Loading...
9709-122 (SFD)LICENSEDCONTRACTORDECLARATION r I ,:eretiy 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 # Lie. Class Exp. Date CV14C. 1231/97 Date 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 ompensation, 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 aemtunder Section B&P.Cfor this reason Date r /11 :k •-ISignature of Owner f „s ✓i�'1i% 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: Carver 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 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 ubject to the workers' compensation provisions of Section 3700 of the Labor C%ode, I shall forthwith comply with thoseeprovisions. Date� L"!w, la .., Applicant.—'- Warning: pplicant- ' Warning: Failure to secure Workers' Compensation coverage i` s unlawful -and_ shall subject arf 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.. to above-mentioned property for inspection purposes /Signature (Owner/Agent) '-� .+ -­-aqi> Date ✓ A F PERMIT# CONTROL# BUILDING PERMIT ) ����- ` " $ 596Ll. DATE VALUATION $77,31(j%20 LOT j ? -TRACT �!7 Y: Rtir JOB SIT 41-4. 0 t}a'�' F,.t�iI DA �,ril!'3.'Ix�.EZ APN 773 ,171-007 ADDRESS �. OWNER CONTRACTOR/DESIGNER/ENGINEER C�R�r .4. tii?"4.A7. ^%" r`er$'�.1':t�! :?t,rlj.,;:);?;t ��. P t; '. gra.., "2772 CALLS AVIL A 45!0i l%1k ) v KUL. 6`1' 3.1 F G C0Ai:'! F',L1,A CA 42 36 [ND10 CA 92201 USE OF PERMIT {+ire.- k'LRAUT D: ES NOT INCLUDE H tJl.`K WKiA.5 O i°L3JOL. i''LM4 0tKX I'Cp4dTiON OF FIrf-3 K40UCI ) ''Y% 1;'0R 1M.[ !:fIY1..E, iS*UP' KC.h OF AN TYPE. TRA: C0Ab37RWIeON 1,210.00 S SF fJARAt:,WC'Ad2isEiRT 506,00 41 ps A e.Y.LY! R MA CC.%. s• !J'4� CoNs ne-N 1 ��JiyEr. d6! CYJNST RUC710N FtW. 101 -WO -418-000 V�. oo 111: AN 1'1 CI; IFFY (diF -nfl ti_439-M g X C l t ANICAL F f -us !M AOW-• 2.1 0010 S-40,50 1.d E 1`Fd.FI AI, FET 101 tlf)C)-:Lf)-C70t) $i F�.7 11LON-16I:NG FEE S121.50 5,0i20T4f?iktti't1 1V'a;FM'.1�FtiEr> 1{il-tlf'(1.?41-¢il�(1 $774 -... £ir'1r1.1:lINO VT:4i.2+.' 4:13'.GW FFdIr1�A�,:i`f.2TJC:;T'ii17.L3'bitiZZ?-(}L?O�i�d3-i�d� T1,')iU..� ' Si,J:I-'lt-l'rAv N, KT1I .iJq`Ti(:)N !,ND ..R,AN C fI CK LESS PiaE'-ft,60) FEES .Cf; 081!?.CPOW $21695,90 RECEIPT DATE lit Y DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings I Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing i Compressor Insulation 7/27MY7 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wali Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS Steet.> Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. 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 117 U 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 ot Utility Notice (Perm) COMMENTS: Desert Sands Unified School District Notice: 82-879 Highway:`lll Document Cannot Be Duplicated Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 9/26/97 APN# 773-181-007 4 No. 16124 Jurisdiction, La'Quinta Owner Name Coachella Valley Housing Coalition' ` No. 51890 Street Avenida Ramirez City La Quinta zip 92253 Tract # Lot # 18 Square Footage Type of Development SingleFamily Residence Comments Permit # Log # ,Study Area 1210 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 undeir 500 square -feet, detached'accessory structures.or replacement mobilehomes. It has been determined the above-named owner is ekempt from paying schooffees 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 1.84 X 1,210 or 2,226.40 the property listed above land that building permits and/or Certificates of Occupancy -for this square footage in this proposed project may now be issued Fees Paid By oc/Bank of America/CV. Housing Coalition `Teiephone• . 347=3157 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Pauline,Pearson Payment Received $2,226.40 Check No., 2006711031 Signature IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996),lhis will serve to notify you that the 90 day approval'period in which 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 projectis sssued or on which they are paid to the District(s) or to another public entity authorized to ollect them on the Districl('s)(s') behalf, whichever is earlier. ' Collector: Attach a copy of county,orcity plan check application -form to'district copy for all waivers. Embossed Original- Building Dept./Applicant Copy- Applicant/Receipt Copy - Accounting .t Coachella Valley Housing Coalition Plaza 1, 45-701 Monroe Street, Suite G., Indio, CA 92201 — TEL: (760) 347-3157 FAX: (760) 342-6466 ATTORNEY-IN-FACT AGREEMENT I/We hereby appoint COACHELLA VALLEY HOUSING COALITION, and/or any of its authorized agents as my/our attorney -in fact for the purpose of executing any notices of completion, waiver, of liens and/or executing contracts with subcontractors, and/or release of Hens and/or handling building permits relating to that certain real property described below. All that certain land located and being in the County of Riverside, State of California, described as follows: LOT 18 BLOCK 59 OF UNIT 5 OF SANTA CARMELITA AT VALE'LA QUINTA, AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 63 OF MAPS, RIVERSIDE COUNTY RECORDS. ate Omar A. P enaloza s ;i'e.- 1d4: . fw• ''i . v s -. �• .�� ° +f J e .5.;00 .d;.::>av�::'sY.:_�•. Ad :_►t .i.i "�� .L s.l:i'st: .'rdv is fk � I II• �5{j•ty�� r 1�1• .� r tea, � f�1 �, �,: i ,• "1 `�.}•'/• $a �'• `off S; y L- j� N i may" 13'i t J •.:-Y. •,•� . r • r i I ,S��1 s +� «.1 � Iq �'i •f +, I� t �:r8 a7Ej�.._� � 1 jt I ;y'A , i, . 1 .. ��f e''1s»•1��'S.H�;�{ �! �''� •�.'1 • ,ems �� , , f w::�: �� M '. �'t ���^�'(� i § .S�tl.a 12 y. 1.. f'.�• i,=. � .% ,.�%2 //'�'Y rl �� ;� `��f�l��'Y 77_,, �• � ti e ,•�.{.• Syte• °� e_ -i Ii"'. v. •.l� �+ �:: :+. •` .. e � (.:9 ",'•. •��'�i. - ^� .o . '; Y►.i�r Z3.. t i t I ^ 7�'r• f fv� �1t'� Dl�� >•�f.ld'r1''c � � ..�i r�' I� v `A- . 1' I�I 11 nil (;ucucln St, hilir.CC I I S L I IIiczn ,Ilurlifina... rd 14 2) •: 0 Ib. bag . GREENSTONE:•," a 1.. AAS. Ia C IIIC COM ... I NOTF: This p vcraµc ,hat -mix.-arcs lin.. lllint; and is lily cxliucoinl. Int I.-.. .... fy. Slaked It-adnr is provided by installsµ the n•yuir.vl nundx•r ..I hat!. 1xr IIXXI s.I• G. :n a minininu installed Ihirkn.�s.. Inslalloknt 111 the voluin l m....1 r .8 Wg, ncly yield nxnr Owl IIx',Ix•.'ilied... inimt Ihi.'k.nssm.1... iniuunu M -iglu per sq. It. A,mad roc.•.at;r will I.- iult....nre.I by j.d. cnnditinnx aid :ygdir:ui.m lr.'huiqur.. anJ 7 n ay r:u'y as . 1, as lo".. w'ill.nn siµuilir:u.11r all„linµ Ila• staled It-vahw. Pailur.• ..I Ihr inslallrr I., provide m Irasl the rryuind nuwhor nl baµ.. per IIXXI sy. 0. and at Ir:..a d.c mininnnn d.i.'kurss mac result in a I ....... r hwallyd N -valor. Qnnp:n'l i.........c --c", during hrotallmi..." A -v It ;Yl, .rquirint: uo no Ilmn Ihr slated nuul her .I h:q:s to ..Maio Ihr . minimum inslallyd Thickness. r Gmnar Stono and Coconn c hndomaiks of GroeonStone, a Louisiana-Pacific company. © 1997 .. - GreenSlone Indushies Inc All' h1 d ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART N VAIue al 1411 C-1mge Ito Adjum !..I Im husox 8-91•TT/G-A 15"1' 1.1ran Minimum 51.4 I:m :. fuv.a;uo: Ifas.'d un Maouw.n Nr.I 56.7 _ Mnunkt ylculht le 'peutule Thickness - ' G lu'y.m uu 16' ('.antes td c' -idle Vv !;Ie..ul: I and 30.6 .917 In51Allell 27.7 Il.e Weu.hl I'r.. �• + le ohlam ml h.sul:dum Insokdin.l SlmuXl Nol Ile &p.me. Ina Mininum. 8aos Itnpunal I'el �4u.ua I nnl N In:aAIMd I:quam Irva llans W. -I cd I'nl I1XX1 Ilraslalve. pllnl, less llnur 1'c. Ilap IIXq!;.pem:h'A In:ad..h...• I'cl W., :;,I".ur. lo -A plu:ha::1 !:hn..hl lLn It, IIlu.t Ilhs.l 1.4154 R-50 13.5 20.5 48.11 21.3 415.:1 R-42 11.4 24.4 41.0 1.2.10 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 .9117 '3'1.0 29.4 R-30 8.1 34.2 29.3 .878 ;16.5 27.4 R-24 6.5 42..7 23.4 .70:1 415.4 21.15 R-22 5.9 46.G 21.5 .644 51.0 19.6 R-19 5.1 53.9 18.5 .55G 59.5 1G.8 R-13 3.5 78.8 12.7 .3R1 87.0 11.5 R-11 3.0 93.1 10.7 .322 102.8 9.7 . n9 s Ieselve . Punted in USA. [IV 30M 8/97. %idpwalls (plosslife filled-,lewwy 2.0 PPCF) 1,a 8-91•TT/G-A 11-13 (2 x 4) 3.5 51.4 19.4 S:CI 56.7 17.15 td 32.7 30.6 .917 36.1 27.7 �• + ' 1 �� it g�I I � 14�ti� :: F"i ' I. I � . v�<.:.`•'•. Ons