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9805-041 (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 cvffC 12/31/,C)8 /Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Licnse Law for the following reason: ( I, as owner of the property, or my employees with. wages as their sole o pensation, 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). (1/I am,gx mpt u • der Section B&P.C. r this reason ii ate ' J % �� Signature of Owner 6 -. , C;w/kkr %a 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. °1RUC1 IrNSi11tAM, s 1 A20071 ! �7U O a 96 (This section need not be completed if the permit valuation is for $100.00 or less). ( ) 1 -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 Ilaws of California, and agree that if I should become subject to the workers' compensation pr iislons of Section 3700 of the Labor b�de, I sl fprt�4th comply with th e p isiS. - r v9 -ate: 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. 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'nspection purposes. Signature (Owner/Agent) Date BUILDING PERMIT PERMIT ft CONTROL# DATE VALUATION $82.946.511) LOT F TRACT171, 3 71 'is SA4 JOB SITE 5.1_8„5 AVI..1�1IDA IIIA$i'Ya1KEZ APN 773-165-0118 ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER MANUE1 MORALES OWNER.! BU11"DER :vrIll, MIC PO BOX '753 45701 it ONI Oii S'C S"1'6 �:r ft1HRt\1t11., i.'.A 9"'l7.ri INDIO CA 92201 (,60:'347-3157 USE OF PERMIT SI�.0 8F'D - (a f3Ei:3ROOPM ) VLR.Mt1* DOES NO t' INCLUDE 6l,i:4CK WALLS OR PAI f Y 14.4 1998 I RAC r %:ONISTRtic'rivev 1,'s{� y.Eiii �;r• Vokc--wflxf10 159.01 3i: -g-�/ L; st>,l�W(i&(',.fl lt,lyC�.WY 51 TCO �i1 j 0 1 T g p' q.g t OF LA Q U 6 G i TP a PERAUTFEC SUMMARY Ct:iNdS'• RI ti_7101J k F1. 101 -WO -41 94YJO x'1. Ai\t cwi K FFF IQs -MO -439-318 $472.90 1.1FX--4Y %N1CAL Fa, 101-000-421.-000 $40.5(1 131,110flfdCAf. E L1r 101-000-420-(i0U $119.41 PLt,WN4 N(1 FEE 101-000.1119-000 91'1..1.5() 'i,t►f 3'+J'f,3 MtP.� 1(f�Af x F ? - RE31r) 101-000.241-000 GRAJANC.t`:.d1 101-000-4123-000 $20.00 eNFRA,` R(Y- �`RL.' FEE 221'-000-443-342 S1,31S.7.2 PRECISH, PLAN 101-000-441-345 525.0" 51.11-TOT'A1. f;.'ONSI`1Z1_fCi' ON AJND P,AN t-'6(FC LESS PRE -PAID FETES 50,0(7 'f6b~4AL PER11W1'1' F i V -S 1'D118j,'t`0V ' RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Arl 4 Ducts Slab Grade Steel Q V Return Air Combustion Air Roof Deck ;0/axExhaust Fans O.K to Wrap F.A.U. Framing –Y Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Dr II -Int. Lath �—s _/1 _� Final Final Z POOLS - SPAS BLOCKWALL PP OVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPOVALS Waste Lines Gas Test Electric Final 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 Final _ Utility Notice (Perm) t�'Y����� THIS ATTIC. HAS BEEN INSULATED T0: This attic has been insulated to the R -value indicated above, with Cocoon', the high -efficiency insulation. Made front a minimum of 80% recycled materials, Cocoon is scientifically formulated to deliver greater efficiency per inch than other insulation materials. R -value is a measure of resistance to heat flow - the higher the R -value, the greater the insulating power. If you would like to add more insulation to your home, contact your Cocoon authorized dealer. .11con,frcnrred BY: GREENSTONE F. " A LOUISIANA-PACIFIC COMPANY \OTE: This coverage chart contpensales for settling and is for estimating purposes only. Stated R-v:duc is provided by installing the required nundxr of hags per Itxx1 sq. fl. at a minirnum installed thickness. Installation of the required numher of flags may yield more than the specified minimum thickness and mininumt weight per sq. ft. Actual coverage will be influenced by joh conditions and application techniques, and may vary as much as 10% without significantly affecting the stated R -value. Failure of the installer to provide at least the required number of bags per 1000 sq. ft, and at least the ntininnun thickness may result in a lower installed R -value. Compaction may occur during installations alwve R-30, requiring more than the stated number of bags to obtain the minimum installed thickness. GreenStone and Cocoon are trademarks of GreenStone, a Louisiana-Pacific company. © 1997 GreenStone Industries, Inc. All rights reserved. Printed in USA. RV 30M 8/97. 8.97-TT/G-A RESIDENCE ADDRESS: LDrt (p 51SIO re z, L� ►.�. � ire �. pi z -ZS � INSTALLED B C, t & 9 -2-2-01 BUILDER: Cy qe, �f S� d I M o n ro e- SJ SNCktu 91-2-o1 CERTIFICATION: This is to certify that attic insulation has been installed in conformance with the coverage chart recommenda- tions on the opposite side of this card using 9 -1 -bags to cover sq. ft. to obtain an R -value of 3 g. INSTALLW'S AUTHORIZED SIGNATURE DATE Cocoon Stabilized Insulation 30 lb. bag ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART 51.4 19.4 Net Coverage No Adjustment for Trusses 56.7 R -Value at Minimum 5.5 Gross Coverage 30.6 .917 WelghtCoverage 75°F Mean Thickness 2' x 6' Trusses on 1Temperature Maximum NelMinimum Per Square FoolThe ;Centers Weight PerInstalled Square Foot of d To Obtain an Insulation Square Feet Minimum Bags Installed Square Feet Per 1.000 insulation Should Not Be Per Bag Required Per Insulation Per Bag Square Feet Resistance (RI of: Less Than: 1,000 Square Feet Should Not Be (Inches) Less Than: (lbs.) R-50 13.5 20.5 48.8 1.464 21.3 46.9 R-42 11.4 24.4 41.0 1.230 25.6 39.1 R-40 10.8 25.6 39.0 1.171 26.9 37.2 R-38 10.3 27.0 37.1 1.113 28.4 35.2 R-32 8.6 32.0 31.2 .937 34.0 29.4 R-30 8.1 34.2 29.3 .878 36.5 27.4 R-24 6.5 42.7 23.4 .703 46.4 21.6 R-22 5.9 46.6 21.5 .644 51.0 19.6 R-19 5.1 53.9 18.5 .556 59.5 16.8 R-13 3.5 78.8 12.7 .381 87.0 11.5 R-11 3.0 93.1 10.7 .322 102.8 9.7 atunwaua tyro R-13 (2 x 4) - •,••x 3.5 51.4 19.4 .583 56.7 727.7] R-20 (2 x 6) 5.5 32.7 30.6 .917 36.1 4 4. " ' P.O. BOX 1504 APPLICATION ONLY Building ^' _78-495 CALLE TAMPICO Address �✓ �o�Iyll�QUINTA, CALIFORNIA 92253 BUILDING: TYPE'CONST. OCC. GRP. Mailing ,�7 _ / Address 7 . � �j�l7A"L, �22% A.P. Number 77 City Zip Tel. ys Legal Description 13a. S las' Contractor Project Description Sf ✓t Qi -Q- H0010- 62Wiv115 De�?_ Address City State Lic.I City & Classif. Lic. # Arch., Engr., Designer Address Tel. 77 J3 City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 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 Contractor's 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 repay any structure, prior to'its issuance also requires the applicant for such permit to rile 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. the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). L: 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 Eaw 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 fhat he did not build or Improve for the purpose of sale.) 1'1 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.) 7 1 am exempt under Sec. B. 8 P.C. for t/phhiiis�s reason � �� XO ' Date wner PL OW 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. O Certified copy ishereby 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 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. 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 I hereby 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 it work thereunder is suspended for 180 days. I certify that I have read this application and slate 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 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: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Sq. Ft. �J �l> Size J No. No. Dw. I Stories Units New Add O Alter ❑ Repair O Demolition 0 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 FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District Notice: 82-879 Highway 111 Indio, CA 92201 Document Cannot Be Duplicated, 619-775-3500 CERTIFICATE OF. COMPLIANCE Date 5/13/98 APN # 773-165-018 No. 17017 Jurisdiction . La'Quinta Owner NameManuel Morales .'. Permit # No. 51-865 Street . Avenida Ramirez City La Quinta zip 92253. Tract # Lot # Square Footage Type of Development Single Family Residence Comments Log # Study Area 1,302 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 following reason: EXEMPTION- NOT APPLICABLE This certifies that school facility fees imposed pursuant to. Government Code 53080 in the amount of 1.93 X 1,302 or $ 2,512.86 the property listed above and that building permits and/or .Certificates of;Qccupancy for this square footage in this proposed project -may now be, issued Fees Paid By Cashier Check/Bank of America/Bill StandeferTelephone- .3.4`1-31'7: ' Name on the check By Dr. Doris Wilson < _ Superintendent 7 - t . Fee collected /exempted by Juanita Green Payment Received $2,512.86 Check No. 2009914079 Signature NOTICE: Pursuant of Assebfibly Bill 3081 (CHAP 549 STATS. 1996 11 this will serve to noyfy,you'that the; 90dayappro4 period in which you may protest the fees or other. payment identified labove will begin to run fro the date on whichthe building or installation permit for this projebt is sssued or.on which they are paid to the District(s) or to another public entity authorized to I tolled them on the Dislrict('s)(s) behalf, whicheJer' 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 CoachelhiYalley HouMng-Oalition Plaza 1, 45-:70,1-Mainroe, Street, . Suite G., Indi . o- CA A 92201 TEL: (760) 347-3157 FAX: (760) 342-6466 ATTORNEY -IN' -FACT AGREEMENT I/We hereby -appoint .CO . ACHELLAVALLEYHOUSING COALITION and/or any of.,its -au'thorj";t,'e.d'agents as my/ourratto.mey-in fact for the purpose of executing, any ,notices: ofrc.orh . 'Ietio, n waiver, of liens and/or exec uti ng:.,co htracts with-su" bcontriic tors;,and/or .release of liens and/or ,: g., -,.perm handlih'g --buildinii its relatihg',to-that certain real property describ6dV',1below. ' All -that certain land aocated and,beihg-.in the County of Riverside, State of California, de9cribed.as follows.;. LOT 6. OF BLOCKj- 5:8' OF UNIT - 50 ' F;`SANTA' CARIVIELITA AT. LA QUINTA, A§.. SHOWWN';BYYIVIAFRECOIRIDED IN 90OK 18, PAGE 63 OF MAPS, R I V E. kS I D'"': El" - -COUNTY ' RECORDS: CL Date Juanita . T . o Var-Alejandro f\sfami1y\anna\miscfor\aftnyfai Date Manue-ir,86to M&albs- CL Date Juanita . T . o Var-Alejandro f\sfami1y\anna\miscfor\aftnyfai