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9803-128 (SFD)N r) O m C) K C) 817 W ~o Z ti Zo O O Awa U) Z cY) 817 N ON U °) Q CLZ r-0 XLu�= mUU O d MH 't Z_ co 5 r" C) Q J 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 i �' t 7467 x3 7i3ii0t) /Date S 9 ignature of Contractor �v 1J 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 exempt under Section , B&P.C. for this reason Date 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. (Y.) 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 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' compensation provisions of Section 3700 of the Labor de, I sh II f hwith comply with tho a rovisis. Applicant Cate: 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 in pection purposes. ignature (Owner/Agent) ' Date f 6 BUILDINGPERMIT PERMIT# CONTROL# DATE VALUATION LOTTRACT 6 O 51119/944 .5373,595.70 2,1 277, JOB SITE APN ADDRESS9-455BQiAWC0y 769-760-014 14 OWNER CONTRACTOR/DESIGNER/ENGINEER LA. GPINMA 011Cklf4RID'PAT�." NI -Ilius SPARKS c6ii•S,,1,lP:tJct'CoNv .P.O. BOX 540 79295 (2A'N•CHO LA QUTI\TrA DR. LA QU)INTA CA 92253 LA QitUiVi t'A CA 522 '3 (7617)771-1.94 (s1C.•iF 2.t; ke x USE OF PERMIT SFO - T,MI JIT 00ESS NOT :Citic UME Bs X<X WA€.LS OR .POOL, t C US ONT COINTS RUCTION 4.519.00M,- .-!i'TY OF LA OUINTAA POYiLr-H/PAT10 -0.00 sil" UARAUEI A.t+`4 ORT 856 0() sp1 I-, C".0 S'C.itUC'T1Uv YEC 1014)00 -AIR -000 S1,-.wg.S) pll, %NCHIRC;K F*921 101_NX)_4?1)-319 Qr `N5y:1 FEt:.G3rAY)S 1171-000-:/1:39-3181 41.000,00 ?rIL•:Cli'.t 141CAF_ ffa 7Gi ti(i-�t2i 430ti Sl ti.SU kLL�t::!`3t.lE,f1i %t;t; 1r1T-t3i�ti'l2f7-�)U(J S;E3tit. Jai ur,T. [r+ter.)H ItjI4N1()-Ai9-()()(ll c:7 75 S'l.WW IN110 T 110N T'�i - R13S 7 1171-000-241.000 `2117 . 6R.r3 IDG F01 1171-060-423-000 520.06 1Nt'CiA;;'!`,t UC`VU,R1w 1+1% 225-000-.443-342 S6,000,.00 KRT N4?x)? MO M .(,FS - RE310 701 -OW -2 -OW-255-900 P,-'AT,r,ON9-r2.IJ(,flON,A-'NO PT,AW (:.ii Cl . lf'tT $((1p;47.R3 LESS VRE-PAM)MES I,t)QO.t3ft 'CC)TAL Y1!1pth11 FA'FX-'% 1<33.IR NOW $9,247,83 RECEIPT DATEBY/ DA FI ALED INSPECTOR INSPECTION. RECORD OPERATION DATE I INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs _ r Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck / $ Exhaust Fans O.K. to Wrap ZS — . F.A.U. Framing Compressor Insulation] _ Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath ��%' Final , Final POOLS - SPAS BLOCKWALL APPROVALS steel 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 4=z=.9 ``'L' Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral �-/� �f� �i f Pool Cover Sewer Connection Z - �' / 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) Building I AAA,... SS" 13 f State Ljc. 4711 o -7 8 Classif. Arch., Engr., DesignerJP, 1~� ,+ 00 I -71L T4tyl 0 4" P.O. BOX 1504 78-495 CALLE TAMPICO CA -JA a JA QUINTA, CALIFORNIA 92253 ;2.;1T3 NT 711 1—(qI Tela ? / 73; . Cityr� Lic. # i _�/ //1"171 Address Tel � � ! 9 !� G ✓G 1�1 yr �''c�C U�.�r o ity t Zip State I+ryIw ti L�.. l 1-7 ;1 if /V Lic.# LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencin with Section 7000) ofDivision3 of the Business and Professions Code, and my license is in ull force and effect. 1-s�/� A l � I� _�I SIGNATUREy `" \ 1A DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors 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 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 Division 3 of the Business and Professions Code, or thathe 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). l: 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, 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 that he did not build or improve for the purpose of sale.) I 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.) 1-1 1 am exempt under Sec. B. & P.C. for this reason Date Owner v r, WORKERS' COMPEISATION DECLARATION I hereby affirm that I have a certificat of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a cartIIed copy thereof. (Sec. 3800, labor Code.) Policy No. Company \ n 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 thF 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 thereis a construction lending agency for the performance of the work for which this permit is i s d" (sec. 3097, Civil Code.) Lender's Name 220 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. L Signature of a0plicant Date Mailing Address City, State, Zip APPLICATION ONLY ILDING: TYPE -CONST. OCC. GRP A.P. Number Legal Description Project Description �j Ft. No. No. Dw. e Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep.„7f� urJ Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure i TOTAL /r/�� ✓ REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback fromRear Prop. Line Side Street Setback from Center Line Setback from Property Line rAD r FINAL A E INSPECTOR I Lied by: DafePermit /Validated by: Validation: LA 0-1—IIM_ WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Mailing,__1 Address�Cl) ?0". City tv Contractor .!5 4 M ,," Address �!+ r'1 ` SS" 13 f State Ljc. 4711 o -7 8 Classif. Arch., Engr., DesignerJP, 1~� ,+ 00 I -71L T4tyl 0 4" P.O. BOX 1504 78-495 CALLE TAMPICO CA -JA a JA QUINTA, CALIFORNIA 92253 ;2.;1T3 NT 711 1—(qI Tela ? / 73; . Cityr� Lic. # i _�/ //1"171 Address Tel � � ! 9 !� G ✓G 1�1 yr �''c�C U�.�r o ity t Zip State I+ryIw ti L�.. l 1-7 ;1 if /V Lic.# LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencin with Section 7000) ofDivision3 of the Business and Professions Code, and my license is in ull force and effect. 1-s�/� A l � I� _�I SIGNATUREy `" \ 1A DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors 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 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 Division 3 of the Business and Professions Code, or thathe 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). l: 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, 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 that he did not build or improve for the purpose of sale.) I 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.) 1-1 1 am exempt under Sec. B. & P.C. for this reason Date Owner v r, WORKERS' COMPEISATION DECLARATION I hereby affirm that I have a certificat of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a cartIIed copy thereof. (Sec. 3800, labor Code.) Policy No. Company \ n 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 thF 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 thereis a construction lending agency for the performance of the work for which this permit is i s d" (sec. 3097, Civil Code.) Lender's Name 220 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. L Signature of a0plicant Date Mailing Address City, State, Zip APPLICATION ONLY ILDING: TYPE -CONST. OCC. GRP A.P. Number Legal Description Project Description �j Ft. No. No. Dw. e Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep.„7f� urJ Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure i TOTAL /r/�� ✓ REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback fromRear Prop. Line Side Street Setback from Center Line Setback from Property Line rAD r FINAL A E INSPECTOR I Lied by: DafePermit /Validated by: Validation: LA 0-1—IIM_ WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District Notice: 82-879 Highway 111 Document Cannot Be Duplicated Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 5/18/98 No. 17046 Owner NameL.Q. Orchard Partners No. 79-455 City La Quinta Street Briarwood Tract # Lot # Type of Development Single Family Residence Comments APN # 769-760-014 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Square Footage 4,519 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 4,519 or $ 8,721.67 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may nuw be ,iss ued A Fees Paid By Cashier Check/E1Dorado Bank/Judy Nolan Telii�001ie '/71-1941 w y, Name on the check By Dr. Doris Wilson r u' Superintendent Fee collected /exempted by Juanita Green Payment Received $8•,721..'67 Check No. 851317883 Signature NOTICE: Pursuant of As�6mbly Bill 3081 (CHAP 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 above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are 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 copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting Certificate of Occupancy t:04low City of La Quinta Building and Safety Department ofN This Certificate issued pursuant to the requirements of Section 109 of .the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For, the following: BUILDING ADDRESS: Use Classification: SFD Occupancy Group: R3 79-455 BRIARWOOD Type of Construction: Owner of Building: LA QUINTA ORCHARD PARTNERS Building Official Wril Bldg. Permit No.: 9802-128 Land Use Zone: RL Address: 79-455 BRIARWOOD City: LA QUINTA CA 92253 By: KIRK KIRKLAND Date: 2-12-99 POST IN A CONSPICUOUS PLACE