The URL can be used to link to this page

0101-233 (SFD),4`i O W � 6Zr� O� ~C:) WW I— a 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 a Signature of Contractor'• i c 7 11 . r 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 ISignature 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 thoseeprov&s&ons. Date: L. ,- �`.. Applicant f.,,.. K Warning: Failure to secure Worke"A' 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 persop at whose request and for whose benefit work is performed under or pursuaht 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 inspection purposes. ! 1' y Signature (Owner/Agent) 14th_ rY-,_� Date • r BUILDING PERMIT PERMIT# DATE VALUATION LOT ��ArJ,�^�.�. TRACT r, b -t "S.+tIifl:"40 Bl,'. ?34 172.; JOB SITE APN ADDRESS AVEMDAk CA AWZA ?744,55-016 OWNER CONTRACTOR / DESIGNER / EN &NEER : :Lfil'tAMMMM3 Ttr!C B."RAUCJ!;`�tf A.fiiN 199 ;1.,fA. Q.-U&TA CA 92253 LA QU.11i roL CA 92253 (7.60)28°15-496131 C` , * 2387 USE OFPERMIT SIM s� YM 1. X & COIb%OINA T 101q' �`�'.A1;af.IND & $0 LIP X 5' OARM 'by�'.AYA, - OW"O BYS'TEM, - PHi8MIT DOE.$ 140T INC)..13DE PO01; OR TDR�V T++°!]tr1A.�'' AP&�k?O.AC;�.. V'6�Oi7bP'➢1+:419813•: ltfi,?:S ► �)t !'1t.B::Ai� T9ACT 0014STR.UCT1013 1.4502A SF PORCkilPAT.10 MUD SF MRAGFIC'ARFCDRY (3F) 6 FT. W Ntl, - CD. tD0 Ly 5 FT, W AL!, 813.00 ).F A . X;Fln"IM) COST OF CO,1'6��vl..�e'.MWX - 1-1<d,N CHECK t�I-a 101-WO.439.316 $308,53 %1WF AIN ICAL FEZ 102 $53.50 ELTi+;:'1M("MY, FFE 101.000.420-000 $130A, 7J.f„E.fa€flhaa FRE 101-000-419_000 $1 ID. -Pi 1,;T.1,10140 MOTION YU, -ROOM 101 -000441 -000 K30 OR, I)INO F)?T? 101-000-423-.000 $7.0.60 rA'RYI Fal; %r1.M4 1(11-000-441.345 V0t1n FEE DEPOSIT 1:lu�lmC. 00.4: 9.318 »3250,001 l.:ru�,�gwef,.R..i.Ity,�8ION 1. ,�{g E 101-000-41 "00 $621.50 1? C,IM "i`kxx:UL`IIV14 AND ,PLAN LSC K $3,461.56 ?_.'iMS PRE -PAID RMS -$250.00 Y UE LA `mssO .O� e V RECEIPT DATEBY DA FI ED INSPECTOR \ '71 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs r �Y Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air _ Roof Deck Exhaust Fans O.K. to Wrap 7 _ e, F.A.U. Framing 0/ Compressor Insulation 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 POOLS - SPAS BLOCKWALL APPROVALS Set Backs Steel Electric Bond _ Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Z 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] Appliances Final _ COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole - pl 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)Wl _.0/Q t% ra �d- - +, ubtrai *-./� OA -W ' 0-yi l ��— S - P.O. BOX 1504 FF ✓4, g 78-495 CALLE TAMPICO APPLICATION ICY A 0"? Building ��y/ Address S3 gsS" hJ4. GAl�-RAf�t 2A LA QUINTA, CALIFORNIA 92253 r,� Or Owner v BUILDING: TYPE'CONST. - OCC. GRP. � A.P. Number '77 � SS 0/6 Legal Description `� % c [ z j y ✓/ . T 2 a r2,�C 7-1 3 [ `, },xrT 4 I 1+12 •u4c L. � �. r * tit• c� . Project Description Mailing � Address (?0 S' -7 City A 01.) (C, � Zip G L, 3 Tel. QL Contractor iij-�le'LCl {A/4Q6L ►t._Nt L Address S/37v City( Zip4,2253 l. T7Lc. 28. State Ljc. & Classif. p� -791 Vy City Lic. # Si' �tlj&2 No. No. sSiz Stories Units Arch., Engr., Designer 1f t., (C 1, ) /,r• , f1 (�, ole New I� Add 0 Alter ❑ Repair O Demolition ❑ Address Tel. 72 t DC7 i�S(J �7r4 _` City /, Cti Zip eI 1 7 State Lic. # �'l LICENSED CONTRACTOR'S DECLARATION I ha er by affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division f the Business and Professions Code, and my license is in,(ull force and etfec`y1 SIGNATURE'- r DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requ/res 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 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. 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.) Estimated Valuation /' PERMIT /v U Aj�10UNT Plan Chk. Dep. r Plan Chk. Bal. Const. Mech. Electrical Plumbing L 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 am exempt under Sec.- & P.C. for this reason I/ S.M.1. Grading Driveway Enc. Date -,%0% Owner-- � Infrastructure 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 [7 Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (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, 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name FINAL DATE INSPECTOR Issued by: Date Permit Validated by: 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 applicant Date Mailing Address Validation: City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 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 BRAVCKNANN , Inc. SITE ADDRESS -53-855 Avenida Carranza APN 774 155 - 015 LEGAL:. LOT 7 BIN NO.: CASE NO.: 2001-388 BLOCK 234 UNIT 2 2 S.C.@V.L.Q. CHECKED BY: Fred Baker DATE: Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a log book to track applications and assign case numbers. 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) Y VED OM UNITY OEVE�OP C�, - Consistency with street/surrounding area: Colors Materials Architecture E CAE N0. . Other Requirements: 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 1/25/01 No. 21568 Owner NameBrauckmann, Inc. No. 53-855 Street Avenida Carranza city La Quinta Tract # 0101-233 Lot # 7 Type of Development Single Family Residence Comments APN# 774-155-016 Jurisdiction La Quinta zip 92253 Square Footage Permit # Log # Study Area 1492 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 foliowiu , reasou: , EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of i 2.05 X 1,492 or $ 3,058.60 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/Wells Fargo official check/Julie Brauckmann Telephone Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Olivia Aguirre Signature Payment Received $3,198.06 : Check No. 7377002654 NOTICE: Pursuant of Assemdly 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 tolled 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 c Certificate of Occupancy City of La Quintal 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 SFD 53-855 AVENIDA CARRANZA R 3 Type of Construction: VN Owner of Building: BRAUCKMANN INC. "1 ---dot Building Official Bldg. Permit No.: Land Use Zone; Address: P.O. BOX 517 0101-233 RC City: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: 06-13-01 POST IN A CONSPICUOUS PLACE