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0208-211 (SFD)a -i ~7 4 LICENSED CONTRACTOR DECLARATION _+ �' T PERMIT# i I heteby affirm under penalty of perjury that I am licensed under provisions+of .g BUILDING PERMIT `Z � Chapter 9 (commencing with Section 7000) of Division 3 of the Business and DATE VALUATION1�21'F��JLOT -2 1-22 TRACT 'MteK PC, Professionals Code, and my License is in full force and effect: t,,^ License # Lic. Class Exp. Date'' 1001-000-418-000 SITE ADDRESS 54-300 AWMIDA 1 PAMZEZ APN 774-244-43.35 j 0;45'31 IS 4i- l ©1 1f//�C $512'$.36 `''i^ �� ` `JOB -"Moo mrCH"IC.AL 797, OWNER CONTRACTOR / DESIGNER VD W '_ .'" F Signature of Contractor, ' ' e ' - 101.000.420.000 $129.05 R°d,P3i.NiBWO FEE 101-000-419-000 $110.75 MONO ItONO NO`1' ION FEE • RPSID (`O OIEL FXfE?,;a ]M COk�tONIM t' �Obl�`!`.RUC-11ON r OWNER -BUILDER DECLARATION $151.00 DISVEloOPER IMPACT FEE $4405.00 PO BOX 4819 78-150 C—MULT64,�5a'LC:�"► $100.00 I herebyaffirm under penalty of perjury that I am exempt from the Contractor's P Y P I ►Y P LAC�UUrt A CA 922; 3 IAQUM A CA 92293 '_:•'" ' License Law for the following reason: ( ) I, as owner the property, or my employees with wages as their sole rmfi 2261 ,of compensation, will do the work, and the structure is not intended or offered for - • t USE OF PERMIT sale (Sec. 7044, Business & Professionals Code). ( ). I, as owner of the property, am exclusively contracting with licensed I N-' y`LE FAMILY DVM1 11M OF contractors to construct. the project (Sec. 7044, Business & Professionals " Code). 1999 S.F. SFD. FIRRti IT DMS NDT INCLUDE BLOCK 'WALLSIPOO:: OR O I am exempt under Section B&P.C. for this reason D.ItIV EWAY 1'..PPROAC1i r Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: Ti` ACT CONS RRUCT10A1 1.399 g0 1JIf ( ) I have and will maintain a certificate of consent to self -insure for workers' PORCHM.A "10 3Y.00 S compensation, as provided'for by Section 3700 of the Labor Code, for the 9, performance of the work for which this permit is issued. RAa#ft•1 OFTB,fln big ( ) I have and will maintain workers', compensation insurance, as required by S' on 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 STATF, AJ'1° D Policy No. 15429;0_01 ESIMMU' Mir OF GQngrATS ON (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•agreelthat'if I should become subject to the workers' compensation(providions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:` ti Applicant-A••K-,AA 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`6f�this City to enter upon the above-mentioned prope"rty for inspection purposes: 'Signature (Owner/Agent) t'• t Date ; t. 3T.1b-TOTAL CONOTP.UC'1'ti' N XbM PT." CREOX LESS PRZ-?An) FSS OIAL T -ERM '2' FUS Dirty NOW I '--CITY OF LAQUINTA I r..�o.�rre�eDT RECEIPT DATE I BY C DAT INALDINSPECTOOF .74 Y .a CONSTRUCTION YES 1001-000-418-000 $702.50 PLAN C11ECK PBE 101-000.439.319 $512'$.36 FEE MO'SIT 101.000-439.313 -"Moo mrCH"IC.AL 797, 101.000 -421 -OW 0230 EL3�.C'TRIC:.AL F, 101.000.420.000 $129.05 R°d,P3i.NiBWO FEE 101-000-419-000 $110.75 MONO ItONO NO`1' ION FEE • RPSID 101.00O -7A 1-000 51134 Cfl2A,1. iNG YEZ 101-000-4Z3-000 $151.00 DISVEloOPER IMPACT FEE $4405.00 PRECIn PLAN 101-000-44.1-345 $100.00 3T.1b-TOTAL CONOTP.UC'1'ti' N XbM PT." CREOX LESS PRZ-?An) FSS OIAL T -ERM '2' FUS Dirty NOW I '--CITY OF LAQUINTA I r..�o.�rre�eDT RECEIPT DATE I BY C DAT INALDINSPECTOOF .74 Y .a INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 FootingsDucts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O. K. to Wrap F.A.U. Framing Q Compressor Insulation.9 Q �ljf,� Fireplace P.L. Vents Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final 302/_ U3 ,!5-;;7_q BLOCKWALL APPROVALS Final steel POOLS - SPAS Set Backs Electric Bond Footings 0 Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping . PLUMBING APPROVALS Gas Test Electric Final Waste Lines / L (f 2 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 Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: paps Building Mailing Address City tractor 11111111=11141I ®a State Lic. & Classif. Arch., Engr., Designer Address City i&31fA8 l i 7 c;ei BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tel. Tel.. City Lic. # .