0203-246 (SFD)M
LO
N
ON
U °)
Q
CL
Cc
C:)
Z
Q O
LL
OLU
J J
mUU
O
a 0,
,�t Z_
ob 5
r C)
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
768195 B t:� ?SCC 9/130103
t �
Date Signature of ContractorJ�Z�
OWNER -BUILDER DECLARATION
r
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 tRe 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
SeUion 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 MATE FUND Policy No. 10306-02
(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 t I
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the'Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety,
for a permit subject to the conditions and restrictions set forth on his
application. ;
1.'Each person upon whose behalf this application is made & each person� at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, &. shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if,
work is not commenced within 180 days from date of issuance of such"
permit, or cessation of work for 1.80 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes. _
Signature (Owner/Agent). 0" '4)"t-00 Date '_•'. �2
BUILDING PERMIT PERMIT#
DATE VALUATION LOT �"`TRACT
JOB SITE '`
APN
ADDRESS 7t?l S Ct- CAsb s +c. sm.uY
1649 �'.�3»Z? 5
OWNER
CONTRACTOR/DESIGNER/EN (NEER
M&A 1 .0 K, ev, ul
DCD DEV, 114C ;ase DE S'Wr CTi',{ES DEV,
74,W0 HICYKWAY'311 #200
70-6130WGIMAX 11I
W��a�AIMEMS CA, 42210
Lk QUIMM CAC 92253
o' C3)'371�'3345(MU) 21so
USE OF PERMIT
4KNO'aE I'.r D -Y e,?;r!ACEI tea
30.-81,00.1%U-NITI9,PAAN IP., :Pfd:r't,MITi'$CJ9SNOT IAfI.`LUD't
P0OL;SPA, •}ii. OK TI,YAI.L,OR faA11TWAY APRAOACH. 7501o!t'.FDUCTIX*44
IN I>'X„AN CHZCX FKF VOR MMI NIPLE I.`:SUANCP OA SAME P I.,K0 TYPS.
TR.F�.f.".'1° G'C)N x'I� 1r2CIC�'l;rJ1`i '14p.0� Ei�'
CiARACEICARPORT 313.60 S!I'
i?;SMIA`,C'�`IY COW Ole CONSMC']." OIN
45,320.00
��'3�..RAlr4'T' �►Y�t�' >�,'C:1.�VtiT�'�
CONSTRUCTION ME, 101-000418,000 X8,000 S3 , so
.PLA,N CHECK FEE 101>000-439-318 SK1.85
MECHANICAL FU 101000.42 } -000 534.50
J,fL9CTIJ(;A1, -I<', X i 01-000-42MOO $65,46
PLUM131N(1 flu 1.01.000-414.2100 382.0
STRONG MOTION FLUE - RESI>D 101-000-241-000 $4.53
DEVELOPER IMPACT IEE
`
.. .7
y1��yyy..�y�� ((..��•y4�ip1�nppp �+�,e��:1,�j��j1� �. py�•Y,*r s, �•�•^ qy t
k k'SlJdrl-ayt.,C3Sa o..}.✓�A.tls��l.IWt1'�1.��:L.lV.4y� .s•%bM�., PLASIF C�&'S .X1VJ.tl..
LAW
�p,y�, ry,��+! ,(
V/•ua243.34
i.��: PRE -PAM MW
$0,00
MAY U 32002
WYOFI,AQUINTA
NA
--E ---- BY D EFI AL INSPECTOR
� Cly: •1�-tf .�
1
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs — % oz-
Underground Ducts
Forms & Footings
Ducts
Slab Grade —vim
Return Air
Steel -
Combustion Air
_
Roof Deck . d Z
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing -,p
Compressor
Insulation D •- Zv L 77
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath • p
Drywall - Int. Lath Ib — Al 57
o �=
G 7�c✓ B -//•o Z S
Final
Final 19POOLS
- 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 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 /a, O'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) ftp -�v ✓�
Standard Notice of Work Completed and Not Completed
NOTICE - All reccommedations may not have been completed. See below- Recommemedations not completed.This form is prescribled by the Structural Pest
Control Board, with whom a copy must be filed by license within 5 days after completion of work under contract.
THIS IS A NOTICE OF COMPLETION ONLY, NOT AN INSPECTION REPORT
ADDRESS OF BLDG STREET CITY: DATE OF COMPLETION
PROPERTY 79-950 Cassia St. La Quinta CA 92253 08/05/2002
INSPECTED: CO. CODE 33
FARMER TERMITE CONTROL AFFIX STAMP TO
P.O. BOX 5155 BOARD COPY ONLY
BELLFLOWER CA 90706
(888) 340 -BUGS (562) 920-7571
I FIRM LICENSE NUMBER PR1401 I COMPLETION STAMP NUMBER
Notice of completion
Sent To and date : 03/13/2003
Owner's Name and Address:
Copies sent to :
This is to certify that the folowing recommendations on the above designated property, as outlined in STANDARD INSPECTION REPORT NO
date : / / REGISTRATION STAMP NO: , have
been and/or have not been completed.
