9906-033 (SFD)- _z .... x
LICENSED CONTRACTOR DECLARATION
1 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 * •;,' I Lic. Class Exp. Date
X5599 B ovi ttl0!
,/bate 1 (fi 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 1 Policy No.
i -f ATE
]Vf,ry J'YEII
(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 pro Ions of Section 3700 of the Labor
Code, I shall forthwith comply with those visions
i/Date: t. -- / - 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.. I
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 benefif 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.irispection purposes.
VSgnature (Owner/Agent) r /' . - 1 " w
r,. �. • :� r. � _ Date
PERMIT # -
BUILDING PERMIT
9511,116.03
DATE " VALUATION $174,.11 ,1 LOT '�� TRACT 2 429
SIfE'
ADDRESS 7�4.t15 QUtia�. Cl�i(i.SISING
AJOB PN 769-582-024
OWNER
CONTRACTOR/DESIGNER/ENGINEER
��tr:I: I'REL1.,I-I'.Atrn' COVE tNC.
COW, IINC.
74785 '14WI' III Sl:8.105
74185 H%VY 1.I x STE 103
INDIAN WELLS CA X210
INDIANWYLLS Cts 92210
_
(760)';'n6,44-50 C18L# 305
1
USE OF PERMITv
SfNGLE FAMILY DWELLING .� �
'16 CORPORATE TE PARK
SFD - PE -MOT DOTS NOT INCLUDE BLOCK WALK, OR 1`001.
'Iiatpl.V.;i CM Sl%2U< RX4 a,84�.GG F
i
PORCEYPA:TIO ;, `x]6.00 Sr
Gi1Ri10EfCAf010RT 646.003F
.Y.ia7�Af4k.� tilt. o9.I, a. ✓i VT�N,4 ii l.T4�1l�,riM
,A. i`i�D. A.�►.wni
!'f!',t'1 FE,.t:SfllMMARY
,
CTJNS7TRWTI0NFEE 1.01-000-4184)Q(3 �9tJ2.Oft
Pls.AN Gilk�Ci�; �?1 1Q! tit? 439-3141 �7Rt);�?
4
M,130. IANICAL -.0, 101-0 ..421-000
FLT f.ItICtVl.F't„-9 141-000-424-000 $1807
P.LT,WINO 17U,' !1'9.1-W-414-000 $LE0.1y
SlIZONG N110 'ION IMEH K;JIES:JD 10.1-0G4-241-000 $171A.i
GR.: OrNc 1 101-000-42:3-050 S20,00
3SSiI:'it<X8"J',fti7t;: rU iS.FEE 225-000-443-342 53,763.21
1112:7' IN $?MLIC PLACES - RE`l11: 701 -000 -25:5 -WO $J8,3.2i)
r
11 'tY_ti'AJ �'.c�hi9r_RI:TC'Y'!0N ANT-) P_,A_N CHFCK
'0-;2I2.�(t
&S FLIMS
I✓��SS PP
42.50.00
Wlir :Adm P1+..48'ti!1I'e_" RDD,3 f;±: "lV08V
S5,9�►2.3iY
RECEIPT
DATE
BY '
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
' BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms,3 Footings
jp--f--q ly
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
— g—
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 --
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
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wirins
Fixtures .
Main Service
Sub Panels
Exterior Receptacles
G. F.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perry)
APPRO ALS
r
—�
COMMENTS:
P.O. BOX 1504 APPLICATION ONLY
Building/j /� 78-495 CALLE TAMPICO
Address 6 s (� 1.4 f c / f1n: s, W r LA OUINTA, CALIFORNIA 92253
Mailing / {''
Address '%e/ 1S 5- !w y /I I Jut
`t F"
City P Zi Tel.
A0141VWrILS qazro 17,4-1-/41so
Contractor
Address
City
State Lic.q p I City
& Classif. (j 1 7 �7 (C'1 Lic. #
Arch '
Desi9nerSir,
Address Tel.
City IZip I State
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 Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, 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 or 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 ($500).
I; 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, Buisness 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 owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
I1 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(s) licensed pursuant to the Contractor's License Law.)
I'] I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
Ihereby 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
n Copy is filed with the city. O Certified copy is hereby furnished.
i
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is lot one hundred dollars ($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: If, 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
I hereby 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 if 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 sof this city to enter the above.
mentioned property for inspection purposes.
Signature of
Mailing Add
City, State,
TYPE'CONST. OCC. GRP.
Number `?,a °/off 0_9 _I -r
I Description L a T 10
Ict Description SFir%
Sq.
Size Ft. �Y r Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
M
Side Setback from Property Line
FINAL DATE t INSPECTO
Issued by:—Date----Pe • I
Validated by: MAY 13 vm
Validation:
J
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
., <Q orb",
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
M
Side Setback from Property Line
FINAL DATE t INSPECTO
Issued by:—Date----Pe • I
Validated by: MAY 13 vm
Validation:
J
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 9/11/98
No. 17700
Owner NameMinistrelli-Painted Cove, Inc.
