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0304-377 (SFD)U) F— (V W O =) M r-- QLO � W OZI� coo 0 0 F-Wa U) 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 634,981 B Ol 1:2f. ©ate- - 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 1tl hereby affirm under penalty iof 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. (u)„'I have and will maintain workers' compensation insurance, as required by Sep ion 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 jyA,T1? I;UtJ10 Policy No. I3429^43 (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)l should become subject to the workers' compensation provisions of Section(3700 of the Labor Code, I shall forthwith comply withsthose provisions. /Date: '-- Y. Applicant\ 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 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. (.,agree to comply with all City, and State laws relating to the building construction, and herebj,,\authorize representatives of this City to enter upon the above-mentioned property for inspection purposesi Signature (Owner/Agent) ` � n ` ti Date —7 ` -BUILDING PERMIT PERMITp C604^��� DATE VALUATION LOT • TRACT Q X1.'11r4L}g. 10 }3IX 234 JOB ITE ADDRESS 53-945 AV.C4:•N'tl A CtkR.f2MZ..61 APN OWNER CONTRACTOR / DESIGNER / EN 1NEER lvi UM, C'Ok3.ON.1�'.;C; CORONJE, L014MIRd3=014 P.O. BOX 389 f fat 51-I 05 At/.I=)A'VI1.A,AM01 t 3AQJJJ1<TA L 92253 1A)UWA CA 9?253 Pi 0)5644604, rB1Allf 2261 USE OF PERMIT SINGLE FAMJLY DW1r'3aG W,(1 7003 S.A. SN'D P1.T2A+I17' 33GLw” b1A7' 1:Nr;rlfOF T:L0C'K WALL, POQL; 0K D1tSt►'1yWAYAPPROAC H TRACT CK31d57'R,IJICTIOIJ 2,003.00 5F POR.CifIPATIO B8100 SF GA IRA4F•IC.ARIPORT 04.00 SF E&r"Fmwi LOS'S' OF coll�S71.pucrCl'OZd .1.21,484.70 CONSTRUCTION F—P 101 -000 -418 -OW- $716,50 PLAN CHICK FEE 101-000-439-318 $593.07 IEEDL1a4S1T 101 -OW -4j9-318 4250.00 NI ZICH ANICAL ;47f f': 1.11-000-421.000 $59.00 E1�i;C".7111CAL I� .101.000.4ZO.000 $128.09 P:LUMB1'NO FEE 101-000-419-000 '1136.00 STRONG MOTION FEZ - RESID '101.000.21.000 142.15 a AP.iiDING FEE 101-000-423•-000 $11.00 DEVE1,0PER IMPACT FC11: S2,40100 PRECISE ,Pt AN 101-aiS(1-4e1i 3415 $zoO:Ott C0I+W7r2'O'f`UORa', 141 P1 AN CHWX 4.8'1 $4,164.81 ��Si7!'3-Tfl`IM, LES8 P1Zr-PAU) P.Bf-1 4250,00 `I<' .' LPE'>1:L1l�J<'Irlsl, ,v J`URVOW. 39s4.�33. JUL 0 8 2003 a` • Al CITY OF LA QUINTA FINANCE DEPT:. ' '1 RECEIPT DATE BY D PIPUI/D G INSPE INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs O Underground Ducts Forms & Footings Ducts Slab Grade If 11 Return Air Steel Combustion Air Roof Deck - Exhaust Fans O.K. to Wrap _ —p F.A.U. Framing _ O 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 — O BLOCKWALL APPROVALS POOLS - SPAS 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 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 Final _ Utility Notice (Perm) - COMMENTS: 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 2,003 S.F. or $4,286.42 have been paid for 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/Valley Independent Bank - Ismael Coronel Check No. 287307 Name on the check Telephone 760/564.4604 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exem ted by Sh on McGilvrey Payment Recd $0.00 $4,286.42 Over/Under 