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0309-049 (SFD)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 6 40'74 B JAW`? �'�. •-r'7J�7'!�t Dates,1 ' �1°;� 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 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. ( ) 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 STATE FUND Policy No. 046-7333.2003 (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- th5tif`l houId become subject to the workers' compensation,provisions,of Section 3700 of the Labor Code, I shall forthwith,comply with those provisions. Date:' %/ Applicant �_ 4T-1 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 inspection purposes "Si nature (Owner/Agent); ,� : // Date�/210 PERMIT #--' ' BUILDING PERMIT W09-049 DATE VALUATION LOT TRACT $4180930 R 7.65.24 JOB SITE ADDRESS ^3. APN 70— IW" OWNER CONTRACTOR / DESIGNER / ENGINEER LQ ORCHARD FAkZM-21,S VARKS C0,991'12 UCITOW PO BOX 1716 79.295 kANC-14.c I QtiTfNTA W , LAQUNTA. CA 92253 LA.QUNTA CA 5122,53 (760)7' 1-1941 C`B: t . 2996 USE PERMIT (O�jF�\�j { �p�f�� + �y([� AY��{J� SI GLE .G A'a1V.8M/Y D W.&L.JadWG 5021 SF SPD—LOT 8 PEP -MIT DOE'S NOT tNCgilt P001, -SPA, VIALILS OR 11.J1IVEWAY.APPROACK 7001 CBC. CUSTOM CONSTRUCTION 4.9". DO SE' PORCH•!PATIO E46.00 SF 0ARAOt?/tiARPt1RT SF FRrIMN RD COW OF COT3SIHUCTION 418 CON3T'R.UC'1` OW 'YER 101.000-•418.000 $1,736,00 ' PL.A14 CHECK F'E;E 101=000.439_318 s.1,451.56 s O'RE DEPOSIT 101-000439-316 4250.Oa NI CHANIC.ALFER $195.00 EL ECT12I.CAL FFE 101-000-420-000 3290.:4 . PI.i}hIBING IEI✓ 101-000-4.19-000 $199.75 Til R0140 MOTION i'PK - R(WID 101.000.241.000 S41,0S O12ADINO PER 1.0'1-000-42.3.000 $I S.Ofr DEVELOPER IMPACT FEE 3�,405,D0 ART 170 PUBLIC K&C'ES - R }U91E 270..000-445-000'$505.'23' • gyp' -4co sT.Etvanow.4m) nm twm . x;6,998.71 LB -113.9 PRE -Pim FFX141J 4250,00 JAN 2 2 2004. cna�, x. pF;w L0 Din, NOW L�1� 6Zs74& 1 A. Qum fA CE RI . RECEIPT DATE BY DATE FINALED INSPECTOR f INSPECTION RECORD OPERATION I DATE I INSPECTOR BUILDING APPROVALS Set Backs Forms & Footings Slab Grade Steel Roof Deck OX to Wrap Framing Insulation Fireplace P.L. Fireplace T.O. Party Wall insulation Party Wall Firewall Exterior Lath Drywall - Int. Lath OPERATION I DATE I INSPECTOR MECHANICAL APPROVALS Underground Ducts Ducts Return Air Combustion Air Exhaust Fans F.A.U. Compressor Vents Grills Fans & Controls Condensate Lines POOLS - SPAS BLOCKWALL APPROVALS 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 Sewier Connection Encapsulation Gas Piping Gas Test Appliances ` Final COMMENTS: 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 (Penn) I -�-" 1 ~ N U) 04 W O=)c) CY u7 LLI r a:OZ� 0' o � U CD W LU ►- a U) Z co L0 N ON U °) CL g Z Lo acc 0 xw!� m<U O rn H Z_ Cb 5ry V 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 Date 674074 B "WIC 077 2( 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 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. ( ) 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: Cartier S.TkTr 1oYgr3 . Policy No. 046-7330-20 03 (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 Code, I shall forthwith comply with those provisions. Date: Applicant 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 e 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 inspection purposes. Sii�nature (Owner/Agent) Date BUILDING PERMIT PERMIT# 0309-0-49 { 7 µ� 4 / �!� VALUATION 4 y p 09 0 LOT p TRACT r� t DATE 01/2,2/2(X 01/2,2 Lr�IR. K:6�ifV�.+'.'a ii N 661.24 JOB SITE ADDRESS � Q +6 �r��10 APN %9-716-04M OWNER CONTRACTOR/DESIGNER/EN (NEER LQ ORCRXRD P RTNEW SPARX8 CONST UC'110N PO BOX, 1716 79-295 RANCHO QUJ-1Wr A 1Yit. LA QMs1`tA CA 92253 LA QLNTA CA 92.233 (760)"771.1941 CBL4 2996 USE OF PERMIT :11Af01ZFAIVIJ f DWRT iwo 501 SP' SF'D-1X3T 8 PERMIT DONS WOT INCLUDE PO01.' SPA, WALLS ORnRlV►xWASi°Ai'3'ROAC;H, 2001 COC. CUSTOM CtaNSTRUCTI0I-41 SF PORfvIVI)ATIO 946.00 Sit' f:i&R#a.Ci..FJC ARP0RT 8911.00 SF 3'1':.D COST OF C�Ci1�'Tv"1<.�-`CTCT��J..i.N ?�i� ^��}}pq �qq���ee��E ` �p�p g,9,,S"1'. P EE��frRB.l..l !nX KCIA A.4V9A Y R COWSTRUCTIOX PER 81,736,00 PLAN CHF -CK .FSE 1.01 4300-�l3!� i16 1yInB 5i:.5G FEE DEPOSIT Cil •C)ti0�m? 9•>� 28-$2�0,t�4 gHW,F.i"JC,KL FEE l Cal ^11£113-421 -f103) $195.00 ELECTRICAL YEE l ti'j. •t1tiC1.42O•d7p0 $290.34 PL?7MBINO Nfr.