0811-007 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm 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
Date Signatureof Contractor
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason:
Q,,.,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 ycontracting with ,licensed
contractors to construct the project (Sec. 7044, Business & Professionals Code).
O I am exempt under Section B&P: '. for this reason
rDate • - Signature of Owner � ,
r 0 4
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.
(This secti6n need not be completed if the permit valuation is for $100.00 or less).
(IV 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 Section4700 of the Labor
Code, I shall forthwith comply with those povlslons._� '
Date: Applicarit
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 application agrees to, & shall, indemnify
& hold harmless the City of In�li�n�Lgll� 'iaofficers, agents and employes
2. Any permit issued as a result of this application becomes null and V_ d If
work is not commenced within 180 days from date of issuance ofj= Lich
permit, or cessation of work for 180 days will subject permit to canc�e1latiO4%
I certify that I have read this application and state that the above info�atj is
correct. I agree to comply with all City, and State laws relating to the 64,ild'
construction, and hereby authorize representatives of this City to enter up n
above-mentioned property for inspection purposes.
Signature (Owner/Agent). Date
ALC 9 I
BUILDING PERMIT
PERMIT: ,
���n-ft��
DATE i? 1. 1179.7VALUATION
57767
TRACT
JOB SITE ADDRESSZ 6ZI P.AUS 0 T[�R
APN 646-03,iPeb11
OWNER
CONTRACTOR
OV ,� R t.I1I.�D R
R08UWr .'.., ,cz At1NJ, %1FrC'j Al'
SAM); AN Af3OW
48021 VA8F '!AIt..f'1W
I,A t UINTA CA 92293
(A0.4
DESIGNER/ENGINEER
USE OF PERMIT! {'JI )
PX IO C'OvkK Ai'i'ROX l#rXtr
FEE DESCRIPTION
FEES
I'i,dCt iirrtk i'iC 170 (W Iiir'
EST; N UMD C't7ST OV C:ONIS"0'i.`.3Jt:'jt CO'�"r'
2,2£1.043
�'.l��Qtlar4YI �'a�;a° tilltb�A�cltt�'
pf1AN r'IfFI;'KI>I'F 101-000-1 10-318 ? .1
: rokNk;M0,111014,FEE looms, 21114100 $,ali
Sf;TP-TOTAL C01%J9i' V(__710'N MD PJAN CI3IaOK
9 0
LESS I'U' 1`AID FFFS
$0.00
T01"At. IPI+�RWIrr v r�F�.S 3)4[�t,, Now
SM11 160
2 p 1995 �
ivrAL PROMCT I" C,R IT FI+,ES
l��,Ci4i
RECEIPT
DATE
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 Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
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
POOLS - SPAS
BLOCKWAL
A ROVALS
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
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)
&atter lla. • Speciy
_ 2 xb &. 24
$06 `otlait vote 64lo+
1pcNft Scally l air 0
ShootRlo. e►ee LatticeLI
Xltlm. lrslr
/meta lr
�l/S"sS- Ial germlite etds at li- •.e,00.
Irak
Ilk
O�tlewre Wler
Provide 1'
learanc
ost To
Concret
Met lBalea or !ells Blocking
rail la:ter to 11WAIRS
A• fie,. R. w 4 - li IS mails ear bolt
M% -Q . m:ar IM
SOM QwwM RJUMC UMC laeaer f is ewe.
Qom[
4L• 4• t.
wimm Sm I1: •+ i to IN
N r
Qadinq %AIM
R
(feet s lacAas) n•�• r'i i.• t to �_7
0tJse 1• 11 tc•2.07. A.
ZYPIGL P�TiG COVER
h 701
12 tri..
78-495 CALLE TAMPICO — LA (]UINTA, CALIFORNIA 92253 - (619) 777-7000
OF FAX (619) 777-7101
November 14, 1995
Mr. Robert Metcalf
48-_621 Paseo Tarazo
La Quinta, California 92253 -
SUBJECT: SETBACK ADJUSTMENT- 95-360 .