} l.. Tel. Zip State Lic. # BUILDING: TYPE -CONST. OCC. GRP._ A.P. Number Legal Description�_,N Project Description Sq. Ft. Size New .9 �^ No. Stories No. Dw. ` Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ Zbyy affirm that I am licensed under provisions of Chapter 9,(commencing with Section. 7I division 3 of the Business andiProfesr.�sions Code, and my license is in full force and effect` Se�. i - _,,. % \_... �..e% t-'x�•.---•i, _:. i i_ �. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031, S, Business and Professions Code: Any city or county which requires a permit to construct, �a@er, improve, demolish„ or repair any structure, prior to 'its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of -? Estimated Valuation N ' as ` �• PERMIT AMOUNT - - ,. f . 7f Plan Chk. Dep. ,.. r1. ; --• ; Division 3 of the Business and Professions Code, or that. 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 applicant to a civil penalty of not more than five hundred dollars (5500). I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 'i. Const. 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 _ Mech. 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 _ Electrical 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.)- 1'1 I, as owner of the property, am exclusively 7contracting with licensed contractors to con- Plumbing 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 S.M.I. ' such projects with a contractors) licensed pursuant to the Contractor's License Law.) I . I am exempt under Sec. B. 8 P.C. for this reason Grading Driveway Enc.' 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 Code.) Policy No. Company r7 Copy is filed with the city. O 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 (5100) valuation or less.) I certify that in the performance of tha 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 'Thereby 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. 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 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 Pe'rmitrA Intlaxit Validated by: �� u v CITYOFLAQUIRTA WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISIONFINAfdGEDEPT _ CERTIFICATE OF COMPLIANCE v�1FIsc Desert Sands Unified School. District -4 47950 Dune Palms Road z "" Q BERMUDA DUNES <•' Date 9/13/02 La Quinta f CA 92253 RANCHO MIRAGE d � INDIAN WELLSLM DESERT ti No. 23615 (760) 771-8515 dy> P LA GUINTA ^�y OINDIO YJ Owner Coronel Enterprises APN # 774-244-035 Address Jurisdiction La Quinta City La Quinta Zip 92253 Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 54300 Avenida Ramirez 1899 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 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 accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,899 S.F. or $4,063.86 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CCNIB - Ish Comel Check No. 264982 Name on the check Telephone 760/564-4604 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Monica GUlllen $4,063.86 Payment Recd Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you 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 project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to'collect them on the District('s) behalf, whichever is earlier. NOjR:: This Document NOT VALID if Duplicated Embossed Original - �Wpding Department/Applicant Copy - Applicant/Receipt Copy - Accounting of Lal;Zuir��:��. C"omm"""Dev.