9818-170 (BLDG)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 A' f the Business and
Professionals Code, and my License is in full force and effect.
License # LLic.Class
C-10Exp. Date /
/ +It4 %JCs�i 4 B
spate t/J'l 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).
(t ) 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.
(X) 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 1110 ("%"'„�. ,, Yc Policy No. n 2 r
-,a , ,1 a �►I�.Y iI�J,., r� 7vZR1fItJ>�.�->3
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of th 0ork 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 Californir , and agree that if I should become
subject to the workers' compensation p ovisions of Section 3700 of the Labor
C6de, Is�ha.,`
ll f��o�rthwith comply with tho a provisions.
ydate: /Applicant—
T—Warning: Failure Failure to secure Worker 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. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorise representatives of this City to enter upon
the/above-mentioned property/Vr inspection purposes.
VSignature (Owner/Agent) Date d
BUILDING PERMIT PERMIT914
CONTROL#
DATE VALUATION $4.074.33) LOT I TRACT 8)54
JOB SITE 77-150 CALLE t' URCi3 A
APN
774-101-011
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
MT -1 VCImJQ
1✓.•1 its F k7 1,
P. it /iii d.�i'a�1�+�77/-f-f�N]
43-698 VIA MAGEL.l.AN
78-070 CALi E CADIZ.
PA GM C ES21n' %A W211
LA Q)UIIJTA
C.A. 532753
(760)5'64- 1832
C;t$f,fS 61116
USE OF PERMIT
40 L..V., CONM81NAi'ION WALL (3' RLI:! . 51 CAFWSNil 142 L!, 51
GtlfZOEN WALL. tilWC) Sf'AN ARD
PA!D
� '� � 1998
6 f-71% �r AL1,. 40.00 IX
5 FT. WA.la, 142.00 LF
%AT1r OF
LA QU[iVTR
�ii;s3C�i�EyTIIL `.ia1► w:a
CONS'TRUCrIONFfW 101-000418-600 $72,00
SA..911-Tf IrAL C,ONS°I',RUC'#'I N AND PLAN t.R+Ch
$72..00
USS RIPL <-PAID FI• IS
$0.00
Tf3 CI , PERMIT FEES 4;0c'Now
$7100
RECEIPT
DATE
BY %
DAT FID
INSPECTOR
INSPECTION RECORD
OPERATION
T77;ATE
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
0. K. to Wrap
F.A.U.
Framing
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.
Steel
Set Backs
Electric Bond
Footings -t(
Main Drain
Bond Beam
Approval to Cover
/
Equipment Location
/
Underground Electric
Underground Plbg. Test
Final-51134
Gas Piping
PLUMBING AP ROVALS
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
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
I
Final
Utility Notice (Perm)
i
ti i
C&hf 414 QU&M
MEMORANDUM
CASE:Star} SS 'dd Location(s): -7
Request(s):
�aG/eet 7��ee-7'"
Your setback adjustment application is hereby approved, subject to
the following conditions:
Conditions:
1. Obtain a building permit from the Building and Safety
Department.
2. The other Zoning Code provisions shall be met.
3. If ground excavation is required, please contact Underground
Service Alert (USA) at 1-800-422-4133. The service is free of
charge provided USA is given at least two working days'
notice.
. 4 . Additional Conditions:
a � d � lea �-� �h �• �
After review it was determined that:
1. This adjustment is consistent with the intent and purpose of
the Zoning Ordinance.
2. There. are special circumstances applicable to the property,
including such factors as size, shape, topography, location or
surroundings that justify approval of the adjustment. These
circumstances are:. Srrna / I lei-
Thank you for your cooperation.
Sincerely,.
Department
Attachments
c: ;,_Building and Safety Department
70-106 CP" C ESTAUO -- LA OUINTA, CALIF( 'IA 92253 - (6191 564-2246
CI'T'Y OF LA QUINTA
PLANNING& DEVELOPMENT DEPARTMENT
APPLICA`1'ION FOR SETBACK ADJUSTMENT
CASE NO: %S -
FEE: $100.00
APPLICANT: Submit this form with two copies .of a scaled site plan,
yawn to adequately depict the nature of the request. A nonrefundable
fee of $100 is required when the Application is submitted. Check must be
snake payable to the "City of La Quint -a".
