0008-393 (PAT)LICENSED CONTRACTOR DECLARATION
. I hereby affirm under penalty of perjury that I am licensed under provisions of
k. Chapter 9 (commencing with Section 7000) of Division 3 of the Business and.
WProfessionals Code, and my License is in full force and effect.
0 :5 ch License # Lic. Class Exp. Date
LO
C3
BMC r' 05�/3a �c
C) Z r�, bDate �� '�' Signature of Contractor
CD L
J U C:) / OWNER -BUILDER DECLARATION
W W Irl- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ U) License Law for the following reason:
Z_ ( ) 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).
C0() I am exempt under Section B&P.C. for this reason
N Date Signature of Owner
ON
0)d Q WORKER'S COMPENSATION DECLARATION
oCc I hereby affirm under penalty of perjury one of the following declarations:
F2 O ( ) I have and will maintain a certificate of consent to self -insure for workers'
X w �= compensation, as provided for by Section 3700 of the Labor Code, for the
mJ Q performance of the work for which this permit is issued.
Q U (11) 1 have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
,It z CartierPolicy No.
Cb � OTATE FUND 044-99-0010497
�d
J (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
subject to the workers' compensatio�vprovisions of Section 3700 of the Labor
Code, I shall forthwith comply witf,Wvl
those, pr slon�
Date: Applicant
o-��
?/ / /
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
r addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
P 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 authorizer�presentatives of this City to enter upon
the above-mentioned property fors nspection. urposes.
i Signature (Owner/Agent) 7�K Date
J ..
BUILDING PERMIT PERMIT#
DATE tt VALUATION LOT 00W.393 TRACT
JOB SITE I
ADDRESS .�1 amomm
APN
s
OWNER
CONTRACTOR/DESIGNER/EN (NEER
DANKE1dT,3 11','
MRX CONI T'�tUM011 ' CO.
55-871 BRAR BURN
UZI25 GARP,34'D 4M, -
LA t1iT.13 fA CA $.2253
PALM Ma5Zexr CA 92211
('160)345-9711 - CaLo 790
USE OF PERMIT
PATIO
170 SY, LATTICE PATIO CDVM, (FREE STANDING) AS P?R..APPR(WID
PLANS 014LY
PORVINPATIO 170,09 OF
"NSMITAWD CO.S"f OF OORb'7'RVMON
2.261.00
PERWT ME: STJA04Lte1!Z
PIAN CHECK Ful 103.000-439.318 $33110
C014STRLICTION FEE 101-000-4-19-000 $34.00
It
STRONG MOTiON FEE - REBID 101.000-241-000
r 7
;
AUG 20-
-1 -TY OF LA
a
t SUB—l'O`I`AL. e..t71n1'STltiCiMOM A'.WD Pl.MT CRECK
$89.60
IXSS T'3:2E•3?AX F=
X0,00
TOTAL PERMIT 19=9 DATE NOW
IMM
RECEIPT
DAtTE p 7,
f i
BY/t j
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings / iR! $ ,
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
can
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P,L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
mal
WALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
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
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
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Ti4
P.O. Box 1504
78-495 CALLE TAMPICO (7 60) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
October 14, 2002
Mr. Dan Kelly
55-871 Braeburn -
La Quinta, CA., 92253
Dear Mr. Kelly,
On August 31" 2000, the City of La Quinta issued a Lattice Patio Cover permit #0008-393,
located at 55-871 Braeburn, to Stark Construction Company as the contractor of record. Our
records on file reflect a footing inspection was performed by Inspector, Steve Traxel, on 9/19/00.
There is no recorded framing or final inspection for this project.
Under the administrative provisions of the 1998 California Building Code, "Every permit issued
by the building official under the provisions of this code shall expire by limitation and become
null and void of the... work authorized by such permit is suspended or abandoned at any time
after the work is commenced for a period of 180 days." (CBC section 106.4.4) Consequently,
this building permit is expired. With no provision for further extension, no further work may be
performed until a new permit has been issued.
Please contact me. directly at (760) 777-7027 as soon as possible to coordinate a plan to obtain
information you need regarding new permits and/or any required inspections.
Sinc ely,
Daniel rawfor Jr.
Building Inspector II
dpc
cc 55-871 Braeburn
Stark Construction Co.
Foe
' o��
City of La Quinta
Building a[ Safety Division
P.O. Box 1504
PFAD
78-495 Calle Tampico
La Quinta, CA 92253
Building Permit Application Tracking Sheet
and
Project Address: S — ��J �j�Al� �jUsQll/
Owners Name:
A. P. Number:
Address: 15"S4-71 �2et 131i/L/1/
Legal Description:
City -ST. Zip: /.-,d Z Z
Contractor: �T�421G �y/�J;eI�G�/per/ �jG.
Telephone: ✓��
Address: 39725
5G// `—S f
Project Description:
.Cin�.ST. Zip; /'�li� ��SDt2G%
G.�' 92� ��
i.d�✓o /L✓6 %/213"G G 1.S j�i0 i l0
Telephone: %O
Gc� v�2
State Lic. _ : 61-777(
City Lic. tr:
Arch.. En_r.. Designer �j�gTt
�//✓/% �
Address:
Cite. ST. Zip:
Telephone: 3��/S Z
Construction Type: /t/,g l� Occupaary
State Lic. _:
Pro. type (circle one) ew Add'n Aha Repair. Demo
Nance of Contact"Person:
Sq. FL:
# Stories:
# Units:
Telephone = of Contact Person:
Estimated Value of Project: .5QzVeg"—v0
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. 7
PG. Awl 11M. -
FAIRWAYS ASSOCIA'T'ION'
August 14, 2000
Mr, and Mrs. Daniel Keliy
RE: Architectural Change Request
Dear Mr. & Mrs. Kelly:
The Architectural Committee of the PGA WEST Fairways Association has
reviewed the plants submitted for a kiva and trellis at your new PGA WEST home.
Based on its review the committee has approved the plans as submitted.
Please contact me at '760) 564-3858 if you should have any questions.
Sincerely,
For the Architectural Committee
GA
iih M0r, 4 n
A ciation Manager
cc Board of Directors
Unit file
Stark Construction - Contractor
Carol Ford — Brookfield Homes
P.O. BOX 13710 - PALM DESERT, CALIFORNIA 92255 - TeL (160) 776.5100 e Fax (760) 776.5111
email: pgawe.it@moitar-chgrp.com