Recommendations completed that are in accordance with Structural Pest Control Board's rules and Regulations:
Recommendations completed that are considered secondary measures under section 1992 of Structural Pest Control Board's rules and Regulations:
Cost: $ 70.00
Inspection fee : $ 0.00
Others : $ 0.00
Total: $ 70.00
Recommendations not completed by this firm
Estimated Cost: $
Remarks
-nil nre-trentment was • r•w • on thi&mramrtv i -t accordance' •� • :•. • •�
Signature
If you have questions regarding the work as outlined above,you should fust contact the licensee noted above. Id satisfaction is not obtain you may contact
the Structural Pest Control Board at :
Los Angeles - 213-620-2255
Sacramento - 916-920-5323
You are entitled to obtain copies of all reports and completion notices on this property filed with the Board during the preceding two years upon
payment of a $2.00 search fee to: The Structural Pest Control Board, 1422 Howe Ave.,Ste. 3, Sacramento,Califomia 95825-3280.
AT21:0320030313
ImsULA T IOC` CERTIFICATE IC -1
Description Of Installation
1. ROOF
7 �r —
Th!ckn esS (incccs` � � J
Nrml; Nu-lbzr
Rcsls:ance (R-Va!ue) 3 r�
2. CEILING
Ean?.et Type
Thickncss (r•c`. cs` 13" Th?:r.:=: sistar.ce
Loe_c Fit l Typc�Ct ,Jt'� Er'nd /1 DO:t'l %4-t
Contractor's rm.n installed wcight/P` ,k- lb t'. ici`n?ss ld_ -7 inches n
Manufacturces installed weight per square foo: to achieve Tic =mat Resis!_Ice (R-Velue)
3. EXTERIOR WALL
A. bt< e- tw L,.Xas aX(o-PiC' 3
Matt real �� Brzrd Nz-c ) Y1� UJO A -I [) c 0. _
Thicicress (inches) — Trennal Resistance (R -Value)
13 . Exterior L.uC Uo
Material C.. _ 3tzr.d Name x.,I,_L
Thickness (inches) �j L� T,e.^a: Resistance (:t -Value) - 1�
RAISED FLOOR
Mmeria, _
Thickmcss (inches)
SLAE FLOOPUTERIMETER
;v'at�: isl
Thickncss (inches)
Pcrimcte: Insulaticn Depth (inches)
Y FOUNDATION \-%.•ALL
Thic' ncss (irch_-s)
T 11C:.='1 I_'.-sistarce (R-Valuc)
Bernd Nate
T, crmnal Resistant: (R -Value)
E.ira Na: -n.,
Tr.e..ma! Res;s:ance (%-Value)
Declaration
I ..=r.7y ccr:ir'• tha! l:._ 3CJ%'C .vas ins!alkd Ln th? 3: _._ a`_o•.: !oca':Cn in w;!h C.: CL'r7:n.
Er,erg:r F tcie..^.Sfar r-_sidcntia! buildi^.gs (Till_ 24, =a- 5, C1!i._Ir-i3 Code rRugala,`:ens) as indielt_--d on the
CC:a'I_3t;; C�CO.T.r!ta::C u--.: aC1iI:CSSIe.
l: m 3 S,i2r _._,Ds:. ins:alkn' (Co.Namz)C,
Gc;,cral Con -m_ -or (Co. ;tame) OR O•A-,nc:
_ f
I:c:n ,
-.a:.:.e, Da'c
S:; ...-. , D_'.-
1 -,:ailing Sul:_ona-lctor (Co.Nam-) OR
Cc-c:a! Ccr:r2c4r (Co. i 3rnc) OR Owner
Su`cor :Imr (Co. Nam,-) OR
C:.._. Ccr.;.._:or (Co. Name) OR Ou-n:r
Certificate of Occupancy)
City of La Quinta
Building and Safety Department
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:
79-950 CASSIA STREET U-19
Use Classification: SINGLE FAMILY ATTACHED Bldg. Permit No.:
0203-246
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: CR
Owner of Building: MIRAFLORES, LP
Address: 74-760 HIGHWAY 111 #200
City: INDIAN WELLS, CA 92210
` By: STEVE TRAXEL
Date: 03-21-2003
Building Official
i
POST IN A CONSPICUOUS PLACE
O0
U�
3
P.D. BOX 1504
BUILDING & SAFETY DEPARTMENT
C�
78-495 CALLS TAMPICO
(760) 777-7012
OFT9ti
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
October 25, 2006
Ms. Esther Sanchez
Riverside County Assessor's Office
3255 E Tahquitz Canyon Way, Ste 114
Palm Springs, CA 92262-6962
Dear Ms. Sanchez,
Please be advised of an address correction for the following patio cover permit.
The patio cover was incorrectly issued to 79-688 Castille Drive, permit # 06-
2518. The correct address is: 79-768 Castille Drive, APN 609-610-23.
Please note this change and contact me directly at (760).777-7084 if I may be of
further assistance.
Sincerely,
Kay Hensel
Counter Technician