9706-009 (SFD)H
N U)
W
p ::) M
O L0
W
tr
O—r
T
P
W W
H d
CO
Z
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:
X) 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).
116 1 am exempt upder Section B&P.C. fole,r this reason
Date A. -1 /� "7 Signature of Owner %�l.�.c.�s.� �.(r/ia'
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declaratiohs:
( ) 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).
" I certify that in the performance of the work for which this permit is issued,
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
Eject to the workers' compensation provisions of Section 3700 of the :Labor
Code, I�shall forthwith comply with those provisions'ti
Date: J 4 _? Applica it
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 sudR
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. I , f
isignature (Owner/Agent;'. Date �! '++
BPERMIT# CONTROL#
BUILDING PERMIT
�74rU114 5260
DATE VALUATION,. LOT' TRACT
24 q. $77,3)4.20 c k35 �, `�).)4
ADDRESS S1-�t3 S AVW1DA CA.l:itkN1A JOB SITE
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
POISE RODIUGUEZ
OWNER BUILDER WIT11-1 CIV131 1C
111010 CA. 9220).
USE OF PERMIT
�.ii i! ,.Pi 3(l�jf, t lfl9'i:i N ti ter! f11J1« i34sC�f F. 14;t�f 1 `.1 �'ft POOL.. PLAN
t tjj �`!•: L F�r3'Itld CfC:t l) 1r 7.9% 170kk (VILTa '('1F% B cmugor sAMK Pj:,AN
Typt1. ,
'i1 ACT
1� sic EN 1t1'lc, l02.fkj S
GARA(31"%CARPC ICY 526.00 SP
77,369.2ZO
PERMIT fefl,*:E, Af,1tIMAttV .
C'0NI;3'f_KUCCf'C)%t'FEEE 101x(00-41i<•,df )n fi wUi,4(i
E't.4 f'1 C't i, e,c?3; 1011,0)439-318 1.3 i.t31
11)lCF,IANIC:.i LFl.% 01 -000 -K -21 -ON
t�i.Is't�''j`121CAt : I.i3I••(iOLl,:3:2CJ.t}11C) S.i16.37
Pi:CJ14jKNC) FRF 1.01-900-419-1,10) $l i. £►
ORA1rANC-.P.f31... 10t-100423-000 �t),IlfJ
jPli%f#A,;1'i2.fJf:C1)lfis t't.�N �d�-t)t�t3-�#43;3�02 $1.'1)U �"�
PlkEC1SE 1>i.AN 101-000-441-3$5 525.01
LESS ME -PAID FEES
TU.Cjf)
JUL 2 4.1997 4;�01-AT, P,RIV1 'r MEN OlaENOAV
$2,[45.%)
L1
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
a
_
I \:
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Stab Grade
Return Air
Steel
Combustion Air
Root Deck
/
Exhaust Fans
OK to Wrap
F.A.U.
Framing
Compressor
Insulation S `(/
d
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
BLOCKWALL APPROV LS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
7/AY
Appliances
Final
Final
Utility Notice..(Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service.
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
/COMMENTS:
G
�^
I
Building¢//
Address �AP V ,te✓dV
Owner
CCi
ailing
ddressty Z�ontractor D
—Address
T419�
"
P.O. BOX 1504 APPLICATION ONLY
78-495 CALLE TAMPICO
%j/PQjjj Q LA QUINTA, CALIFORNIA 92253
17.
tur e -U
`f),o 4Z 4!F
City Zip Tel. gov Lv/
State Lic. City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State I
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 following
reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a
permit to construct, alter. Improve, demolish, or repair any structure, prior to �lts 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 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 ($500).
I'. 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 or through his own employees,
provided that such improvements are not intended or offered for sale. It. 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 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 notapply fo a owner of property who builds or improves thereon, and who contracts for
such proje a cOntracfor(s) licensed pursuant to the Contractor's License Law.)
