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9801-080 (SFD)'., N_ W O M ' W o Z, �0o H� W LU H d U) Z co L0 N ON U °' d Q L0 ¢Ir 0 X W LL— m' U U O Z Cb O J 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 'l^`.1V`14C, i 21 Al *G 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 ex mpt u der Section B&P.C. 1pr-tpjs reason Date a 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: Cairier Policy No. i i�fJ�.'.cew YAYw7� t.`�f"ti��4d� i A:" 17 4370'00 -96 (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 sU bject to the workers' compensation provisions of Section 3700 of the Labor Code, I sh II fort ' ith comply with those 26M75, 'ons, Date: 'Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful.and .shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for ri pection purposes. iSignature (Owner/Agent) _A - Date 2. BUILDINGPERMIT PERMITk CONTROLN DATE VALUATION q•{£��LOT TRACT 6715 1.JOB ��. ADDRESS S 591-346 /�VENI.��1� >i.AR.�f�lNZA APN 711-0424i(6 OWNER CONTRACTOR / / lDESIGNERiENGINEER y� lie i cis iilc C�kI S1t �N .i L L'i� Zfi i 3 �(II �i2C3�ijtials fi'e' �+M, 6 IN010 CA 9x21)1 1'NNO C. A !i2cti! (76f1)34743157 C4'lp3,tr USE OF PERMIT SFU A, ti , Lr- .i'�tiktii-l" l:]�,�tis t•!c)1 ll�ti�,litlMi ���.+.iCX WA1 �,a Cfli t�i�Z: L �#LA �"`� l' rs�l:iCK'KIE.TIGN I -)F E.H Ct13OUCE11) 7!,% FOR. M1=rA.WLE, t WTANC OF SAME, PLAN'EYP AN 31998 '1.'RACI' C M i` ILII TION I,W.00 01,70 1 6 Y OF LJAU (U1'AmTA kyRr fuPATio k02.1li) Sl. 0ARAlv.•k: CAR11ORT '36.0 SI e sy�I.l�A37 1:'t�i�' !J'i3a�h'�'��Z:`O 77,4 1610 i,',ORSI'RUCTI.OI4FvE 101 _�Ow'_47.$-0(10+ $Sg0,5O Pt -1 �0 C, I; LEM1 1 FFF 3 IA)II)11-43fii-Mg $114.!!1 ``XIEC-. IANIC:AL F03 ' 101-000-421.-000 f E f 1.Y�lt r1r .1;1;1: , ' 1.Q - D0,420-000 $116.37 f Ui41f31'dvtil Frl� .. 101430-419-000 $.121..A }0!-000 241-000 Z,'PRONyy�O, MOTION -.REESE) J01-000-241-000 M111. 104-000-42."M -1 px6¢74t7e,./r1,��e;fi�Jx NEtAAiUCTUUt'FIX 22.51-(W-4.43-342Ye`i.1fJ.r+i 9?RECISr PLAP S1,11)=T(Y.rAL Ct:>`N"'XRr..IC 111K N ANli MANtaECR IV, 69C%, �¢ . LESS P.p\G'P H. i� eM1.�DiJ RECEIPT DATE BY f� 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 Insulation Compressor Vents Fireplace L. j Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. LathAF_ �J Final FinalPOOLS - SPAS BL0CKWALL 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 _T 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 2 Appliances 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 o Final Otility Notice (Perm) �j� Building Address Owneri a ; kt� `.� �µxf � Ilelkl Mailin Address>r w r� - City JZipq Tel. Contractor witYl " P.O. BOX 1504 78-495 CALLE TAMPICO 001711 LA QUINTA, CALIFORNIA 92253 City Zip Tel. State Lic. City & Classif. Lic. # Arch., Engr., Designer Address Tel. City Zip State 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 I hereby affirm that I am exempt from the Contractor's License law for the fallowing reason: (Sec. 7031.5,Susiness 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 rile 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 thealleged 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 (8500). L: I, as owner of the property, or my employees with wages as their sale 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.) ( l I, 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 contractors) licensed pursuant to the Contractor's License Law.) 17 1 am exempt under Sec. B. & P.C. for this reason l b41 Date-Owner"'!,-,Lz e a . c 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. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg work. for which this permit is issued, 1 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: It, 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 it 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 Address City, State, Zip APPLICATION ONLY BUILDING: TYPE'CONST. `- 40CC. GRP. A.P. Number 17 —1'3 [l9-2 �r(�DS Legal Description �� l3T 2D l�L•K �� , i%1�1 %• Project Description l7 r Sq. Ft. No. No. Dw. Size /Q��Q• Stories f Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 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 Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District Notice: 