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9510-018 (SFD)
LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with r W Section 7000) of Division 3 of the Business and Professionals Code, and my C) 0 Lo License is In full force and effect. §3990+0 3511196 r- W License # Lic. Class Exp. Date Zn Date Signatureof Contractor crp Fr` OWNER -BUILDER DECLARATION J 1 hereby affirm that I am exempt from the Contractor's License Law for the W following reason: IL (D ( ) I, as owner of the property, or my employees with wages as their sole Z 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 aP-.C. for this reason Cl) Date®- SU Signature of Owns LO N Orn U WORKER'S COMPENSATION DECLARATION FL Q I hereby affirm under penalty of perjury one of the following declarations: g Z O I have and will maintain a certificate of consent to self -insure for workers' ' Lo H O compensation, as provided for by Section 3700 of the Labor Code, for the X W . LL performance of the work for which this permit is issued. p J J ( ) I have and will maintain workers' compensation insurance, as required by m Q U Section 3700 of the Labor Code, for the performance of the work for which this O U permit is issued. My workers' compensation insurance carrier & policy no. are: CL rn H Carrier S rA'1'.6.F i 14D Policy No. =290'3' 3w;s ? Z (This section need not be completed if the permit valuation is for $100.00 or less). 00 O ( ) 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 a Q., 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 application agrees to, & shall, indemnify & hold harmless the City of Indian Wells, its officers, agents and employes 0 2. Any permit issued as a result of this application becomes null and vc�d if G 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 cancelln. I certify that I have read this application and state that the above information 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 ALCM L.DING PERMIT ?ERM«=.%.as�-f1.2N �n6_U, , DATE VALUATIONW—I— LOT TRACT JOB SITE ADDRESS 51-525 AVE. QWPLAMA APN 773-16-" OWNER . CONTRACTOR I1� H CONSTRUCIYON '. L,EOM. MEJER 77029 TKOQPQIS R.. 5I-825 AVE. Cii.R.R.ANZii INEiUN V ELLS.. CA. 92210 INDIAN WELLS CA. 92210 ( 19)345-7260 CBL# DESIGNER/ENGINEER USE OFPERWT'=1 ;3* E rt"V t 1..uYv}�L F.t1*5 V817161 duals not l,ncluda blur k Walls ar pool. FEE DESCRIPTION FEES 1;tCM( d'('ViY iil{U�-'i ION i.W3.w 511 GARAOFfCARPORT 4S(},r}ti Sly 6 F7. WO07.7 FENCE 11F ESTILVIATED CONT OF CONSTRUCTION 95 979.40 d'E311VA1'1: VE.F. NiJ:M:MARY F,ET UEPOSIT PLAN CHECK 1 EE 101-OMA39-318 ssa t.3x CONSTIRUCVON,FEE 101-0004118-000 $64610 ,VECI JVNICAL FEr 101-000-42.1.000 $53.50 F LLF,,CMICA:s FIX. � 101.00()-420-000 S.17.9.54 PLUM MING FE 101-000-119-000 $133.50 ST 014Z.; MOTIOW 116 - REWD 4 00-0mv i -ow $10.19 GRADING FEE 113.(-04(1-42. -000 $20.0 WF.RASTR1JCT[JRGFBE 215-01)0-443-342 �2.:.tsud PRECISE PLAN 101-000-40-M5 525.00 SUII TC}1AL CaNS'1RLICTION WD PLAil! C14ECK $.3,740.73 F LES, 3 FLE-i't1 M ,I ECS ^$2_10.00 '�'0TA.1'., PE'.1llY�t1'�''WEE3 DU E!;'i�`OW 0/ 9� j 170 iAi*..MOi.F.C"i' PMU FEES $3,490.73 3,740.73 RECEIPT DATE BY DATE FINALED INSPECTOR OPERATION DATE INSPECTOR ' OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs O 3/ 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 ge Vents Fireplace-P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath y Final ' Final POOLS - SPAS BLOCKWALL APPROV0,11S 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 0 3j j Encapsulation Gas Piping Gas Test p 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 Final Utility Notice (Perm) Building S'(j' � 5- Address rJ Owner T.Atyl uu�cu P.O. BOX 1504 78 105 CALLE ESTADO C�UINTA, CALIFORNIA 92253 APPLICATION ONLY n %," i -c-t 10 1 W r IN C�_ I r t~ BUILDING: TYPE CONST. OCC. GRP. ( A.P. Number 1-73- (�� [ — Q/ i r Legal Description/ � Mailing Address _ City Zip Tel. Mech. Electrical Project Description 51 DContra"ctor k / I r Address —A Y City Izip State Ljc. City & Classif. Q -a Lic. # Arch., Engr., p� Designer ( 1 CA �n P Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION thatI am licensed under provisions of Chapter 9 (commencing 3 of the Business sand Professions Code, and my license is in OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's 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 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 ($500). 1,1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I' I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I I I am exempt under Sec. B. 8 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company r7 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($ 100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, 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, aher 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. 1 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION Sq. Ft. No. No. Dw. Size Stories 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 Cr#et Line Rear Setback from,Rro Line Side Street Setb CentLine Side Setbac�C✓f m Pr9,pertyrt to V FINAL DATE IS,& INSPEPOP Issued by: Validated Validation CONSTRUCTION ESTIMATE NO, ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS SLAB GRADE 2ND FL. SO. FT. @ BONDING YARD SPKLR SYSTEM -POR. SO. FT. p MOBILEHOME SVC. BAR SINK GAR. SO. FT, POWER OUTLET ROOF DRAINS FOUND, REINF. GAS (ROUGH) DRAINAGE PIPING CAR P. I SQ. FT. FL OTHER APP./EQUIP. REINF. STEEL WALL SQ. FT. fEC TEMP. POLE DRINKING FOUNTAIN SO. FT. ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES _$ WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SPARK ARRESTOR SO. FT. © c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11A c SEWAGE DISPOSAL LATHING SO.FT.GAR @ 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATIONISOUND PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING R AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB, BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND, REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION --- FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ' LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL I SENT BY:PALM DESERT ;10- 9-95 ;11:49AM ; FORSITE ESCROW INC -4 619 345 3136;# ' FORESITE ESCROW, INC, 41-995 BOARDWALK SUM O-2 PALM DES92211-5110'" l ERT, CA (619)773-5333 FAX (619) 7739289 / DATE : October 9, 1995 TO: : Leonard Meier FAX NO :345-3136 ATTN FROM : Denise FAX TRANSMITTAL TME: 11:31 AM TOTAL I IWER OF PAGM; �_ (INCLUDING THIS PAGE) SUBJECT: . Per our conversation, the legal description is: Lot 4, Block 57, Santa Carmelita at Vale La Quinta Unit No. 5, as shown by .map on file in book 18, page 63 of Maps, Records of Riverside County. California IWORTANT NOTE: Should any of these papers require an ORIGINAL SIGNATURE, Please take it XEROX COPY BEFORE SIGNING. We will not accept an Origulel Signature on FAX paper. Thank you for your cooperation in this matter. THIS MESSAGE IS DMNDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED. AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED OR CONFIDENTIAL, IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE, TO THE INTENDED RECIPIENT YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE READ THIS COMMUNICATION IN ERROR, PLEASE NOTIFY U5 IMMEDIATELY BY TELEPHONE AND RETURN THE ORIGINAL MESSA08 TO US AT THE ABOVE ADDRESS VIA THE U.S. POSTAL SERVICE. IOTT CHORD SPLICES611-12=3X6; 'LATE OFFSETS (X=LIFT,Y=TOP):(j4=3,31,(j5=6,1.51,(j6=3,31,[j8=10,21,[j10=3,3.5I,[jll=10,21,[113=4,2.51,(jl4=3,1.5), !0 : PROVIDE ADEQUATE DRAINAGE TO PREVENT PONDING 12-8-9 17-0 25-3-7 31- -1 38-0 -5-3 6-3-7 4-3-7 8-3-7 6-3-7 6-5-3 6X/y 4X6 3X4 5X6 4X14 5X6 3X4 . 14- 13 12 11 10 3X5 4X10 3X4 4X14 5X14 3X4 fi-5-3 12-8-9. 17-0 25-3-7 31-6-13 3B-0 r 6-5-3 6-3-7 4-3-7 I 8-3-7 —�, 6-3-7 } 6-5-3 3X4 R. HL TO PK :38-0-1 LEFT HEIGHT:1-11-15 SPAN:38-0 RISE:3-0 RIGHT HEIGHT:1-6-1 LOADING (QSF� MAX STRESSES -MINIMUM GRADE OF LUMBER - L TOP 5-6=0.764 TOP CHORD:2*4 No.l&Btr GR DF -L TOP 20 10 BOTT 11-12=0.710 BOT CHORD:2*4 No.l&Btr GR DF -L BOTT 0 10 LL.DEFL.Q11=0.21 < L/240 WEBS :2*4, STANDARD GR DF -L STR.INC.: LUMB =-1.25 PLATE = 1.25 SPACING : 24.0 in. o. c. REPETITIVE'STRESSES USED NO. OF MEMBERS = 1 WEB: 5-11 TO BE 24 No.188tr GR DF -L DEFLECTION(IN.) LL= 0.21,D.L=0.21,T.L=0.43 OCT 0 9 1995 PLATES ARE MITEK M20-186,147 MANUFACTURED FROM ASTM h 446 GRD A GALVANIZED STEEL(EXCEPT AS SHOWN) PLATE MUST BE 1NSfALLED ON EACH FACE OF JOINT, SYMMETRICALLY(EXCEPT AS SHOWN)DESIGN CONFORMS WITH NDS DESIGN SP B - CSO,TPI-91 THIS DESIGN IS FOR TRUSS FABRICATION ONLY.FOR PERMANENT. AND TEMPORARY BRAC(NG(WH1CH IS ALWAYS REQD)CONSULT O OR ENGINE; .�' tv� v�� t4 LNIL �P OF CALWF V -==«<<A.C.E.S Version 7.1»»========[ 475789 ]-=======««BOBS-BLDG-CTR»»=== Customer : M.V.H.CONST. Fri Oct --06 17;35:57 1995 Project #: 95229 Truss ID A Family # 317 Span 38-0 Quantity 17 Top Pitch 0.158/12 TOP CHORD BOTTOM CHORD WEBS REACTIONS - SIZE 1-2m-460 7 -Bi -2238 9-10= 0 2-14= 1088 5-11= 3687 1=-523 3.50 2.3=-1050 8-94-649 10-11= 2237 3-14=-159 6-11=-437 9=-712 3.50 3.4=•162 11-12=-1721 3-13=-917 7-11=-336 12=-1782 3.50 4.5=-162 12-13=-1721 4-13-317 7-10=-305 5.6=-1909 13-14= 1050 5-13= 1992 8-10= 2278 6.7=-1909 14-1= 0 5-12=-1657 IOTT CHORD SPLICES611-12=3X6; 'LATE OFFSETS (X=LIFT,Y=TOP):(j4=3,31,(j5=6,1.51,(j6=3,31,[j8=10,21,[j10=3,3.5I,[jll=10,21,[113=4,2.51,(jl4=3,1.5), !0 : PROVIDE ADEQUATE DRAINAGE TO PREVENT PONDING 12-8-9 17-0 25-3-7 31- -1 38-0 -5-3 6-3-7 4-3-7 8-3-7 6-3-7 6-5-3 6X/y 4X6 3X4 5X6 4X14 5X6 3X4 . 14- 13 12 11 10 3X5 4X10 3X4 4X14 5X14 3X4 fi-5-3 12-8-9. 17-0 25-3-7 31-6-13 3B-0 r 6-5-3 6-3-7 4-3-7 I 8-3-7 —�, 6-3-7 } 6-5-3 3X4 R. HL TO PK :38-0-1 LEFT HEIGHT:1-11-15 SPAN:38-0 RISE:3-0 RIGHT HEIGHT:1-6-1 LOADING (QSF� MAX STRESSES -MINIMUM GRADE OF LUMBER - L TOP 5-6=0.764 TOP CHORD:2*4 No.l&Btr GR DF -L TOP 20 10 BOTT 11-12=0.710 BOT CHORD:2*4 No.l&Btr GR DF -L BOTT 0 10 LL.DEFL.Q11=0.21 < L/240 WEBS :2*4, STANDARD GR DF -L STR.INC.: LUMB =-1.25 PLATE = 1.25 SPACING : 24.0 in. o. c. REPETITIVE'STRESSES USED NO. OF MEMBERS = 1 WEB: 5-11 TO BE 24 No.188tr GR DF -L DEFLECTION(IN.) LL= 0.21,D.L=0.21,T.L=0.43 OCT 0 9 1995 PLATES ARE MITEK M20-186,147 MANUFACTURED FROM ASTM h 446 GRD A GALVANIZED STEEL(EXCEPT AS SHOWN) PLATE MUST BE 1NSfALLED ON EACH FACE OF JOINT, SYMMETRICALLY(EXCEPT AS SHOWN)DESIGN CONFORMS WITH NDS DESIGN SP B - CSO,TPI-91 THIS DESIGN IS FOR TRUSS FABRICATION ONLY.FOR PERMANENT. AND TEMPORARY BRAC(NG(WH1CH IS ALWAYS REQD)CONSULT O OR ENGINE; .�' tv� v�� t4 LNIL �P OF CALWF V