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HomeMy WebLinkAbout0311-225 (SFD)LICENSED CONTRACTOR DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Fes-- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 04 W Professionals Code, and my License is in full force and effect. O ch License # Lic. Class Exp. Date r� W r- 7/S Cta�1 B ! 3� 1 /0 Zr-- Dete 12 Signature of Contractor O� % CID U CO OWNER -BUILDER DECLARATION W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's F— CL License Law for the. following reason: U) Z_ ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do lthe work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). c'') O I am exempt under Section ' B&P.C. for this reason O N Date Signature of Owner Q WORKER'S COMPENSATION DECLARATION O CC I hereby affirm under penalty of perjury one of the following declarations: U-) H O () 1 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 m� Q performance of the work for which this permit is issued. Q 0 („1) I have and will maintain workers' compensation insurance, as required by A U Q Section 3700 of the Labor Code, for the performance of the work for which this Il H permit is issued. My workers' compensation insurance carrier & policy no. are: ao Carver 3TAT F1 rN � Policy No. 44-113-&353 �C3 QJ (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, 1 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 v orkers' compensation provisions o 3 subject to the f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: i 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 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 L & hold harmless the City of La Quinta, its officers, agents and employees. l 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 issuanceof 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-mentioneld property for inspection purposes. I Signature (Ownet7Agent),-•• �� . �� . 1---•- ,�I. r,-_ �• Date; ' / -BUILDING PERMIT P MIT# �� DATE VALUATION LOT'S TRACT JOB SITE APN ADDRESS 8p -9N IC()Y.T['L195 7G4—iV(Jk-(XYY OWNER CONTRACTOR l DESIGNER l FN INEER D1k J11,21-,I110ME ' 111. LLC FiMPfiCM'F'1C;1% D i.�17 _.��1%M>� Vii'+' CORP. 5 F. -A.73 r' 0T.Rtt3ba AwlMUTE,." 2105 5 F: (7-0130 A.Vi.-,. SITE. 205 'N I,r` DS 'CA 92373 Z.Mi LMD111 CA 92373 (909)796--Y, 88 MA -0 4911 USE OF PERMIT 0Tl:4l:21&' .1+'l'.NMSLY )DWL1'I:LI1wIG SFD . 60T 78, Pl,& d 28R... PL'.) MiT r101!S NOT INCLUDE BLOCK NAILS, F001, SPA, OR (VI'1'EW.t Y A.PP,11.t'±t',t:K 7:6°vn REDUCTION TO PLAN (3—If?+:.K FEE PLIE YO MUIJIFILL'' ISSUANCE OF SAIAZl PLA14 TYPE ':°WTCM C0))J. TPRt:1CTION �,7'I oo ;:F F'+: RCHfk kTiO _550.00 9F +��lt �`.ttEli •AfL1�C)l;�' t'µt9,G© Sly Ennap' n) cosr oar consroknow "6457.40 HiR r FFIIE aACAUUa.Y CONOTRUCTION FEL '1 til -000-4 l E;.,tW,0 v,119"00 PLA*N CHECK PLeE 101-006-11?9_318 t a.oq MECHMIC:AL FEE 101-000.421.000 $163,00 ELEC'Pit1t A.4,FEE 101-000-4213-000 1192.74 PLUTAFlNGF17E A01-000-419-E7C7t) Sf7;),I$ :.'1'kar`NO MOT10114 FEE . RES'ID 101 -000 -241 -WO re -i. 6§ ORAi1MO FFFE 10110100=423_000 $K(IQI DkVFJ.DPF1R IMPACT FEE s.d405.00 ART 04 P1161AC t'LACESS • Rl!;011 1^r0-00CM445.000 $91,49 7' , C09ffr 11f„":i" P'&T A71:7 PLJV J (_"TF1,0 . e 1.r- z PJ.M-.PAID FFIVs.� $0100 DEC 15 2003 TOTA,(, F.�.?vL13` FYMS 1)1 r. N(1)w V),4.1.637 CITY OF LA QUINTA FINANCE DEPT. RECEIPT DATE i_•� -moi BY '�. DATE FIN LED �t! INSPECT03 �' �` e- 6�. INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BULDING APPROVALS MECHANICAL APPROVALS Set Backs = Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Z: 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 4- Z6 POOLS - SPAS BLOCGCWALL 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 Plumbing Final Water Piping Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Agv 7 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 (Penn) lachella galley Unified