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9807-212 (SFD)LICENSED CONTRACTOR DECLARATION U)I hereby affirm under penalty of perjury that I am licensed under provisions of I— 'Chapter 9 (commencing with Section 7000) of Division 3 of the Business and cv W Professionals Code, and my License is in full force and effect. O =) M License # Lic. Class Exp. Date O _ CVFIC 123V98 oZ r,- Date Signature of Contractor �O1�_ J U ca OWNER -BUILDER DECLARATION Lli H WW I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: , Z ( ) 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, Business & Professionals Code). ( ) 1, as owner of the property, am exclusively contracting' with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). co (�, I am exem o t under Section B&RC. fo his ason N VDate +9 V 95 Signature of Owner Orn d< WORKER'S COMPENSATION DECLARATION p zcr I hereby affirm under penalty of perjury one of the following declarations: LO O ( ) I have and will maintain a certificate of consent to self -insure for workers' X W �= compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. m Q I have and will maintain workers' compensation insurance, as required by O U Q Section 3700 of the Labor Code, for the performance of the work for which this li 0 Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. cb O fl�,td�1�'.'I '�UT�A:i Cam. t (12001 4370 00 J (This section need not be completed if the permit valuation is for $100.00 or iess). ( ) 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 3 subject to the workers' compensation prove ions of Section 3700 of the'L'abor Code, I,shell fort. nth comply with thos pr�v�rsio s. Applicant—i4_ �-_- �- 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, indemnity & 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 re resentatives of this City to enter upon the above-mentioned property for in ec io purposes. Signature (Owner/Agent) Date �% G BUILDING PERMIT PERMI,# CONTROL# )137-i DATE VALUATION .�1.ei2.946.50 LOT ,? I TRACT t7t Z 9 4 7 P�Lz+L-b - JOB SITE Y APN / ADDRESS 52-2430 e341[+'IMMA CA7tRANZA 773-261-002 OWNER ' CONTRACTOR / DESIGNER /ENGINEER �yJi`�0hAf 11, [,IV �AINry 1 JEI R ►DLI��V+.1 l.`r 1/ 46-2a 1 JMCKSON Afrr 143 45701 i1�iCN.ROE ST S". F G INDIO CA 92.201 1N010 CA 92201. (760)347-3157 . CB11# USE OF PERMIT SuV�.1.F'.NAi�SI.L1 T-►L�'1Ji.�iu 5F'D - PERMIT DOES NOT 1hYMXDE SACK WALL Olt 1100L.-75% PLAN .'TRACT 1:13\ SM111C11'1014 1.302.00 Sr POi`ZCI:UPM10 - 159.00 SF 0ARAJO.:JCA1tIyOR.'1' 517.00 SF 9Y�FINIATA1COST11COST131# ti.''CDi'.�+1.., IRILICTION'' / 0145 fitUC7'i.UN H 101 -M -418 -ft) Saf3.0U P.4,AN C:t4'CA FRE NIEC HANICAL ksli 1 LF.CTT ICAL rEM' PLLMBING FEE S'1'RONOMU.C.ION IxNFRASiRUCTCIRCIM PRECISE PLA14 101 -MV -439-318 $1. M, 11113 '1017000,421-01111 $40,50 101.-000-420-000 $119,41 101-0004.1.9-000 $121.511 lO t -000-241-1;00 .2?3 10190110-423-000 $'A' W 22f"00-443-342 $6.18.72 101-000-441-M5 525.00 51..03-TCY1'A,T, CONF5TRUCTION AND. PLAN CHECK. LESS 1'RE..'PAID FEES RECEIPT I DATE I BY I DATE FINALED I INSPECTOR cis y4i��J.'4�� $0.00 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs 1 Underground Ducts Forms & Footings _'.1 Ducts Slab Grade Return Air Steel Combustion Air Roof Deck —22 Exhaust Fans O.K. to Wrap Framing /�� '571, f= ''7 F.A.U. Compressor Insulation _ 7 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath _ 57 Drywall- Int. Lath - Final Final o �� g� BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam / Approval to Cover Equipment Location UDz/L 3G If Underground Electric Underground Plbg. Test Final Gas Piping PLUM 6� NG APPROVALS Gas Test Electric Final Waste Lines 2- / A Water Piping /l/�9 Heater Final 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 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 i F Final Utility Notice (Perm) /,z� 'e t_ 5 7 COMMENTS: P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO LA OUINTA, CALIFORNIA 92253 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 em 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 ellect. SIGNA7uRE DATE 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). CI, 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 .'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'1 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.) 