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0105-237, 0201-050 (SFD)w . (V LU C:)=) Mt- t- (Y Lr) LLJi C) Z l� CDO 0 H� W w '� I— a U) Z Lf) N ON U °) CL Q It Z LrQO XW — mUU O tl LO C))H v Z_ oo 5 �O Q J LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (com.nencing 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 f Date - �µ"" '` w Signature of Contractor,14% .•..rw...wr......•.w • Y 1 • F e . L't •.� 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 o, 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 Policy No. ACCORD 44"M91 MkID (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 ovisions:i Date: /, �r �" Applicant�!^%��� o_.. ..,....._.,....�.,,... • Mar ,. �' ,:',. WSHUng: 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. r 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 & e son at whose request and for whose benefit work is performed under o r any permit issued as a result of this applicaton agrees to, & sha 'I� nify & hold harmless the City of La Quinta, its officers, agents and y s. 2. Any permit issued as a result of this application becomes null voi if work is not commenced within 180 days from date of issuanc su permit, or cessation of work for 180 days will subject permit to can ellatio I certify that I have read this application and state that the above infor tion Is • correct. I agree to comply with all City, and State laws relating to thelb ildir construction, and hereby authorize representatives of this City to enter the above-mentioned property for inspection purposes. f � / r ! Signature (Owner/Agent) / e""//��?"bi: – Date`'y o 'y ✓� BUILDING PERMIT PERMIT# DATE VALUATION LOT 010-23.1 TRACT 61," '.x2iRC8.3'?4AW2. '11'2. JOB SITE ADDRESS n::7744MMA '17-740 CA1,� 00:M OWNER CONTRACTOR/DESIGNER/EN INEER J.A011M: Me=11q 1'TEswr COVE DEV. X. c COa'>`'fS°!(` ITC11014 )DESIGNSYSTEMS STEMS W C 201B7Xi28 Ia. (). B4:'678 W%QU3tEtA. C101 92153 LAQ 04TACA 5020-53 f 7Ci0Yn 1.3593 MS .i830 USE OF PERMIT PEWIT WAL1000USPA O D'AWKWA'i APPROACH. d RAC:T CONSTRUCTION 1,9.1.00 OF POPC:HdPATIO yZ80 SY C ARA07 t , �asz,aD SF UlM1' ED cC3l.T Or CeDM'"RUQ. ION SM,3.a4.; 0 COMT11UC:"ION FRE 1011-000.4.38-0041 11fi �.CtO PLAN Ck W.K YEE. 101-000-430-318 5531.83 FEE F?1::1'C Urk 101.00©-439,:31.8 -S-250,N. I-fZONANICAL, F18,L 101-000-421-000 560.0 EY..1�'�`TRICIAL ME, 101-000.420-000 it i s,10 PY,3T"1. OTHO f'P.e'. 101-000-419-1:i O $136.019 1, 1011TRON0M,t')TI 0 X RK • RT+01D 101.-000,24.1-001 39,W VIRAt'i.MO ME 103-000.423-000 $20.00 );rFni'I U:iP I II.1P� C�`I' FVF, PRECIS � � � = � 101-000441-945 �Ifso.t�f st. " . ��L Cc NSTRuM 0W AND PLMI � a1.8a s4ar RECEIPT DATES I/' BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs _ _� - Underground Ducts Forms & Footings ��/ Ducts Slab Grade Return Air - Steel _ Combustion Air Roof Deck8! Exhaust Fans O.K. to Wrap ((p!Q $•r' � ¢ZZ F.A.U. Framing O ! cj177 Compressor Insulation �r �o �� 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 I 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 APP OVALS 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 69�%%`Q ( �r 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) Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 5/21/01 No. 22031 Owner Name Jack McKenziew Desert Cove Dev., LLC No. 77-740 Street Calle Colima city La Quinta Tract # U21 Lot # 12 Type of Development Single Family Residence Comments Jurisdiction APN# 774-085-024 La Quinta Permit # 0105-237 Log # zip 92253 Study Area Square Footage 1,591 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 2.05 X 1,591 or $ 3,261.55 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/ El Paseo Bank - Mark Roe Telephone _- Name on the check By Dr. DorisWilson =� " Superintenideiit Fee collected iexeinpfed by ' Paula Ruiz _- Payment Received $33,261.55 :. _ Check No. 023679027 s . Signature NOTICE: Pursuant of Assembly 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 tolled 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 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: Use Classification: SINGLE FAMILY DWELLING 77-740 CALLE COLIMA Bldg. Permit No.: 0201-050 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Owner of Building: DESERT COVE DEVELOPMENT, Address: 78-401 HIGHWAY 111, STE. F2 LLC Building Official City: LA QUINTA, CA 92253 By: RICHARD. KIRKLAND Date: MARCH 20, 2002 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 'S RIC � 1102 DateSignature 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. () 1 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 STAU COMP 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 ' alifornia—and" agree that if I should become subject to the workers' compensation provisions of Sect�?3700 of the Labor Code, I shall forthwith comply with those provisions .D "ate:►!P, Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is ,not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City,, and State laws relating to the building construction, and hereby authorize representatives of this. City to enter upon the above-mentioned property for inspection purposes. t gnature (Owner/Agent) Date �u ✓-"3'� BUILDING PERMIT PERMIT# DATE f ` VALUATION LOT . . CYfSYI,-L%.[1 TRACT JOB SITE+y ` % APN ADDRESS 1/7-740 CATAX. COLT -04A. OWNER CONTRACTOR/DESIGNER/ENGINEER D1~ i t T C --GYVE Dk%VEi CIP—la ! ,1W, PA.0 D t1 E+ VANTS 1YLI. ,1039 WC'. 111, �l+:1�'�.6 1?,KT�al�D£:� . tu'1 p.1-UG5"3>aF11AY' �� /�ryrf LA Q L.?"11 TA CA . `.4. 5 3 LA �!yp�c�?� .��.� C�•fii,��.1.9.J�.� CA J �4 50'I (760)399-141-1 CBW 62A6 USE OF PERMIT SUPP.€.ERb3XW #AL PEti.A{IT TO CIHAAtW C'1$? COT4kAC cm, (OR10. .ri;aAPAI•{.�,7'dd'J.+S..�il ) COS�� QJJ': �n�3�t��.� 43li bdi+�'i�G '4irVfJ' �.y,q��q��a pp�� R'�7fe.R�.7XJlA.'.f. �SBf. tNUMM-A(0.Y :YUPTILEME149'.A+?,r PERMIT FU 1.01:060-423.000 � '�S► D JAN u 9 2002 CffYoF LAQUWA 9 7k..�: T1CW_KL Cowir-1+;.UPT109"JO a 1.1m C HWIC `A.10 1,10B PRE -PAW $0.00 rwrm, rawarrds DUN now $460 RECEIPT DATE fj �? 1B �....:...�_..�.....,... DATE FINALED DATE INSPECTOR /�r INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING 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 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 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 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 a0 o2--' Utility Notice (Perm) COMMENTS: