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9606-164 (SFD)
N b to 1R J) H W '= vr' toLU Er O� 1— (3) U� U.1 a Z M to N ON Ua. Q to rr Q O 0 J J m Q Q O. a UV L� z Cb 5 na g 3 LICENSED CONTRACTOR DECLARATION :I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of ivision 3 of the Business and Professionals Code, and my License is,in full f r e and effect. License # Lic. CI s Exp. Dte 4)0584 1.,.3t1 .x/ ,6ate r IM Signature of Contracto OWNER -BUILDER DECLARATION 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). ( ) 1, as owner of the property, am exclusiv contracting with licensed contractors to construct the project (Sec. 7 Business & Professionals Code). O I am exempt er Section B& f 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 37r Ltt a iGode, for the performance of@dY�o jt9;,._b) h 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 $100.00 or less). () I certify that in the performance Of work for which this permit is issued, I shall not.employ any person in any anner so as to become subject to the workers' compensation laws of Calif ia, and agrg a that if I should become subject to the workers' compensatio provisions o($ection 3700 of the Labor Code, a h comply with t s ovisions J)Ate:. Applicant Warning: Failure to secure Work Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the costof compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth 'on ,his application. 1. Each person upon whose behalf this application is made & each person at whose requestand for whose benefit work is performed under or -pursuant to any permit issued as a result of this applicaton, agrees to, & shall, indemnity & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes. null and void if work is not commenced within 180 days from date of issuance of such. permit, or cessation of work for�18days will subject permit to cancellation. I certify that I have read this applin and state that the above information -is correct. I agree to comply with, and State laws relating to the building construction, and hereby auth i36representatives-of this City to enter upon the above-mentioned property /Signature (Owner/Agent) rr . Z Y . BUILDING PERMIT PERMIT# - °ONTR°`# 3801 DATE 74311/96 VALUATION '33=j19. 137,70 LOT TRACT JOBSITE 54435 Cfl.i`IRKY HILLS APN 769-620.0,15 - ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER STEM A&M CONS' WC!'ION '53835 (~til'I<K ' HL;; iS 4+ii I `.AU13 i:'ADV LA Q1.? IN 1 A CA 927 53 LA (,)IJ INTA CA. 971- 53 '771291.3 (619.) *A 8-17., C1?ll,f: 6741 ANI) •• lI.1ET,BFR USE OF PERMIT S1fv�3Lfs I�A;V111 1' t_i1NI Li 11+10: ' 80-720 J&'iM1NE t.,ANE INDIO 9'...Ji SISI,)-f%RNIrr ftc1C;S NOT !'N(3JJDI,.131. OCIS. WALL OR 14 01.. tft. +Rt.31 VATIQ 11,074.th) Sh' GARAc LYC'ARPORT (N)I.rAP Sr EST MATED COST OF CONSTRUC"E10IN 358,137.70 1'ERN8.r1 F N'dt:lM: tr47Ni11lIA.K� Co1J:413wer1E7N tree 101.000.41$-M $l., f6.w 1'L AN 01fRw4 : F F1 10 I.ON-439-31 S $11.253A0 - MECHANICAL 0ZE 101-000-421-00 5117.010 FLOC 1'R.1CAL FJ'X 10t, (M-420.000 !'t.4.!Ai'3INQ III: 101 -MU -419-0000 3Z1" 251 tfl'kA4G [vbO'1 KYN F E4 s Rl£3ID 101-000-2,11410 ORADI NI G FFh 1101-000.423-000 1t�F'1z.AS'rRucE�'xr.: r1:;. 225.000.443-342 $t�,ttfK►,t� ART tN .1`CBLI f LINCE 5 - RESIT: 701-0W-255,VA_ ifid 9.3=t SUB -TOTAL COMAS RUCnON AND PLAN CHECK S1.0,01), �)I LESS PRL --PAID FEES •$7_%.0U j L 3 0 1996 RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans OX to Wrap F.A.U. Framing Compressor Insulation Z 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 BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground PI . Test Final Gas Piping PLUMBING AP.PRqVALS 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 .1* NotEpe (Perm) COMMENTS: Buildin Address c&tv, 4:4 Q0, P.O.. BOX 1504 L-i'll> 7&105 CALLE ESTADO LA QUINT,A, CALIFORNIA 92253 ,I&F k! fir/ "( elr— 44 / Address Contract K I State Lic.I City & Classif. Lic. # Des 2.0 J A� K(Pk . (-A) 14-2- '?0,�t6 Zip State 1 ni n I I Lic. '# LICENSED CONTRACTOR'SDECLARATION I hereby affirm that I am licensed under provisions of Chapter g (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is n 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, ager, Improve; demolish, or repair any structure, prior to .@s Issuance also requires 'Ma appficant for such permit to NIe a signed' statement, that he Islicensed pursuant to the provisions or the Contractors License Law, Chapter 9 (commencing with Section 7000) of Division 3. of the Business and Professions Code, or Mat- 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 appricantto a civil penalty of not more than live hundred dollars ($500). 17 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 knprovements are not intended: or offered. for safe. If,. however, the budding or :impro-vement is sold wifhin_ one year of completion, the ownei-builder will have° the burden of proving. that he did' not bod or improve for the purpose of sale.) f'1 1, 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�Cpntractor's License Law:) i-1 I am exempt,under Sec. B. 8 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 CodeJ Policy No. Company r] Copy is tiled with the city, D 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 dollar; ($100) valuation or less:) I certify that in the performance of the work for which this permit is issued, I shall not employ any parson In any manner so as to become subject to the. Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: ft, 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 I hereby affirm that there Is a"construction fending agency for the.perfonoance of the work.for whichAtifs permit Is 'issued; (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building, permit when properly tilted 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 City, State, Zip BUILDING DIVISION APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP. A.P. Number �C7 1 �r�C/ V ! S-- ,Legal Description q� Project Description. S (4— c Y awl 6V- 4- E Sq. Ft. tt ,0 No. No. Dw. Size r f0 ` Stories Units Newx Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep: -MOD Plan Chk. Bal. Const. Mach. 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 Validated Validatior CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. Ce. S UNITS • ROUGH PLUMB. BONDING Y ARD SPKLR SYSTEM 2ND FL. SQ, FT. 0 FORMS SEWER OR SEPTIC TANK POR. 50. FT. MOBILEHOME•SVC. BAR SINK GAR. SO. FT. a, POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DBAINAGE PIPING CAR P. SO. FT. 4>? TEMP. POLE WALL 50. FT. a GROUT DRINKING FOUNTAIN SO. FT. a FINAL INSP. URINAL�� ESTIMATED CONSTRUCTION VALUATION S WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation a =$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB GAR. FIREWALL SO. FT. 0 c WATER HEATER MAX. HEATER OUTPUT, B T.U, SQ, FT. RESID @ 1'A o SEWAGE DISPOSAL SQ.FT.GAR @ V c HOUSE SEWER INSULATION/SOUND GASP IPING PERMIT FEE FINISH GRADING PERMIT FEE PERMIT FEE TOTAL FEES MICRO FEE __JDBL MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING 3 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ a =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION -- FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL COACHELLA VALLEY UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE (Government Code 53080) Project Name: Project Address: 55-835 Cherry Hills, La Quinta, CA. 92253, Project Owner's Name: James and Marie Mein Phone No.: Project Description: Single Family Dwelling Building Type (Check one): , Residential xx (Include No. of Dwellings) Commerciat-Industrial Tract No.: Lot No.: (iftract, attach Schedule "A" of all lots by tract, square footage for each lot and total.) Assessor's Parcel No.: 769 620 015 8 (If Schedule "A" is used show Assessor's Parcel No. for each lot if one exists or Assessor's,Parcel No..for parcels before subdivided.) Total square feet of Building Area: 4,187 Sg . Ft . Certification of Applicant/Owners. The person signing cet this statement under penalty of perjury and .further represents owner/developer. Dated: 30— l to Signature: City/County Certification: (Signature) Optional 4hat the above information is correct and makes he/she is authorized to sign on behalf of the r (Title) NAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAl1AAAAAAAAAAAAAAflAAAAAAAAAAAAAAA.AAAAAAAAAAAAAAA SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SA ACCORDANCE WITH ONE OF THE FOLLOWING (CIRCLE ONE): Gov. CodeGov. Code Project .Agreement Existing Not subject to fee 53080/65995z 65970 Approval prior to 1/1/87 requirement. Total Number of Sq./Ft. 4,187 Amount per Sq/Ft. $ 1.84 Amount Collected $ 7 , 04.0 School District: Official AX "T " Pensis Date: July 30, 1996 Note: Title: Asst. Superintendent, Administrative Serv. Phone. (6191399-5137. Eat. 235 Note: * AB 2926 and SB 201 fees are capped at $1.84 per square foot for all residential construction, and at $0.30 per square foot for commercial/industrial projects. July 3, 1996 Mr. James Stein. 55-467 Southern Hills La Quinta, Ca. 92253' Re: 55-835 Cherry Hills Dear Mr. Stein, Mr. Adolph has reviewed the custom home plans you submitted. Approval is granted, provided the trim around the windows is of a bronze or tan color as we discussed July 3, 1996. If you Elect to use the original blue color for the window trim, you must gain approval prior to doing so. Upon choosing a contractor, please present his contractor license number and proof of insurance to this office. A $10,000.00 deposit is required before commencement of construction. Thank you for your cooperation. Sincerel III, Kelly McGalliard Business Manager PGA West Residential Association, Inc. P.O. Box 1060, La Quinta, California 92253, Telephone 619-771-1234 FAX 619-771-5125 Certificate of Occupancy City of La Qudnta 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. ollowing. BUILDING ADDRESS: 55-83.5 CHERRY HILLS Use Classification: SINGLE FAMILY DWELLING Bldg. 'Permit No.: 9606-164 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: R-3 Owner of Building: STEIN Building Official Address: 55-835 CHERRY HILLS City: LA QUINTA, CA., 92253 By: DANIEL P. CRAWFORD JR. Date: MARCH 18, 1997 POST IN A CONSPICUOUS PLACE .' - ' � �' .-, - — :W � . I',,'_jZ,�' ,t " - , — . I 1 _:�4,1'� " , J�!' .. .. "' -1, :, - ,,, - ," ". . , . :., ,, - , 'e , " . I '.. . . , , , . ,;;; , � ,,, - %. 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