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0106-137 (SFD)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 .f f 789M LL //,• p Date r Signature of Contractor s/ 4� - _ C_e, ' J 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 Sectlon 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. S`Z'',tAT11y1.f`k1 U 0400663",227 (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 -3-79,00 of the Labor Code, I shall forthwith comply with tho�',hrovisioX <9111 s`rr•. D`ate:- - # Applicant— Warning: Failure to secure Ws' Co penatsation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set fortL9D_bjs_ application. - r —V 1- Each person upon whose behalf this application is made & 6 3,,rson at whose request and for whose benefit work is performed under pd ant to any permit issued as a result of this applicaton agrees to, & st I Indmnify & hold harmless the City of La Quinta, its officers, agents an pl yeesl U L 2. Any permit issued as a result of this application becomes n and Did Tfi work is not commenced within 180 days from date of issuh ice cj such permit, or cessation of work for 180 days will subject permit t 6 ,ance{l C" C�n jl certify that l haveread this application and state that the above nformation is EI "correct. I agree to'corn nply with all City, and State laws relating t f ding ---- construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inpection purposs Signature (Owner/Agent) <'�- ✓i•' ' Date. L'r�'t'-Y BUILDING PERMIT PERMIT# DATE VALUATION LOT 010&137 TRACT A• .n G d Y 6-1ti nM' s JOB SITE ' ° '' .2 APN ADDRESS -U g} 'R7 • 7 G A PR R_7 9"# Pig OWNER --' - CONTRACTOR/[ / EN INFER PLL AW MAN HOW 1rUT%,d ERS WO ;` -A, AMPRAMM 140MY a3MITYTZ3 WC PALM DEWRIr CA 922191 PAi..�'J.7sESTRT CA 53'22'11 (760)20€10277 GBL4 6.373 USE OF PERMIT SP .. Pt�,f hUT DOES NO INCi, UD9 51.,,L CK WALL•, POOL, OR LkwF!) AY APPROACH TRACT CONS T 11.UCTIVO 1,7V.00 Sr' 5 Mr.W000 FENCE XiFJIN LI? t #ARA- 09� 4,10.00. SP :SrMMIATED COST Up (110HIVIZil(`1E ON 10702,$.0 CONOTRUCl'ION FRE 101.000-618.000 $067.50 PLAIs.?d i';HWX ng 101-000-139-•318 $330-M FEE EPOSIT 101-000-439-316 42". 100 MECHANICAL PEP, 101-000-421-000 $55.30 J FI1<;'.CTRICA16 RE 101-0Gq--420.000 $110.53 PLf.SP/1lIU40 P IE 301-OCIO-419-000 $616.75 =03140 MOTION 9T:..11.6?MD 101-000.241.000 '$1.0.72 OR.P.iJINO 101 ••(1610-423-ODO $2G.fW FRE �Ff$H6°n�.0�4 �6�fip�S�A•EZ,f,`�PS]ER IMPACT .*, /�.,`(�. A.a y ..e @ .f'l.ekw 10 `M1.`�.aP4�44A-145 $100.00 '.)'1TAT.,C�iN&YRt;�C'°�;if.��1AV.TDPLAN (MIRCI. T :W :PRIE k"P DF ES 42.50,00 10 2001 TMAL I;"EMIT I,'`KES I.) UE .NOW *x 7X; OF LA t1WITA 4Ai4CE DEPT RECEIPT DATE BY DATE FINALED INSPECTOR J r ILS! 1 n . 11 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR . BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings /)Q- _ r Ducts Slab Grade Return Air Steel Roof Deck /�_3_/ p Combustion Air Exhaust Fans O.K. to Wrap F.A.U. Framing q �%� Compressor Insulation l Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Q 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 Gas Piping PLUMBING APPROVALS Gas Test .Electric Final Waste Lines Heater Final Water Piping Byl "7i �� Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 8 j�/dr/ �! Encapsulation Gas Piping (, Gas Test Appliances Final COMMENTS: 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) P.O. BOX 1504 Building_ 78-495 CALLE TAMPICO ' Address �� 4��/�R/4,VZ LA QUINTA, CALIFORNIA 92253 Owner Mailing Address 7 (®— q J-1,yiZ SL%yf• /T ✓� Cit�j Zip Tel. �L�`l !