`lleP4. fI � 1 I U=N 760 '777 No , 5211 P • 2 9PACEi roR'ARC011ceaa use 77 THE UNME IGNED.GRANTCff (8) DE.CIARE:(:a) ff1� oocuhiENl'AR` TRA1180FG(- ❑ eo nl]tlsd on tuil tf due 9q' 1►r�perty Cur1v`eye t or [� eompuk®tl on full valuelc...s vtdue ol9f �ns;br¢itirC'-um faRceS malning at time of le - ANO s-nincorpOraled area ❑ - ty of, _4 „ FOR VALUABLE C:ON' IC!t=RAY}41it, receiP viNct1 is ha ret)y acl.n�wladyed; -, ° ,BRUNo `.13. PUiivra���§ ` herOy GRANT(s) to the°following dasCPlliesa eal' ropljrD% iA 114 county of :;161e ofCsllt,;rnla. . IrJ J.' Pal , COR�Ir:Q REOUEgTE019Y " WI gKib IiHo`EEetl111r t l>!fo Itm unEM 6TM[14U d'.Ii(L tl1' *y II►OV YAIIT� HIM .. c... STATE OF CALIFO C 3�L COUNTY qv Nem* r C1C.y of. La-�Qui:+Cd On th's 1r f rata per enfilly air+ Sox ;1504: La Quanta, CA 92252 before me: tha un rr n i'', 0Nah sz,ilf — �- Q oeisonaI Mqw-n,to Me . h �-No fee. GoSi'flment Ggde .;Id tome bn 1ho'baa. -it anlrslacaexy,3vitlen t c. to be tho parcoo-whose n]arne 1e utls,e<It ed to this u,�tmuaurn, .1nd �dRae++l th 0 1A1. SEAL '.' adglid tome that he (ohe or Iney) a:ei u>etl f A,wllsAi a'+nTEll�nner(+/,aioA� _ Name .. Address WryA t�tnal.E7C#1PSDot'.1$1942: cW fir@ Sate L �. L oC�.Q6o1�la. • �'�, �. TIhIB11E1�p0s_.. �uurwmlm.__ —_.-- 9PACEi roR'ARC011ceaa use 77 THE UNME IGNED.GRANTCff (8) DE.CIARE:(:a) ff1� oocuhiENl'AR` TRA1180FG(- ❑ eo nl]tlsd on tuil tf due 9q' 1►r�perty Cur1v`eye t or [� eompuk®tl on full valuelc...s vtdue ol9f �ns;br¢itirC'-um faRceS malning at time of le - ANO s-nincorpOraled area ❑ - ty of, _4 „ FOR VALUABLE C:ON' IC!t=RAY}41it, receiP viNct1 is ha ret)y acl.n�wladyed; -, ° ,BRUNo `.13. PUiivra���§ ` herOy GRANT(s) to the°following dasCPlliesa eal' ropljrD% iA 114 county of :;161e ofCsllt,;rnla. . IrJ J.' Pal , I P.01. .s STATE OF CALIFO C 3�L COUNTY qv On th's 1r f rata per enfilly before me: tha un rr n i'', 0Nah sz,ilf — �- Q oeisonaI Mqw-n,to Me . h „_ . { .;Id tome bn 1ho'baa. -it anlrslacaexy,3vitlen t c. to be tho parcoo-whose n]arne 1e utls,e<It ed to this u,�tmuaurn, .1nd �dRae++l th 0 1A1. SEAL '.' adglid tome that he (ohe or Iney) a:ei u>etl ,.r f!0'1aRv W�t1C `GL6UkiVN:.lt.: . faEv4Et:dtrYT1 : i1 t�tnal.E7C#1PSDot'.1$1942: cW fir@ I P.01. MRK-Lb-'zWW6 b r : k04 AM DUCT LEAKAGE ANU DESIGN DIAGNOSTICS P. 03 CF -6R ,DUCT LEAKAGE REDUCTION I' c sun�atu>r. l Gst Results (CFM (tr 25 PA) Test Leakage (CFM) 70 It' Fan f=1uw i+ C iticulated us 400 cfm/ton x number of ions,•or as 21.7.x Heating Capacity "Thousands in of Rtu/hr; enter calculated value here e7v ff' fan flow is measured, enter measured value here: 1_c„�agc Fraction. - fest Leakage/(Measured or Calculated an Flow) Pass if leakage fraction S 0.06 y ❑ ❑ F'ur :1 KROSOL TYPE SEALANTS ONLY- The following• dlagnostic testing was Pass Fail completed: Duct Fan Pressurization at rough -in measured _leakage (CFM) CHECK •AP'TE:R FINISHING WALL: ❑ 1 es ❑ No ❑ Pressure pan test or House pressurization test ❑ l rs ❑ No ❑ Visu'al Inspection of Dtict Connections /l/�� ' ❑ ❑ Pass Fatl THERMOSTATIC EXPANSION VALVE (TXV) Yes ❑ No Thermostatic Expansion Valve (or CommissionAppruved equivalent) is installed and Access is provided for inspection ❑ Yes is a pass Pass hail ❑ DUCT DESIGN i ❑ lIes ❑ No ACOA Manual D Design calculations have been completed, Duct Design.is on the plans and duct installation matches plans. / ) / ' C3Ycs ❑ Nu 'rXv is'installed or Fan flow.has been verified, If no TXV, verified fan flow mafches design from CF. 1R. Measured Fan flow = _ Yes for both I and 2 is a Pass Pass Fail I, the tutd�rst, ncCi, vertl'y th,,.t the above diagnostic test results'and the work 1 performed associated with the tcst(s) is in unf rm:u,cc �� i:L t!te feClu,rements for compliance credit, (The builder shall provide the HERS provider a copy of the C;F-bll h)- the builder ernployees or sub contractors certifying that diagnostic testing and. installation meet the requirements for �• St�nan,re, Date Installing Subcontractor (C:o. Name) OR —� I'cr!'urn1el U Budding I)eparnnen( General Contractor (Co. Name) IIf: RS Provider (it'appiicable) 1cs;.:19 Owrier at: Occupancy