 77�� ! Pj a,,A,1, VrA� (w N, A�ji9 l: ^v 1.7 it Fj ea,i �,. I)f n;�i ; 12.-933 A MW I,t^Q\1E (!(-)ACI4}-'TJ..A CA kVti USE OF PERMIT �fiNlifal FF MII.,i ll�Vi:l,I,thl &4) • k' ALIVifi°'DcJE N,,,# i' JN;..LODE W4,J!'k WALLS ilii t -1-0L 1 Al t�.��'Y'L,�,�iV,J i•l�.t�l��YLtS� 2,�iY)�,%� �#�' c'utti'ivl+ie I`i<a Aim ! lJAi2.Alr}'eti!'�,{(�l,I)t`4',�tL9 Zitf Si' Xir.! a �i� f.rA.�(•d! 1r�v it ii.�• �itii :" s i�.i1t'�I'r�'t"� .� ►« �'sal.:9ii 1a�:�ifl=if`� �(:ri+,f�. �iJk`is119.r0�tiY U` 8').'R.t,t(_ 1.'lQNFLtt, ii)!-tif)U-�d_tt�-t)()Q gfatffi:+tt 14AN 01-041< VE'r 101-W10-14,10.3Uq tom�T,�•' 7 1h t ri SvSI .-L�t i,x'<.i ✓nt� FIVE 1�1'i/V4=`sa. ��lillr) � J. y L-L,f11.;A10L-A)i ii W; iti)1-.000 -,12"00 X135.r4l 1't UNITHOU FEJ4" 101-0)0419-000 `v'1pON(YM(fvrTONWIZ-fi) Im-i!f)f1.')gl-{itt(1 �11.it Q.e yy ♦MG FIC •! .000 - f��:��s�t..�,i�,iac ��tan�,� w� �t �i,ut►.trt, ` PJ0,. 1SF PLAN [01.OW-441-345 sittElmo ATIT IN 011"t,tr 131 AC - RU -.1r, 701A0__Pr-,-f)(X) :S t1; DO �O IT 101 OW4-11?-328 4211;0;,,t S1,44 1-0NKMT (070N AN411 04 16 f 1fi'(",}}t: ro TOTAL PERNIVII'V E ENN 00 C, N(A«' *;J%423.2,5 RECEIPT DATE BY ' ' DATE FINALED INSPECTOR 4f 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 co Exhaust Fans O.K to Wrap Framing !f- — oo y- 13 - opo F.A.U. Compressor Insulation 9-.-7- Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath y- 3 _ oo' Final Final 1 ovPOOLS BLOCKWALL APPROVALS - 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 O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection a . --C94 S Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) �d ELECTRICAL APPROVALS Temp. Power Pole 3 ( o S 7 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: rsi 7X Building ��..�.-..1v",�yV" -'•�w.+..^��'��v...,i-.r�s,��•,�� 5_rv+i.C'i.`.-ti.-.::y-ff9%w ".-:,'�.•d�.,v'..:."1"ti`.r.:.1 v�/.�-ii. h4..,�c,, vvy:.....�. �.. r . - Q ul�cv � "P.O. BOX 1504 APPLI4T ON ONLY 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 , }s , orv� Y ILDING: TYPE•CONST. A R+. OCC. GRP. FkI,f. '. Number ��07, 1 �� • !" ��> Mailing 1 Address T�� -5 City \ t1 City r Zip Te1.398 -1347 ress State Lic.I City & Classif. Lic. q Arch., Engr., Designer City Zip State 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 I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to ,its 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 !or thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty o! not more than five hundred dollars ($500). 12 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, 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 of 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.) ,Ias owner of the property, am exclusively contracting with licensed contractors to con. sir l 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.) i? 1 am exempt under Sec. B. & P.C. for this reason I r� °,, ii d Date � �O ner 1;�t .t t 1 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 n Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i! the permit is for one hundred dollars ($100) 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 I 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. 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 ateMailing Address City, State, Zip ,I Description fct Description %i '~"_'_..tet f Sq. Ft., No. , D2. 21999 Size , (rte Stories s New,< Add ❑ Alter ❑ Repair ❑ �WpAvh 3timated ValuationA�„° , PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. y Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. . Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line 12UT-11111111197jj4 Side Setback from Property Line INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 1/14/00 No. 19905 Owner NameSalvador Moreno CERTIFICATE OF COMPLIANCE APN # 773-183-013 Jurisdiction La Quinta No, 51-775 Street Avenida Navarro City Coachella zip 92236 Tract # Lot # Permit # Log # Study Area Square Footage 1863 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: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.93 X 1,863 or $ 3,595.59 the property listed above and thatbuilding permits and/or Certificates of Occupancy for this square footage in this proposed project r any-iiow be issued C, w Fees Paid By CC/Wells Fargo & Co./Salvador Moreno Z6�3981347gT€I" r�:r ,phony Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Ellen Patino Signature Payment Receive Check No 0l f � Received $3,595.59 0503003441 10TICE: 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 bove will begin to run from the 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 ollecl 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 RC Di ' ri - Planhina ReviewForm This form is to be used by CDD staff forreview of single family dwellings in the RC (Cove Residential) District, in order to determine the -applicability of compatibility issues or need. to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to . Building &Safety as your correction list. Pease attach additional explanations as necessary. SALVADOR MORENO. APPLICANT: PROJECT ADDRESS: 51-755 Avenida Navarro APN:. 773-183-0.13 LEGAL: LOT , BLOCK , UNIT S.C.- @ V.L.Q. ' - CVD BY: Fred Baker BIN NO:. CASE NO. 2000-179 ..CHECK -DATE: Inform the assigned Building plan checker .upon.,y.our._assignment to this case. The' CDD Executive Secretary maintains a log book to track- applications and assign case numbers. The zoning code, architectural and landscaping'manuals, and/or assigned' inspector should be consulted where uncertainties arise. The completed checklist shall be maintained in the Building .& Safety address file. 3 February 2005 The City of La Quinta Department of Building and Safety 78.495 Calle Tampico La Quinta, CA 92253 Project: Single Family Residence for: Mr. and Mrs. Salvador Moreno 71-775 Avenida Navarro La Quinta, CA Regarding: Project Observation c• a -p ' f CHARLES D. GARLAND Architecture, Interiors, Space and Land Planning Structural Calculations I am the Structural Designer of Record for the Project noted above. On or about 1 February 2005 a member of my staff visited the noted project site to perform code required structural observations. My staff member is Mr. Efrain Cardenas, currently a candidate for his civil engineering license in Califor- nia and is fully capable of properly observing structural construction. Mr. Cardenas is also currently under my direct supervision. At that time of his visit Mr. Cardenas noted .only minor blocking, nailing and strapping issues that were resolved at the time of his visit. Therefore, in light of the record construction documents I, Charles D. Garland, Architect and Structural De- signer of Record for the noted project, do hereby certify that the noted single family residence is in substan- tial conformance with design intent of the record construction documents and is hereby declared ready to wrap. If you have any questions or comments regarding this issue or any other issue please do not hesitate in contacting my firm. nI W IR IL 74-854 Velie Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340.3528 ❑ Facsimile: (760) 340-3728 61 P a] + � ,x^ , �;:. y '. .. � •!, ,. ;„ ' '}�=111 .,...aff GARLAND, LUJAN & SE HEN z GROUP - a. ARCHITECTURE • DESIGN ' LAND PLANNING 74-854 VELIE WAY SUITE #5- Q PALM DESERT, CA 92260 r ` _ (760) 340-3528 (760) 340-3728 Fax January 10, 2000 CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 CALLS TAMPICO • ' , «, + f LA QUINTA, CA 92253-- Project: Single Family Residence 51-775 Navarro Re: Salvador Moreno's Residence ' Truss calculation review. Y To Whom It May Concern, Having been supplied with truss calculation package prepared by AC Houston'Lumber at Las Vegas NV. and having review them I hereby state that'they, are in substantial conformance with the siructural design intent represented,by the construction documents. Please do not hesitate in contacting me if you have any further questions regarding this matter or any'other concern regarding the subject project: " Sm ere �b. i1 4r 110 ARC, . Charles D. Garland, �` ", U� �10. C11991 0 Architect > _ - + z EXP- D TE •� �. r F r , wv.'( 1 lo Certificate of Occupancy City. o*f La unta.'.. Building and Safety Department This Certificate issued pursuant to the requirements of ' Section 109 of the Uniform. Building Code, certifying that, at the time -of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following.! BUILDING ADDRESS: 51--775 AVENIDA NAVARRO Use Classification: . SFD Bldg: Permit No.: 9911-172 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building SALVADOR MORENO- Building Official Address:. 52-953 ADAM LANE City: COACHELLA, CA 92236' By: STEVE TRAXEL Date: 09-01-00 POST IN A CONSPICUOUS PLACE