/�St�R 4Z'zl/ Zia -x2.77 ress Zip j Tel. State Ljc. Q s I City 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 Contractors 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 lila 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 orimprovement 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 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.) I I I 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 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. CONSTRUCTION LENDING AGENCY 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.) 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 applicant —Date— Mailing ateMailing Address City, Stale, Zip �U�Ir'Y•-'{'�'�cJ�Mr'I AS'Y'. T��^: MRS. Kw`V�I.�v� APPLICATION 4LY BUILDING: TYPE -CONST. OCC. GRP. A.P. Number 1, 4 bW�' i �d� Legal Description (r D 7— Project Project Description S iF D / Sq. Ft. G No. No. Dw. Size O 7 Stories Units New .i Add ❑ —+ Alter ❑ Repair ❑ Demolition ❑ �. Estimated Valuation— 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 FINALAl INSPEC � Issued b rmit Validate -7001 M AY 2 5 CITY OF LA QUINTA FINANCE DEPT WHITE = FINANCE._ YELLOW = APPLICANT ro 04 � Z CITY -0- �_A�A QUINTA cFtioF°� BUIL�IGS FY DEPARTMENT } Q 2 \ -- INSPE TIO�H UEST LINE �. '� ; ; � l'(• � - ., 7 1415 > >1� \ a AMERTC .' O BUILDERS OYVrlef • t ContractorLLy��lYIE ME BUILDERS Permit Number D�0'I-137 P"7ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL. APPLICABLE SPACES JOB ADDRESS 54-395 CARANZA SFD-DOES NOT INCLUDE POOL, BLOCK WALLS, OR DRIVEWAY APPROACH. TUVELL MASTER A ELEVATION TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING `j r PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB - JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT - A/C FIREPLACE } ROOF BOND BEAM O.K. TO WRAP GROUT O 40^' ❑ 8' FRAMING INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR Q — `Q S•% EXTERIOR LATH Q — 6 POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK FINALS ELECTRICAL PLUMBING FINAL GAS TEST. HEATING - A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER. ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 7/10/01 No. 22231 CERTIFICATE OF COMPLIANCE APN # 774-242-018 Jurisdiction La Ouinta owner NameAll American Home Builders Inc. No, 54-395 Street Avenida Carranza City La Quinta zip 92253 Tract # B287U26 Lot # 8 Permit # 0106-13 7 Log # Study Area Square Footage 1787 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 2.05 X 1,787 or $ 3,663.35 the property listed above and that building t. . permits and/or Certificates of Occupancy for this square footage in this proposed project may now. be issued Fees Paid By CC / 1 st Bank - Mark Tuvell Teleph®ne Name on the check r _ By Dr. Doris Wilson Superintendent Fee collected /exempted y Annette Barlow Signature Payment Received $3,663.35 Check No. 59733 IOTICE: 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 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 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 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 per Section 9.50.090 of the Zoning Code. Its purpose is to determine: 1) that the proposed house design does not duplicate the same architectural style of any house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmitted this information to the Building and Safety Department as part of your correction list. Please attach additional explanations as necessary. RECVJD FOR APPLICANT All American Home Builders ASSIGNED TO SITE ADDRESS 54-395 Avenida Carranza (/NIT%q APN 774 - 242 - 018 CASE NO.: 2001-484 LEGAL: LOT 8 BLOCK 287 UNIT S.C.@V.L.l. CHECK AND APPROVED BY. Michele Rambo 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 Verify legal and APN information Consistent with MDG on file (as applicable .- rr CM6(,� MDG filing required (5 filings since 9/3/98) Architectural variety within 200 feet of the surrounding area: Colors Materials Architectural design features '9 0 CgsF �Bil 00, �i OgIF O,o � l O Other Requirements: Fp l