82-879 Highway 111 Document Cannot Be Duplicated Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 1/22/98 No. 16538 Jurisdiction Owner NameCoachella Valley Housing Coalition No. 51-340 Street Ave. Carranza City La Quinta zip 92253 Tract # Lot # Type of Development Single Family Residence Comments APN # 773-082-005 La Quinta Permit # Log # Study Area Square Footage 1210 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 1.84 X 1,210 or $ 2,226.40 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now.be ssued Fees Paid By Cashier's Check/Bank of America Telepr hone t Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Ellen Patino Signature L Payment Received f, Y $7_,226t4fl Check No. 2006714095 NOTICE: 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 above 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 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. `1 ATTORNEY - IN - FACT AGREEMENT UWe hereby appoint COACHELLA VALLEY HOUSING COALITION, and/or any of its authorized agents as my/our attorney-in-fact for the purpose of executing any notices of completion, waiver, of liens and/or executing contracts with subcontractors, and/or release of liens and/or handling building permits relating to that certain real property described below. All that certain land located and being in the County of Riverside, State of California, described as follows: LOT 20 BLOCK 67 OF UNIT 6 OF SANTA CARMELITA AT VALLE LA QUINTA, AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 67 OF MAPS, RIVERSIDE COUNTY RECORDS. Date Christi n J. Murua Dat Veronica Soto Murua r'a me rs,+T��`(t' "'t�Pz� n`. ►'tn vi'i` (j'j JJp?a{Fl{iK { r �j yj} td f. +Y1.r .. 1,•",}�• %l ;� �d5d!{.f9���r r��+,"IrIT tr�f r\ �T �tj X+ d� + All J i 1rr,I {♦ � � • ria 1.� A. --,,._••'rte,. °.� ,1hrF: d. �l �,j;r,' :�/. '.Ail Jl: '{.t�tf5' .♦\ `••� �r r,lfr •�' •r .i' , iL • . +`. r ren fi�-`J�C•11)) A �,OC: C 01.1 .)tabid%LCA 1.11SLIkI[tiOIl 30 Ib. bast r. ,Ilrrrrrr/irilrrr', v! 1!1': GREENSTONE"" A 10U1SIA N A -PACIFIC COMPANY \U1'li: 'I'hie cover gc chart c, nnpcn.anc. li,r nouling; and i< lilt cslimaling; puryu ,>r.. only. St.ucd It-c:due i. provided by insudlinp the ra luin•J nunJ x•r of ha F;. per 10)1 sq. II. aI a minim mon in,malled dlicknv» g Inalall:ninn nl the l,rIniwd n.n4wr nl h.!c, man' cirld more than the .alxrilicd minimum Ihirknc.- and minimum xcoig;ht per sq. I1. Ai mal rl,xrr.ry,o .. ill I- inlf .n -n. rd by jllb ,Innlition..:Ind .q q,lir.11 ilnl rrr hni.plo... .uul In..) v;..y .1. nwi1, .L. to l"an .igtnilir.nnh alli•rling the .maled It."ah.r. ISlil lrrr „I III,- insIA4., In protide :a Ica.NI the IcgnilcJ nunlhrr of h,lp. per 1000 sq. A. and aI Icaal rbc minimum Ihicknc+. man• result in a II,,,t'r in..ladled h ,:dor, I , ..p.o Ii. n, m,.n' occur during; ino-udlalil nl.. ah,nr If. in. wq.'innp nu,n- Than the .shoed nu nl l,rr „I' L,.Ig, I. „blain Ihr I minimum in..loll"I 116, low". GreenStone and Cocoon are trademarks of GreenStone, a Louisiana-Pacific company. © 1997 ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART R -Value at 19.4 Net Coverage No Adluslnlcnl for trusses 56.7 75•F Mean Minimum Glass Coveray" Rased no Maximum Nel 30.6 Minimum Wiaghl Temperalme Thickness 2'x 6' busses on 16- Cenle4 Coverage Pei Square, Fool Installed I he wCothl PC, To Ohta,n ao In;ulalmn Minimum Bags Square, [not of Barls Req red Insulation Should Not 8e Salome Feet Renuned PP.r InsIaIlCd S'l a Feel Pe, 1.080 Rrsstanced1lol: less Than. PC, Bag 1,000 Sunmclrrt nS. 111.nn Pei Ban Square tees PnGlcsl SITmdd Not Ile I I:sx ih:lm Ill.!; 1 R-50 13.5 20.5 48.8 1.464 21.3 46.9 R-42 11.4 24.4 41.0 1.230 25.6 39.1 R-40 10.8 25.6 39.0 1.171 26.9 37.2 R-38 10.3 27.0 37.1 1.113 28.4 35.2 R-32 8.6 :32.0 31.2 .937 34.0 29.4 R-30 8.1 34.2 29.3 .878 36.5 27.4 R-24 6.5 42.7 23.4 .703 46.4 21.6 R-22 5.9 46.6 21.5 .644 51.0 19.6 R-19 5.1 53.9 18.5 .556 59.5 16.8 R-13 3.5 78.8 12.7 .381 87.0 11.5 R-11 3.0 93.1 10.7 .322 102.8 9.7 Ba GreenStone Industries,' Inc. All rights reserved. Printed in USA. RV 30M 8/97. Sidewalls (pressure filled -density 2.0 PPCF) 8-91-TT/G-A R-13 (2 x 4) 3.5 51.4 19.4 .583 56.7 17.6 R-20 (2 x 6) 5.5 32.7 30.6 .917 1 36.1 27.7 in