No. 79-165
City La Quinta
APN # 769-542-024
Jurisdiction La Quinta
Permit #
Street Quail Crossing _ Log #
Zip 92253 Study Area
Tract # Lot #70 4a Square Footage 1
Type of Development Single Family Residence No. of Units 1
Comments
f
Under Grandfather Agreement 2,980sq. ft.
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:
Under Mitigation Agreement
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Mitigation Agreement in the amount of
628.00 X 1 or $ 628.00 the property listed above and\,tha't-building
permits and/or Certificates of Occupancy for this square footage in this proposed project-iliay now be issued r
Fees Paid By CC/1 st Community Bank/Kevin Peters mto
elephone,.;,776 1450`r
Name on the check F ', `• f` -�
By Dr. Doris Wilson - t!
Superintendent
..,;
Fee collected /exempted by Juanita Green Payment Received $628.00
Check No. 081667
Signature6v114Mr1_1,�
NOTICE: Pursuant of Affiembly 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 tTom 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
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
Dear Builder:
TW�p 4 4 Q"
PUBLIC WORKS CLEARANCE LETTER
FOR
CUSTOM HOME LOTS
Prior to issuance of a building permit, you will be required to obtain clearance from the
Public Works Department for one, or more, of the following:
1. Verification that rough grading is complete, and the pad elevation certifications
prepared by a licensed surveyor, or engineer, are on file in 'the' Public Works
Department.
2. Verification that infrastructure improvements and other required tract improvements
are complete, or sufficiently advanced to warrant building permit issuance.
3. Prepare an engineered grading plan that provides for on -lot storm water retention,
and have it checked and approved by the Public Works Department.
• Tract 26524 (Estancias)
• Tract 26769 (Mountain View Estates)
4. Prepare an engineered grading plan that provides for building pad grading in
accordance with the existing soils reportand tract grading plan, and have it
checked and approved by the Public Works Department.
• Tract 28034.(South Valley Estates) .
FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT
TRACT: �� 1
LOT: D
PUB IC WORKS AUTHORIZA ON DATE
FAPWDEPTIDOCS\FORMSXPW CLEARANCE LETTER.ss
COMMENTS:
OCT -22-98 THU 03:14 PM MDS CONSULTING
MDS CONSULTING
PLANNERS . ENGINEERS • SURVEYORS
17320 Redhill Avenue, Suite 350
Irvine, CA 02614
October 22, 1998
Engineering Department
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
FAX NO. 714 251 0516 P. 01
Posf-46 Fax Note
01 1,
7671 Date S vt�
To t
From —2
i�
CoJDept.
Co.
Phone #
Phone 4
Fax!1")
Fax t
Rough Grading Verification
La Quinta - Tract 25429
We have checked the area referenced below and find it to be in substantial conformance the approved
rough grading plan.
Lot #
Elev.
As -Built Elev.
Variation
54
45.0
45.1
0.1'
57
45.1
46.1
None
65
47.3
47.3
None
66
48.1
48.1
None
70
(075
50.4
0.1'
72
49.5
49.5
None
73
47.3
47.3
None
74
47.0
47.0
None
75
46.6
1 46.7
0.1'
Stanley C. MoYTd
R.C.E. 20596
Expires 9/30/01
G:1307W4\cer-1154.57.6566.70.72-75.doc
S
Q;�pF ESLn
No.
20596
Fxp. 9-30-0146�
S
STANLEY C. MORSE GARY DOKICH SKIP SCHULTZ
>fl JUN -21-1999 10:41 ESI/FME 949 261 8506 P.01/02
ESI/FME, Inc.
STRUCTURAL ENGINEERS & CONSULTANTS
June 21 st, 1999
MINISTRELLI CONSTRUCTION CO.
50-445 Mountain Shadow
La Quinta, CA.92253
ATTN: Kevan Peters
RE: Roof Truss Calculations and Layouts on "PAINTED COVE", Plan 7A - Lot 70 to
be built at 79165 Quail Crossing in La Quinta for MINISTRELLI CONSTRUCTION CO.
(ESIIFME 194-6225-123 / BBG 124-0612)
Dear Mr. Peters:
We have reviewed the calculations and layouts by SPATES FABRICATORS and they appear
to- comply with the requirements of our calculations'and plans.
The review of these drawings does not relieve the contractor from compliance -with the'
drawings and specifications. This check is only for review of general conformance with the
design concept of the project and general compliance with the information given in the contract
'documents..'The contractor is responsible for confirming and correlating all quantities and
dimensions, selecting fabrication process and techniques of construction, coordinating his
work with that of other trades, and performing his work in a safe and satisfactory manner.
In addition at your request, Our Office will provide field observation for the above mentioned
project.
Thank you for your attention to this matter. Please do not hesitate to contact us if we can be
of further assistance to you on this project.
Sincerely,.
ESI/FME,Inc.
STRUCTURAL ENGINEERS
By:
Danny Matsumoto, CE33307
1921
E. CARNEGIE AVE..
UNIT 3-J, SANTA ANA, CA 92705 •.
Ph. (949) 261-1811 1 FAX (949) 261-8506
Z/Z A
8881'ON
L911A LL 09L ANVAOO
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