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9806-053 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm uhder penalty of perjury that l 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 Date CVHC 12/31/98 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). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). (�)• I am xem t under Section B&P.Q/%r_tlhis reason yDate 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. (K) 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. (This section d no be cR mpfeLd' if the permit valuation is for $100.0 orr 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 3700 of the Labor Code, I h II fort with comply with t se rowslons. vDate: , Applicant Z; a� Warning: F ilure 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. p a 1. Each person upon whose behalf this application is made & each person ate: 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, 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 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 tthhe,,above-mentioned property f I 1 spection purposes. I "Signature (Owner/Agent) Date toks t BUILDING PERMIT PERMIT# CONTROL# DATE VALUATION 98116-6153 TRACT LOT 7143 I tis JOB SITE _ APN ADDRESS S1-980 AVENI,DA RAMIREZ 7r_t-a71<-U1? OWNER CONTRACTOR / DESIGNER / ENGINEER GENARO RIVAS GONZA.LAS OWNER/ BIJIMER WITH CV1IC PO BOX 1045 45701 MONROE ST STM G INDIO CA 92201 INDIO Cry 92201. (76+0)347-3157 CBLt# USE OF PERMIT SFI? (C1215DL) - PFnUT DOES NOT INCLIUDE BLOCK. WALLS OR POOL. PLAN CHECK PORTION OF FEES REDLICED 75% FOR MULTIPLE iq. 1 (' OF S �4F PT, AW TVPF TR ACT CONSTRUCTION 1,215.00 SF PORCH/PATIO 23.00 SF GARAGE/CARPORT 455.00 SF 3 FT. WOOD FENCE 200.00 LF ESTIMATE, D COST OF Ct2NSTRUC71ON 76,895.40 PERMIT FEE SUM -MARY cONSTRucrION FEE 101-00041.8-000 $536.00 PLAN CIi`ECK FEE 101-000439-318 $115.82 MECHAiINICAL FES 101-000421-000 $53.50 ELECTRICAL FEE 101-000-420-000 $121.13 PLLRL:IJ3ING FEE_ 101000-419-000 $143.50 STRONG M011ON FEE. -.RESID 101-000-241.000 $7.69 GRADING FEE 101-000--423-000 $20.Ofl INFRASTRUCTURE FEE 225-000-443.342 $1,685.08 PRECISE PLAN X101-000-441-345 $25.00 x, .. r �I 'S - OT,L CONSTRUCTION AND PLAN G1iECI:. JUN 1.8 1908 LESS PRE -PAID rEES $0.00 PERNIff. FEES DUE NOW $2,709.72 _TOTAL RECEIPT DATE 'BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION I DATE INSPECTOR OPERATION' DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings i Ducts Slab Grade i Return Air Steel 4 Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing ; - Compressor Insulation I - Q Vents Fireplace P.L. Grills Fireplace T.O. I Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath T. D� ,Ce �d Final C J7 Final �L� POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs I Electric Bond Footings Main Drain Bond Beam / Approval to Cover Equipment Location Underground Electric 1 Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines �-/� 'J��oc Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure - Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection - Q_ _ Encapsulation Gas Piping Gas Test _ Q Appliances ] 1 Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit ! Rough Wiring I Low Voltage Wiring Fixtures Main Service { Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power 1 7 - Final Z— 7-K,— ftlity Notice (Perm) '� "'��'�"'�+,*V"vt'j•'l�"a.,, ,��f+....�,�.,�. AW 0 u�,t` P.O. BOX 1504 APPLICATION ONLY Building 78-495 CALLE TAMPICO Address _n <2 n Ar ,. - LA QUINTA, CALIFORNIA 92253 Address D ^ a . City 1 Ip Tel. Address p j Tel.. BUILDING: TYPE'CONST. OCC. GRP. A.P. Number��/ Legal Description 6....44, — Project Description V n .r P .w r I i` State.Lic. ( City I S Classif. Lic• # Sq. Ft. No. No. Dw. Size /-7 ! Stories / Units Designer Address City.( Zip ( 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 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 repair 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 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). 12 1, 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, providedthat. 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 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 contractsfor such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I'! I am exempt under Sec. /] B. 8 P.C. for this reason Date Owner Al /J� .. on •f. -/A 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 O 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 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: 11, 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 if work thereunder is suspended for 180 days. - - I certify that I have read this application and state that the above information is correct. L agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorise representatives -of this city to enter the above. . 'mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip + • ti WHITE = FINANCE YELLOW New. Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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: PINK = BUILDING DIVISION - �I Desert Sand's Unified School District 47=950,Dune;Palms Road Notice: La Quint# -CA 92253 Document Cannot Be Duplicated_760-771=`8515 ' CERTIFICATES OF'COMPLIANCE . Date 6/16/98 No. 17184 Jurisdiction Owner NameCoachella Valley Housing Coalition No. 51-980 Street Avenida Ramirez CityLa Quinta Zip..92253 APN # 773-171-012 La Quinta Permit # Log # Study Area Tract # Lot # Square Footage 1,215 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 accesso- ..structures or replacement mobilehomes. It has been determined' the above-named owner is ekempt '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 1,215 or $ 2,344.95 the'property listed above -and thkbui ding permits and/or Certificates of.Occupancy for this square footage in this proposed prctiectt:m'ay.rtow be issued Fees Paid By Cashier Check/B of A/David Brudvik TelepHune 147-3157 Name on the check By Dr. Doris Wilson Superintendent . Fee collected /exempted by Juanita Green Payment Received $2,344.95 Check No:. 2009914990 Signature NOTICE: Pursuant of Asseybly Bill 3081 (C"P;549 STATS. 1996) this will serve to notify you that the 90 -day approval, period in which you may protest the fees or other payment identified will begin to run froml'(he date on which the'building or installation permit for this project is sssued or on which lheyare paid to the District(s) or to another public entity authorized to collect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copyfor all waivers. Embossed Original- Building Dept./Applicant ,Copy - Applicant/Receipt Copy - Accounting Coachella Valley Housing Coalition Plaza 1, 45-701 Monroe Street, Suiie.,G.-, Indio, CA 92201 TEL: (160) 347-3157 FAX: (760).3424466 ATTORNEY-IN-FACT AG.R.EEM5NT I[We hereby. appoint COACHELLA VALLEY- H.O. I USING, COALITION, o zed agents�as m ur y/o' e and/or any of it,§.auth attorney -in fact for the purpose of executing any notices of cbmipleitio.n, waiver, of liens and/or executing contracts with sdbC'ohtrac:.tors,apd/or release of liens 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 o f,California, described as follows-, LOT 13 OF 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.' 9' Date /y7 Date fAsfami1y\anna\rniscfor\aftnyfa ' ,GENARO RIVAS GONZALEZ WENDY 13ERNAL RIVAS a :TAY j `t 4 i' 1�7, t TM C�g�h-o53 ,V THIS ATTIC HAS BEEN INSULATED T0: This attic has been insulated to the R -value indicated above, with Cocoon'; the high -efficiency insulation. Made from a minimum of 80% recycled materials, Cocoon is scientifically formulated to defiver 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. G U- -�)R RESIDENCE ADDRESS: Lot INSTALLED BY: AI)V,ANCED IN,S'TALLATLONL 81-771 Oleander, Unit #1 Indio, CA 92201 BUILDER: 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 bags to covey q. h. to obt3iu,.an R -value of AUTHORIZED SIGNATURE DATE • .c '''. • 4' "Tog, :N, WW r -x; Cocoon Stabilized Insulation 301b. bag (` Alanufactured Ry: r GREENSTONE:•:r" t. A LOU ISIAN A• PACIFIC COMPANY V v 56.7 751 Mean NOTE: This coverage chart compensates for settling Gross Coverage Based on and is for estimating purposes only. Stated R -value is R-1 3 (2 x 4) provided by installing the required number of bags Temperature per 1000 sq. ft. at a minimum installer) thickness. 2' x 6' Trusses on 16' Centers ! more than the specified minimum thickness and minimum weight per sq. ft. Actual coverage will be influenced TM Installed 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 To Obtain an 1000 sq. Ft. and :u least the minimum thickness may result in a lower installed R -value. Compaction may Square Foot of occur during installations above R-30, requiring more Bags Required Cocoon Stabilized Insulation 301b. bag (` Alanufactured Ry: r GREENSTONE:•:r" t. A LOU ISIAN A• PACIFIC COMPANY V v 56.7 751 Mean NOTE: This coverage chart compensates for settling Gross Coverage Based on and is for estimating purposes only. Stated R -value is R-1 3 (2 x 4) provided by installing the required number of bags Temperature per 1000 sq. ft. at a minimum installer) thickness. 2' x 6' Trusses on 16' Centers Installation of the required number of bags may yield more than the specified minimum thickness and minimum weight per sq. ft. Actual coverage will be influenced by job conditions and application techniques, and Installed 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 To Obtain an 1000 sq. Ft. and :u least the minimum thickness may result in a lower installed R -value. Compaction may Square Foot of occur during installations above R-30, requiring more Bags Required than the stated number of bags to obtain the - C• r, - minimum installed thickness. r' Installed F i GreenStone and Cocoon are trademarks of r �•,� Per Bag GreenStone, a Louisiana-Pacific company. © 1997 V � / ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART R -Value atNet 19.4 Coverage No Adjustment for Trusses 56.7 751 Mean Minimum Gross Coverage Based on Maximum Net R-1 3 (2 x 4) Minimum Weight Temperature Thickness 2' x 6' Trusses on 16' Centers Coverage Per Square Foot Installed The Weight Per To Obtain an Insulation Minimum Bags Square Foot of Bags Required Insulation Should Not Be Square Feet Required Per Installed Square Feet Per 1,000 Resistance (R) of: Less Than: Per Bag 1,000 Square Feet Insulation Per Bag Square Feet (inches) Should Not Be 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 � e. GieenStone Industries, Inc. All rights reserved. 19.4 .583 56.7 Printed in USA. RV 30M 8/97. Sidewalls (pressure filled -density 2.0 PPCF) 6-97-TT/G-A R-1 3 (2 x 4) .917 36.1 27.7 �5.532.7 3 � e. 19.4 .583 56.7 17.6 R 20 (2 x 6) 30.6 .917 36.1 27.7 � e.