2Z Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting CERTIFICATE OF COMPLIANCE JF>EDsc Desert Sands Unified School District -0:0BERMUDA 47950 Dune Palms Road Date 7/8/03 La Quinta � CA 92253 RANCHO MIRAGE CJ INDIAN WELLS No. 24677 ( 760 771-8515 � PALM O INTA V LANDIO INDIO Y © Owner Mn/M Coronel APN # 774-155-019 Address P.O. Box 389 Jurisdiction La Quinta City La Quinta Zip 92253 Permit # 0304-377 Tract # BLK 234 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 10 53945 Avenida Carranza 2003 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 2,003 S.F. or $4,286.42 have been paid for 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/Valley Independent Bank - Ismael Coronel Check No. 287307 Name on the check Telephone 760/564.4604 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exem ted by Sh on McGilvrey Payment Recd $0.00 $4,286.42 Over/Under 2Z Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting Fred Sheu Structural Engineer 15434 Sage Street, Suite 125, Victorville; CA 92392 (760) 955-7522 3600 Lime Street, Suite 125, Riverside, CA 92501 (909) 684-1075 June 16, 203 Building & Safety Department Attn: Plan Checker Ref: Coronel Construction Lot 19 Carranza La Quinta, CA Dear Sir: Per builder's request I reviewed the"plan and truss calculations for the above referenced project. It is acceptable to me that the entry tower is supported by the girder truss below. Should you have any questions, please feel free to call me. Thank you. Sincerely, 5l/F Fred Sheu 0 No. S-41, i m Structural Engineer cr EXp.6_310_0/ k Fred Sheu Structural Engineers Project -5g Date SGA RR-A'NZAz Inspection Report Item Description Comment c�!l � 5 �vo� Except Fo//ow:ng /tEMs ; PLYwoop bio ov R R16HT 51,0E GARAGE rjoolZ 1-4EADE-R 6)G)2IppGE WALL� 3/8 pYwe®b W NAIL (� "' .. � Z' � par petwec,0 Inspected by: Fred Sheu, Structural Engineer _ QPpF ESS�pn� 0S No. S-4111 m Exp.6-30-0� S UCTV �, Q�'Iri•p3'gT p CA6 P juL_ lr vii 1G -G4 rK TO 9-5644202 P.01i01 �:y�C.'wV• t: 1.. :,9. •. / •�: 1•� fw;?'•fin"' � REPORT OF FIELD COMPMCTIOIV TE5TS EDOA7 NO.: o C -S gr ' Cu&i:✓ C _ oaYc ! L O PROJEGTe A-vt G,(;A."t NUCLEAR GAUGE INFOAMATION AND DAILY STANDARD FZL&�no)IUMBERS VAAIATION, PERCENT,+h GAUGE ADJUSTMeW % VARIATION FROM C?)JSRArom COUNTS FAO. SN u7S COMMENTS NO. LAX; USE r:.UCE TYPE: OX PSE1L MOLSTl1AE: MO•STVA€ MOLSNRE. MOISTURE; OENSITY, m c,OCL NO.: -3 p DENSITY: OENSTrY: OENSfrY: OENSRY: {I RQCTOR INFORMATION SOIL ID M I VISUAL CLASSIFICATION OF SOIL I MAX. DAY DENSITY, PCF I OPTIMUM MOISTURE. %• j TEST EL3VATI0N MOIS`URE WET/DRY PERCENT COMMENTS NO. COMPACTION Mots—. URE REQUIREfJIENTS. % REQUIREMENTS, GENERAL LOCATION: 5. a i - TEST READING QUOTIENT/ I SOIL TEST EL3VATI0N MOIS`URE WET/DRY PERCENT COMMENTS NO. PCF I ID NO- DEPTH, IN OF TEST CONTENT, OENSITY, COMPACTION �• �- {I � fb Ye PCF 4�+•8' � •—�9, 1 � �. Wyk � •� !'20 "07 , L.�----iy1-Izz _2._/j �• �- 1 � fb q. � lir .9. 4�+•8' � •—�9, TECHNICIAN: FµJ. M - =YtST RE3ULT5 COMPLY WfTH SPSCIFICATIOKS z - AACX LL R -CO MPA=ON PERc3DcTAGE DOFS NOT COMPLY -Trm SPecTcAYION5 3 - 6 -ASF CDUFZc C - Ptlt T OF PREVIOUS TrST sueaAsE D « IAOISTVRS w EXC= OF SPSC*lCATIONS s - SOIL CE)wEMT f « )AOL-TUa£ SaOW SVC4:MCATlCKS . 6 OHO% ** TOTAL PAGE.01 **