Sec. B. & P.C. for this reason
Date
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 if 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 it work thereunder is suspended for 180 days.
I certify that 1 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 a0pficant Date
Mailing Address
City, State, Zip
ILDING: TYPE'CONST. OCC. GRP.
'. Number 773 — / & 4 r o i e
)al Description Lcr 6, 8i -e �7 �VL
-Q 5
eject Description
Sq. Ft. /2-j -0 No.
Size Sto
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Driveway Enc.
Ir structure
TOTAL
REMARKS
AMOUNT
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
f�i►►_l��lcr�q
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Date 6/5/97
No. 15602
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
APN # 773-164-018
Jurisdiction La Quinta
Owner Name Jose Rodriguez
No. 51865 Street Avenida Carranza
City La Quinta zip 92253
Permit #
Log #
Study Area 113
Tract # Lot # Square Footage 121.0
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
1.84 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 issued
Fees Paid By oc/Bank of America/Coachella Valley Housing Telephone 347-3157
eoatitioix Name on the check -
By. Dr. Doris Wilson
Superintendent
Fee collected /exempted by Pauline Pearson
Signature
Payment Received $2,226.40
Check No. 2003318233
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
ollect them on the Dislricl('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
L
Coachella Vaiiey Housing Coalition I i
Plaza 1, 45-701 Monroe Street, Suite G., Indio, CA 92201 —
TEL: (7 60) 347-3157 FAX: (760) 342-6466
ATTORNEY-IN-FACT AGREEMENT
I/We 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 6 BLOCK 57 OF UNIT 5 OF SANTA CARMELITA AT VALE LA
QUINTA, AS SHOWN BY AP RECORDED IN BOOK 18, PAGE 63 OF
MAPS, RIVERSIDE COUN RECORDS.
cA
Date Jose Antonio M. Rodriguez
Date
CU�9u '
Mari De Jesus Zaz t
02/19/1998 21:59
D,evnis S.
February 20, 1998
76077136066
Wish PE
Mr. Daniel Crawford
City of 1A Quittta
Department of Building and Safety
78-495 Calle Tampico
La Quinta, California 92233
DENNIS S. WISH PE
PAGE 01
STRUCTURAL ENGINgERING COWULTANT
5&M5 AVENIDA BERMUDAS. LA OVINTA CALIFORNIA 922W
780.564.0884 PHONE •760.771.36MFAX • W19HCCWIA.00M
fter,&g. CoacheUo Volley Horsing Coaadoa -- Phase I Lot 6 51.865 Avenida Catsan a (TjpieaO
In compliance with UBC Section 1702, a structural observation was perforated on the Mumm located at 51-465-AvWda Catnm�oi"
also inspected the residences on either side of this one which is typical of the first 10 homes constructed under Phase One of this
development. The Observation was performed on this building on February 19-1998 at 2:30 PM. An inspection was performed for
the load path elements including; shear panel type and nai4n& shearwaU to roof connections, blocking, drag and strap connections,
general framing (in conformance to conventional framing standards) and mechanical anchorage. The residences are light gauge steel
stud structures with proprietary plated trusses made from wood.
EMrnt from 1994 Uniform $uildine C e Section 1702 — StnwWA Observation
Structural Observation shall be provided in Seismic Zone 3 or 4 when one of the following conditiow exists:
1. The structure is defined in Table 16-K as Occupancy Category I, II or III or,
2. The structure is required to comply with Section 403, or
3. When so designated by the architect or engineer of record, or -
4.
r4. When such observation is specifically required by the building official.
The owner shall employ the engineer or architect responsible for the structural design, or another engineer or
architect designated by the ertgiReer or architoct'responsible for the structural desiM to perform structurdl
observation as defined in Section 220, Observed deficiencies shall be reported in writing to the owner's
representative. -special irupector, contractor and the building official. The structural observer shall submit to the
building official a written statement that the site visits have been trade and identifying any tgmrted deficiencies
which to the best of the structural observers knowledge, have not been resolved.