Sch of District D. Box 84'7, Thermal, CA '274 A) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DF.VF:T.0PER FEES PA, AREA. AMOUNT LEVEL ONE AMOUNT. LEVEL TWO AMOUNT MITIGATION AMOUNT. COMMAND AMOUNT. DATE RECELPT CHECK 1l INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) 'roject Name: Birdie Homps Date: December 8, 2003 )wner's Name: First paci f i ra Development Phone No. roject Address: village Drive Counl es Court La Oui nta CA 92253 'roject Description? LPN: Tract #: 28983 Lot #'s: 9596,71-75, 77-79 'ype of Development: Residential XXX Commercial Total Square Feet of Building Area: 21,710 Sq. ft. Industrial .ertification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement nder penalty of perjury and further represents that he/she is authoriz d to sign on b half of the owner/developer. )ated: i Sign SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN kCCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) :ducation Code Gov. Code Project Agreement Existing Not Subject to Fee .7620 65995 Approval Prior to 1/1/87 Requirement Note: Vumber of Sq.Ft. 21,710 amount per Sq.Ft. $ 2.19 kmount Collected $ 47,544.90 3uilding Permit Application Completed: Yes/No 3y: Carey M. Carlson Asst. Supt., Business Serv. c certificate issued by: E1 vi ra- Mattson Signature: Office Technician NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES iection 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to he project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of hese Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall ;erve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of my other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether sayable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project hat is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. \,J 1a' AV c/mydocs/devfees/certificate of compliance 09/30/02 Date f I � P.O. Box 1504 78-495 CALLE TAMPICO (760) 777-7000 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101 PERMIT FEE SUMMARY November 21, 2003 Owner: Birdie Homes 111, LLC. 5 E. Citrus Ave. Ste 205 Redlands, Ca 92373 Proiect: 7 SFD Tract 28983. T,nk 95. 96_ 71. 75. 77_74 Builder: First Pacifica Development 5 E. Citrus Ave. Ste. 205 Redlands, Ca 92373 Lot Plan Sq. Ft. Address APN Permit # Fees 95 2AR 2,780 56-222 Village Drive 764-040-017 0304-180 *$5,115.52 96 2B 2,780 56-192 Village Drive 764-040-018 0304-181 $4,416.27 71 3AR/EX- C2 4,020 56-961 Village Drive 764-050-030 0311-222 *$6,143.81 75 3AR/EX- C2 4,020 56-985 Village Drive 764-060-004 0311-223 $5,228.63 77 1A 2,550 81-954 Couples Court 764-060-006 0311-224 *$4,958.72 78 2BR 2,780 81-934 Couples Court 764-060-007 0311-225 $4,416.27 79 2B 2,780 81-914 Couples Court 764-060-008 0311-226 $4,416.27 TOTAL AREA 21,710 //..2/, 0,3 TOTAL PERMIT FEES $34,695.49 VCuOWS IUII lee permit. remaining permits retlect /M/o reduction to plan check tee due to multiple issuance of same plan type Nmm; �-- - Certificate of Occupancy O p Taf 44 G OVY Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDINGADDRESS: 81-934 COUPLES COURT Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0311-225 Occupancy Group:: R3 Type of Construction: V=N Land Use Zone: RL Owner of Building: BIRDIE HOMES, LLC Address: 5 E. CITRUS AVE. STE. 205' City, :ST, ZIP: REDLANDS, CA 92373 By:. GARY HARTMAN Date: JANUARY 27, 2005 Building Official POST IN A CONSPICUOUS PLACE Coo, 'd N ANN o 0i C erriticate o f Occupanc4Y (X 4 pi t, OF Building & Safet Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. 33 Fc Sr BUILDING ADDRESS:. 81-934 COUPLES COURT k1 Use classification: SFQ Building Permit No.: 0311-225 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: BIRDIE HOMES 111 LLC Address: 6 EAST CITRUS AVENUE, STE. 205 City, ST, ZIP: REDLANDS CA By: GARY HARTMAN Date: 1-27-05 Building OfficiaV' POSTIN A CONSPICUOUS PLACE