1-1 1 am exempt under Sec. B. & 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 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 It 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, alter making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such previsions 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 a0plicant Date Mailing Address City, State, Zip 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 (D BUILDING: TYPE'CONST. A.P. Number � �� o Legal Description Project Description C") OCC. GRP. — 62S:a� e xxY �l L� Mailing Address1g6 _ City Zi Contractor Address City Zip Tel. State Lic. & Classif. City Lic. # Sq. Ft. Size No. 1 No. DW. \ Stories Units Arch., Engr., Designer ( N Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address t_ Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 em 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 ellect. SIGNA7uRE DATE 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). CI, 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 .'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'1 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.) 1-1 1 am exempt under Sec. B. & 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 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 It 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, alter making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such previsions 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 a0plicant Date Mailing Address City, State, Zip 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 June 24, 1998 Mr. Daniel Crawford - Inspector City of La Quinta . Department of Building and Safety 78-495 Calle Tampico La Quinta, California 92253 STRUCTURAL ENGINEERING CONSULTANT 54625 AVENIDA BERMUDAS. LA QUINTA CALIFORNIA 92253 760.564.0884 PHONE i 760.771.3606 FAX • WISH@CWIA.COM Regarding: CVHC Plan 320 and 420 - Truss Calculations — Group 9 (Typical all La Quinta Projects) Dear Daniel: I have reviewed the truss calculations from Imperial Roof Truss which is to be used for the roof construction of the 3 bedroom and 4 bedroom homes in La Quinta. The truss calculations labeled "320 Plan" are for the 3 bedroom plan that is associated to the "96-051" job number listed in the lower right corner of the architectural plans. The "420 Plan" truss calculations correspond to the "96-052" 4 bedroom drawings. I have reviewed the truss calculations to confirm the capacity of all design loads drags and bottom chord loaded girder trusses. I have found each to be in compliance with the intentions of the structural design I have also verified that the roof dead loads used in the design of the trusses exceed the design loads on the structural calculations. 'Be truss calculations are more conservative and therefore acceptable. The Truss calculations will be used the self-help La Quinta Project - Groups 4, 5, 6, 7, 8 and 9. Each group will use the same plans as those mentioned above that these truss calculations conform to. I have provided a separate letter referenced above for each group. These are intended to simply the City's records and allow a separate approval for each block of homes. Coachella Valley Housing Coalition can provide the addresses for each lot in each of the groups listed Please contact me at your earliest convenience if you should have any questions or additional requirements. S' rely, - / aa ennis S. Wish PE Structural Engineering Consultant lO�C;^F -SSI-7 �J DENNIS S. WISH f 10. C-041250 LU STRUCTURAL ENGINEERING FOR • CUSTOM HOMES • REMODEL • COMMERCIAL • LIGHT INDUSTRIAL • SEISMIC RETROFIT 8 REPAIR • UNREINFORCED MASONRY • RETAINING WALLS 8 FOUNDATION • REPORTS: DAMAGE ASSESSMENT • NEW ROOF • INSURANCE CLAIM • DENNIS S. WISH P.E. HAS BEEN A MEMBER OF THE STRUCTURAL ENGINEERS ASSOCIATION OF SOUTHERN CALIFORNIA SINCE 1983 e Coachella Valley Housing .Coalition Plaza 1, 45-701 Monroe Street, Suite G., Indio, CA 92201 — TEL: (760) 347-31 S7 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 21 OF BLOCK 81 OF UNIT 10 OF SANTA CARMELITA AT VALE LA QUINTA, AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 70 OF MAPS, RIVERSIDE COUNTY RECORDS. 2LZ0��'� Date 2, Date f:\sfamily\an na\miscfor\attnyfa DARIO GRANO MARIA ESPERANZA GRANO Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 7/31/98 No. 17423 Jurisdiction Owner NameCoachella Valley Housing Coalition No. 52-280 Street Avenida Carranza City La Quinta zip 92253 Tract # Type of Development Comments Lot # Single Family Residence APN # 773-261-002 La Quinta Permit # Log # Study Area Square Footage 1,302 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 1.93 X 1,302 or $ 2,512.86 the property listed above and shat building. ,y y permits and/or Certificates of Occupancy for this square footage in this proposed project`may noNk� be issued . Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Payment Received $2,512.86 Check No. 2009916226 Signature I NOTICE: Pursuant of embly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 9D -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