�r 101-000-419-000 $290.75 3TR0140l1.OTION FFS - RESID 101.000.241.0100 541,31. 041hDMU FEF 101-000-423-000 $15.00 DE'9`1*WPER IMPACT MEE $2,40,00 P.m IN PUBLIC, PLAC;1r.9 - la.E:311: 2,70-000-445-000 $5Q5.25 WB TOTAL C;C)tN:l'i'2iUC'NOW AND PLO CITECK sr)Y99L.'71 M, 53 PR -TE -PAID FIT..E B 4250.00 'U i.�" ► Y' �f31+9l1':Ct`I 1<:5 WV1, NOW &6.748.71 RECEIPT DATE BY DATE FINALED .INSPECTOR l 9 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 'Set Backs Underground Ducts Forms & Footings 'J - Ducts Slab Grade J' - —y Return Air n Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap - y F.A.U. Framing S Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final — Final _ —Lp BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg, Test Final I 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 Gas Piping _ Encapsulation Encapsulation 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: P'p�cJ �93� y ce BOX 1504 Building 2 78-495 CALLE TAMPICO APPLICATION ONLY Address /'7 9—J � �CLj A LL0 000 LA QUINTA, CALIFORNIA 92253 mdrmry D 30.. Address 7/� City Zip Tel. 1,6? 9 Z LJ--?> 70 o? 71 1-9Y/ %,unuacrUr I 03/7/ Zip Tel. y z 2; 3 1 j&v 7 W State Lic.�� 7 City 8� Classif. C7 Lic. # Arch., Engr M� Designer &j�cly L VA� �� `f v Address u� O�(v� ITeI. CityZip State /4/D11i,v6lill_S 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 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 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 (5500). 1-] 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, Bulsness 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 ownet-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(5) licensed pursuant to the Contractor's License Law.) 1-1 1 am exempt under Sec. B. 8 P.C. for this reason 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 (7 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 IS 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: ll, 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 Ihereby 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 it 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 a0plicant Date Mailing Address City, State, Zip BUILDING: TYPE-'7CONST. OCC. GRP. � A.P. Number / 4O 9 74,-0 0O /A/ Legal Description "T�7 Z f, 2� 40 7 8 Project Description Sq. Ft.— f No. No. Dw. 5 Size _o ZI Stories Units NeWIV Add ❑ Alter ❑ Repair ❑ Demolition ❑ G Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Ora , Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. !T� _- Grading flffl Driveway Enc. Infrastructure]// \C% 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: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Date 1/21/04 No. 25383 Owner LQ Orchard Partners Address P O Box 1716 City La Quinta Zip 92253 CERTIFICATE OF.COMPLIANCE Desert Sands Unified School District 47950' Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # 4���1FIEDSCI �-. 1 O Q 13ERMUDA DUNES r RANCHO MIRAGE d �J INDIAN WELLS V' PALM DESERT ,y t}� LA QUJNTA QINDIO O 769-760-009 Jurisdiction La Quinta Permit # 0309-049 Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street Unit 1 8 79330 Briarwood Unit 2 Unit 3 Unit 4 Unit 5 Comments S.F. 5021 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 Lot # No. Street S.F. 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 5,021 S.F. or $10,744.94 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 CC/California Bank & Trust - Judy Halpain Check No. 24603101 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharon McGilvrey Payment Recd $o.00 $10,744.94 Over/Under Signature G 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. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting WALLING & McCALLUM / LTD ARCHITECTURE • PLANNING • ENGINEERING 45-190 CLUB DRIVE WALLINGARCH®AOL.COM INDIAN WELLS, CA 92210 FAX (7601 360-0796 (760) 360.0250 7'9.330 oOJ January 26, 2007__ City of La Quinta Department of Building and Safety Post Office Box 1504 La Quinta, CA 92253 Re: Sutherland Addition Lot 8 The Estancias La Quinta Gentlemen, I have inspected the shear walls, post and beams and their connections to the structure for this residence, and have found them to be in reasonable compliance with the drawings. Yours JGW/jls