If the Applicant is not the owner of the property, a letter «<ust- be
submitted by the owner authorizing the Applicant to execute.this document
in his behalf.
PLEASE PRINT OR TYPE
qti
APPLICANT/CONTRACTOR: SANTA FE HOMES DATE �iG13/-951
ly
r
CONTACT PERSON (IF DIFFERENT) SKIP LENCH, AGENT _'IIONE 619/ 186F
9
MAILING ADDRESS: 3790 VIA DE LA VALLE 0111, DEL MAR, CA - 92014_
(Address) (City). (State) (zip)-. /
OWNER'S NAME: SANTA FE HOMES PIiONE 619/755-1114
MAILING ADDRESS: 3790 VIA DE LA VALLE #111, DEL MAR, CA 92014
(Address) (city) (State) (Zip)
STREET ADDRESS OF PROPERTY: 77150 CALLE ARROBA,.LA QUINTA,.'CA 92253
LEGAL DESCRIPTION OF PROPER'T'Y: LOT W 12 BLOCK 195 TRACT SANTA CARML'LITA VALE
ASSESSOR'S PARCEL NUMI3EII: 774-101-011
ADJUSTMENT REQUESTED: FRONT AND SIDEYARD SETBACK FOR POOL (WATER LINE)
FROM 5' TO 4'
REASON FOR REQUEST: DUE TO SMALL LOT - TO ACCOMMODATE POOL (SEE ATTACHED
SKETCH)
JUSTIFICATION: No request for a Setback Adjustment shall be granted
finless it is determined that it is consistent with the intend and purpose
)f this Ordinance; that there are special circwnstances applicable to the
,roperty, including such factors as size, shape, topography, location or
surroundings that justify the approval of the adjustment of the setback
-equirement, and that the adjustment will not be detrimental to the
ealth, safety, and general welfare of the community or be detrimental to
roperty in the area of the parcel for which the adjustment is requested.
FORN.013/CS
PROPERTY LIN
5' HIGH WAL
4' HIGH WAI
Z-4 F
LEGAL DESCRIPTION:. LOT 12, BLOCK 195'
ADDRESS:. 77.150 CALLE ARROBA
LA QUINTA, CALIFORNIA
PLOT -PLAN
SCALE: 1/4" = 1'-0"
Y LINE
EKI-1 IT
Ljj&_CPiSE NO.
Z-4 POOI-
LEGAL DESCRIPTION: LOT 12, BLOCK 195
ADDRESS: 77150 CALLE ARROBA r
LA QUINTA, CALIFORNIA
f
DECK,,\ MINIMUM RADIUS
^9DAM " 1 -0�� R
d " WATER SURFACE
_ 16_"' 4'-1 l" '
VARIES c
SEAT �pQ o 19) 'v M
i
-0
.� "
5 r 14 -0
1
7'-0" , 24'-0"
ri
31'-0"
f
LONGITUDINAL) SECTION ON Ct
SCALE: 1/4" ;= 1'-0"
5'-0"
CANTILEVER DECK
'
EXHIBIT 'B
-CASE N®. S -s(o
CARLOS ELIAS
REGISTERED CIVIL ENGINEER
38825 Charlesworth Drive
Cathedral City, California 92234
Telephone (760) 328-7271
September 22, 1998
City of La Quinta
Department of Building & Safety
784.95 Calle Tampico
La Quinta, Calif. 92253
Gentlemen:
This letter concerns the residence to be constructed at
77150 Calle Arroba, La Quinta, California.
I have reviewed the layout and bearing points of the
roof trusses designed by Silver States Components, Inc. and
find that their design is in conformance with my design intent.
Very truly yours,
Na is Carlos Elias
'D
'CE: j
Of