9902-129 (AR)LICENSED CONTRACTOR DECLARATION
I,fiereby 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
341036 E 8s31� 3
Aa e'l—__Q -ft1Signature of Contractor `)
OWNER -BUILDER DECLARAT ON
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 yrfPolicy No.
.. ri.,", A'�'ND 211 " ' .
(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
C?e, I shall forthwith comply with those provisions.
D te: Applican01
t l,}
Warning: Failure to secure Workers' Compensatlon�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 f
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, indemnity
& 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-mehtioned property,for inspection purposes.
k
Signature (Owner/Agent) ), -- Date^N �c1 fiG
/ ") I
BUILDING PERMIT PERMI 9412-1
Z9
DATE VALUATION LOT TRACT
"' • 14. Q
JOB SITE
ADDRESS 4'&986 % i)AC.`ldlli,Ll A DRAVE
APN 646-2641-110
OWNER
CONTRACTOR / DESIGNER / ENGINEER
rRfCff A Q41 -TER
ROG CR, L. 101FNS,10N
303 Sc?fi1lEl0h"1' OR
773301 .JLJN1PEfL
-SHAWN QE MIS;cll.ON KS . 662OX
PAI -M DESERT CA 92260
(70())5684205 QRT-1t, SSBI
USE OF PERMIT
1�E81t)EN'11" A -01)1'110N
124 S.P. AD0i7i.i,)fi 'i 0 f rJ CIRE '
w rte+ �.rt r. it waren. r.wr e.. r
1.1.;.3�.it.lN.�l i,t�l`�N��lk.ly T, tt,'1} 1tr4.00 .JI'
R,Rk`1 I' F L E SIC, M41ekiIV
PLAN C':IWK.FEL 1()!-Oils-��-�ln 417ri:0i
i`(1i11?aii�ls'i"1'1r�'rijT;F+I+ 1014W)�4I941i1()
10.1 °001-12j.-wo
tf l 1 i.`t_t.Ct1i fs% 101-t1a1-4120-0017 :51.9.33
P1 IJ141f11Nt t fr'3.F� 1()1-0(30-414.0110 SZ1 00
wRt' mn A,tryrfow 1:9?r, rt titft 101-()(K).741-(101)
i411WA . C N�� i R1 t") ON NN1i P1.AN 01t:C1
12 4')'A-,
1.:(:S: -S PRE- PE.rS
$0.00
g
�IMA1,Pk'XMtET ii'1'e%S DUE, NOW
X24'}.34
1999 I
FLEOEIPT G `�
DATE r i Jf d
r
B�; V V
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE.
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Underground Plbg. Test
Ducts
Slab Grade
PLUMBING APPROVALS
Return Air
Steel
Heater Final
Combustion Air
Roof Deck
-Z/ - -
Exhaust Fans
O.K to Wrap
O.K. for Finish Plaster
F.A.U.
Framing
Sewer Connection
Compressor
Insulation
_5 7.
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
—(Z—
Drywall - Int. Lath
Final
Final
BLOCKWALI A PROVALS
POOLS - SPAS
COMMENTS:
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
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
COMMENTS:
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
Notice:
Document Cannot Be Duplicated
Date 2/24/99
No. 18387
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Jurisdiction
Owner NameErich Quer
No. 49980 Street Coachella Drive
City La Quinta zip 92253
Tract #
Lot #
Type of Development Residential Addition
Comments
.24 sq. ft. addition to kitchen
APN # 646-260-010
La Quinta
Permit #
Log #
Study Area
Square Footage 124
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:
Residential Addition 500 Sq Feet or Less =
EXEMPT
r �
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amouni of0:,.
0.00 X 124 or $ 0.00 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 n/a Telephone
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Adriana Gauto Exempt
I7
Signature
Check No. n/a
NOTICE: Pursuant of Assembj� Bi113081 (CHAP 549, STATS. 1,046) 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 t e date on which the building ori allation 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
I
March 25„ 1988
I
TO DR.. AND MY f .E;RICH QUI' -.:R
In.your letter.of March 18, you requested approval to
make certain a-dditi.ons and altera ,ions to your condo-
minium and, in support of your request, you have
submitted sketches showing what. you plan to do. You
have stated that, if approved, the remodeling will be
carried out in the same good tas.te as your previous
addition and will maintain the harmony.of-external
design and location in relation to surrounding -structures.
In summary, the plan is as follows.:
1: The west wall of the living room/dining room area
would be r,,owed out a. distance of six feet and the roof
line would be changed slightly to accommodate the ex-
tension. None of this would enclose the common area.
2: It would encroach on the common area only to extend
the patio area five feet from its westerly lane. This
would allow a patio slightly sntal.ler than the present
one.
With the. understand.i.ng that in executing .your plan you
will comply with the fo.rego:i ng specifications and repre-
sentations, the Archi..tect,.aral ComMittee unanimously
approves yourr
SI GN ED:
;alter-ohnson, Chairman
Architectural Committee:
Walter Johnson, Chairman
Bill Bradford
Edga..r. Rodgers