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0102-164 (SFD)LIJ C) ro d u7 W oZl� e(o 0- oe �V� ~LUa N Z C'Y) L0 N ON C) rn CLa Lo Q 0 0 JJ mUU O rn H Z o 'ted Q J LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Crapter 9-icommencing 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 02;5381 D`�, 07/31 W X 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 exempt under Section , B&P.C. for this reason Date 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). ( ) 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. 'bate: "211 -- 7 A f Applicant I. Warning: Failure to secure Workers"Compensaiion cc yerage 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)Aand 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 ism 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 BUILDING PERMIT PERMIT# DATE VALUATION LOT 0102464 TRACT �aee 6 yY qq ♦♦`` JOB SITE APN ADDRESS OWNER CONTRACTOR / DESIGNEREN 1N�EER dAwyyle 3��M9SJR.th7 �..>6.�LV fi�.S j`:v R/'t.✓d,Y\J1Cfl .1 4�+.Lr �], 1,�2•?wl/r�'.�:G:J 51.�+rL7.GeM.6J�w�i'SA®AV 111719,13111? "Wln s 11 i 9 S TUMMY 3 OCT.A.MWEYE t:;',A,, 920.54 3 %0CyF,at�qJZr11 E CA �y920.54 �y i935 , USE OFPERMIT 871 CHYFIALIAUy YeEILLM77 0..97) a PERMIT iONSXOT %s`+ifwLi ULE BLOCK W'.i 4AfPUN),.,,iPjPA A-P3"%iD,4,VPaa O 3 nC5 UC X. ION 1,14211, 90 .V f7•r1^1�Jt'�1r4rT t'7fw�`t�A��cW^ d';'4Afi.4iH P'AT110 36.00 kEt 13ARAOE1'C, AR ROUT (M 9,9".09 S PT. 'KtifOOD, P'8. NC H 1100.00 LP HUM A1117.0 cog �% OF f"'On ISIMUC11170N P MAITUNXESUMMARYNOyyV'RUCLION FER 101-000-418-000 V1"000-4y8^0V0 A ,50 M W(`,8 AANIC,Al , VVE 101-000-421-000 Nt AX51 YLECTTICAL FRE i Cl "f1t O.4.20 -0C 0 $129,44 101-000-419-011k) $ I I a. 74 MONG PSC>?'ION FEE - X X411) 101-000-14-1-000 53193 r IZADIKI.RSE $20,00 DFIVELOPERhh'RACT WE $11"7100 PR.ECI RIA"q $100.1+9 P14AN 5.a.TR�.:'� K :Jf11Xr �, 101 -OW -439-318 $121,01 FRY FiXPOSI`" +fit Z�BI fl�3i1••CC 3 ' ?i, 4250.00 B-'dMAL PLA11 6 CAVAL, $3,055.630 A.at -$250.00 FEB 22 2001 :rmm,—r-�uvwrnzumr.Now T10-LA,uuffil 1 RECEIPT DATEB DATE FINALED INSPECTOR h INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backsf Forms & Footings Slab Grade ? _ .0ir— '1J' Underground Ducts Ducts Return Air Steel_ -10 Combustion Air Roof Deck 7--O 7 S7 Exhaust Fans OX to Wrap S% F.A.U. Framing Insulation__ _ (- OC g� Compressor Vents 16 Fireplace P.L. Grills Fireplace T.O, Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final .Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I Gas Piping PLUMBING APPROVALS Waste Lines _ / / /� Gas Test Electric Final Heater Final Water Piping l �36dL Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection 3 /p ( S7 Pool Cover Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: l 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 2(_ O / Utility Notice (Perm) �/G Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 2/22/01 No. 21687 Owner NameDavid Ross Miller No. 52-900 City La Quinta Tract # CERTIFICATE OF COMPLIANCE Street Avenida Carranza Lot # Type of Development Single Family Residence Comments APN # 773-322-008 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Square Footage 1421 of .03 cents made for the overpayment. 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 2.05 X 1,421 or $ 2,913.05 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 CC/Temecula Valley Bank - J. R. Rodriguez Telephone Name on the check By Dr. Doris Wilson C Superintendent Fee coll4/ex,ted by Annette Barlow Signat Payment Received $2,913.08 Check No. 14820 JOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified ibove 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 Districtes)(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 DISTRICT - PLANNING REVIEW FORM This form is to be used by CDD staff for review 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 the Building and Safety Department as your correction list. Please attach additional explanations as necessary. APPLICANT SITE ADDRESS PACIFIC TRADES 52-900 Avenida Carranza APN 773 _ 322 _ 00:.8 BIN NO.:CASE NO.: 2001-3.99 LEGAL: LOT 19 BLOCK _ CHECKED BY: Greg Trousdell UNIT S.C.@V.L.Q. DATE: Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a log book to track a plications and assign case numbers. 1� REQUIRED ITEM Y N COMMENT/CORRECTION Compatibility Review Case logged and number assigned Verify legal and APN information Consistent with MDG on file (as.applicable MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: �� �'� • Q`ann Mir, yy Architec h n9 0 mu 5x0vt ons Other Requirements:yL G'� I .: T ZS -S9 '7J-32 rA. A pzo ' 020 - 01E 020- p9/ nfSESf+•f 1 RfM•GSES p"t/ ` CQLLf ► F + NOGALES �-- 1 26 © / _ / r �a F!T Z626'/ /25.02C2 Z -- cJwk= O3 .... .240 .O 3 1/ 0 v J - Za O ©j. ?c O '3- O . CO 13 D © G ~ 0 13 O Q 4 J Z3O 0 e 23 �J 4 V {OS b 22O S© 17 S O S- 22 O ©5 4 22 O S . h � !' ` � Z/ 6O . 6 e 6 / 6 .. O O 6 V 2, 6 �O 6. v 3/ 32/ 322 «a 323 32-4 = 325 e O.?OO OT On� h ql 20 ®T m 1p O ' o orB B A.,J. ©O /9 %gl. ©j Oo o, /9 O ©B ; /9 .O O "2 = :O 9 ,C �/U O 9 /O (1 ' Q 9 ,©O c� 9' h /O O !' -9 co-�A am_ � � � —' r.wowa-an v c o o "© ,O' Q V /7 /� O /O Q !T IO e /O Q /7 /p Zt ,5 liil // ��" /6 v/ Q // 1 /6 // U /6 /O. /Z /5 ,2 Q /Z /S -t2 - /S O @.,Z /S `J I rZ a oro_or, : _ O= o L •_- _ r. cwn ".� _ �_ ,- .� O./7/3k• - �� �_ - .� v, f- �- _ _ cra — —'=O ZZ.i4 n_ >_ Iz = c ==14 > w /a ®t - /3 > /4 /3_ X/ = /tQ (� /J ; /4 ( /3 f = i`�<��. .tom _ '- _.� _ •� - �. - �o � - -J - : v >'^ _X Air �. $on/o Cormc%fo A/ Vi//e 1.0 Ouinln unit NO -16- SAV99 I 1 65 26O C, / s 2S O ,4 2 i 24 3O e3 I 2!6 /© 6 ! j 20 O 2- 1 ; ,9 O /9 B i 80, i t i i i i 140 ,3 i A 1 A5Y,SSOR-S A -P OK>73 PC_32. RNCRSIDC COVVrr, CALIF- . Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building C certifying that, at the time of issuance, this structure was in compliance with the various ordi aj of the City regulating building construction or use. For the following: BUILDING ADDRESS: 52-900 AVENIDA CARRANZA Use Classification: SFD Bldg. Permit No.: 0102!164 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC l II Owner of Building: PACIFIC TRADES CONSTRUCTION Building Official Address: 1719 S. TREMONT City: S.. OCEANSIDE, CA 92054 By: STEVE TRAXEL Date: 06-21-01 POST INA CONSPICUOUS PLACE