The structure was found to be in conformance with the design details, framing plans and structural notes. The engineer
responsible for the structural design has certified to the best of his knowledge that the building complies with the design,
drawings and details for the lateral resisting system.
❑ Structural corections have been made and confirmed by the engineer responsible for the structural design on
. This letter shall be submitted to the building official to certify that compliance with Section 1702 and
Section 220 of the 1994 Uniform Building Code and previous deficiencies haw. been corrected. The engineer certifies to the
SnWT,jR" ENOINEERS4 FOR. CUSTM NOYES • REMODEL • CONNERCIµ • U0R iN MnLAL • SEMK RIROFIT Q R[OA7R • UNREINFORCEO MAOD RY. *MfdNO V LLS 5 PO *0010N • gEPORi�:
weWx AeeEsercNr 9.mow Roor . o mjRm n etre . Dogms s. waR o e. I lW BM A NRMBER OF THE 0TRVCTVRA� l�yNeERe AesOWf10N OF eou�xeRN CAL+MorwA ewce 1089
02/19/1998 21:59 76077136066 DENNIS S. WISH PE PAGE 02
- Page 2
best of his knowledge that the structural deficiencies have been resolved and are in conformance with the intentions of the
structural design, drawings and details
The following deficiencies were identified. Corrections shall be made before framing inspection is complete and final
wrapping is approved. Where remedial design work is required, contact the Architect or Engineer of Record for design
coordination and additional detailing necessary to correct the problem. Incomplete work shall be completed as shown on
design drawings and a final Observation shall again be ordered to verify that deficiencies has been corrected to the best of his
knowledge.
Number. Description of Structural Deficiency
A preliminary Observation was performed last week where a number of discrepancies were.discovired and reported to the job
foreman. 71te most pressing of these was the connection of the shearwall in the Garage to the truss situated adjacent to the wall rather
than directly over it as indicated on the drawings. A correction was issued at the time that called foie solid bloc idng to be installed at
the -top track of the 2x shear wall connected with 08 wood screws at 4" o/c from below the top track. The blodang was to be set flush
to the bottom chord of the drag truss and seamed in place with Simpson A33's — one per block.
Upon my second Observation, I inspected the installation of this shear transfer repair and found it to be in tact. i'hetefore, it is'my
professional opinion that construction of this phase meets the intention of the structural design and that the load path on all shear
transfers is complete from roof to foundation. I therefore, recommend that the residences be allowed to be sheathed and roofed,
if you btfv l any specific concerns, please contact me at your earliest convenience and I will address them as soon as possible.
Engineering Consultant
Dot SO1.01 7/29/97
I
SMVCnAtAL EhO1NEERY/0 foR. cueTai NowEs •REMODEL . colydeRpAL . LIOMT �hDU9fRWL . aclsr/c RE7ROFR a RfAUR . U/dl1tINFOROEO MA60NRY • AEfA1hP►tl wuLt! a �d TieN •
ItEPOItTB: ONMOE A68W V4N► • NEW ROOF . VMMANCE CLAIM • OEMM3 9. WtM D.E. N48 @F&4 A MEMEER OF TK UMUMAAL ENOINMO AJMMION of 90UM"N CAuspwaA GNCE low
Certificatel'of Occupancy
City of La Quinta
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:
Use Classification:
Occupancy Group:
51-865 AVENIDA. CARRANZA
SINGLE FAMILY DWELLING
R-3 Type of Construction
Owner of Building: JOSE RODRIGUEZ
Building Official
Bldg. Permit No.: 9706-009
VN Land Use Zone: RC
Address: 51-600 TYLER ST #37
City: COACHELLA, CA., 92236
By: DANIEL P. CRAWFORD JR.
Date: 7/31/98
POST IN A CONSPICUOUS PLACE