LOCATION - 48621 PASEO TARAZO (LAGUNA DE LA PAZ)
Dear Mr, Metcalf:
This letter is to report approval of your recent application for 'a setback adjustment, pursuant
to Chapter 9.188 of the City of La Quinta Planning and Zoning Regulations. The'following
setback adjustment has been approved subject to conditions and in accordance with attached
Exhibits A, B, and C.
SETBACK ADJUSTMENT: Rear yard setback reduction
FOR: Patio cover in rear yard
CONDITIONS: a. Obtain building permit from Building & Salty Department
b. Comply with Laguna de la Paz architectural. requirements. -
c. Support posts. (4" x 6") shall be no closer than 3' to rear property
line with maximum 1' eave overhang into 3' setback.
After review it was determined that:
1. This adjustment is consistent with the intent and purpose of the zoning
ordinance.
2. There are special circumstances applicable to - the property, including such
factors as size, shape, topography, location. or surroundings that justify
approval of the adjustment. These special circumstances Ere:
a. Small rear yard size
b. Provision of open space at rear of property
Itrss.332
MAILING ADDRESS - P.O. BOX 1504 LA OUINTA, CALIFORNIA 92253
stment will not be detrimental to the health, safety, and general
'the community or be detrimental to property in the vicinity of the
which the adjustment is requested.
I d ►
3.
stment will not be detrimental to the health, safety, and general
'the community or be detrimental to property in the vicinity of the
which the adjustment is requested.
ViALWW
CLOSE7_
C
vl�!�focm c
C
C
lard BMAT
e b
t"7111)
. ---/ I
1950 SQUARE FEET
WING ROOM
FORIVIALDINING
THREE BEDROOMS - TWO BATHS -
FORMAL DINING ROOM • KITCHE
ENTRY ii, WITH BAY-VIINDOWED NOOK
ATTACHED GARAGES #2
InetBEDROOM j! I . ... . . . -
In the interest cf continuous improvement,
B AiTHRM Laguna de /a Faz Association reserves the right
to make modifications to plans, exterior
C)- —WV -Jt designs, prices materials and specifications
at any time MOW prior. notice
All maps, plan., and elevation renderings are
BEDROOM #3 artist's concepifons and not necessa
fily to
scale: All squaw footages are approximate.
Fencing and wsft will vary according to size
andl'ocation oP lots.
11NE
MORNING
I
ROOM
-KM>EN
O
MASTER
st
PIan 2
.BEDROOM
r
ViALWW
CLOSE7_
C
vl�!�focm c
C
C
lard BMAT
e b
t"7111)
. ---/ I
1950 SQUARE FEET
WING ROOM
FORIVIALDINING
THREE BEDROOMS - TWO BATHS -
FORMAL DINING ROOM • KITCHE
ENTRY ii, WITH BAY-VIINDOWED NOOK
ATTACHED GARAGES #2
InetBEDROOM j! I . ... . . . -
In the interest cf continuous improvement,
B AiTHRM Laguna de /a Faz Association reserves the right
to make modifications to plans, exterior
C)- —WV -Jt designs, prices materials and specifications
at any time MOW prior. notice
All maps, plan., and elevation renderings are
BEDROOM #3 artist's concepifons and not necessa
fily to
scale: All squaw footages are approximate.
Fencing and wsft will vary according to size
andl'ocation oP lots.
y
-
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0
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I
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-
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LAG
u
1)E 1.A PA7.
ARCHITECTURAL VARIANCE REQUEST
Unit 1 Date 11171,?S
street Address '7`�6�/ �iS��G'o.' Ti472itza
Local Phone�7 /— �S % 9 other Phone
To the Architectural Committee:
we, the undersigned owners, request your approval of the
modifications proposed on the reverse side i).f this form.
Attached :re drawi-�s :f the t.. -
maLer1.ii to be used are •indicated on the d7swings. we
understand that building permits for home improvements are
required, : n
by the .City of ..a Quina and that ."the cost .of the
Permits and responsibility of obtaining permits .and
subsequent inspections will be borne by 'us.
we .ackowledge that'all approved changes I.n the original
design will be at our expense; that any, damage to or
relocation of existing sprinkler systems,y.nd'e-rground
utilities,, .building, structure and. exterior landscaping or
other damage resulting from construction ofthese permitted.
improvements will be at our expense; arid' that maintenance of
the pe-rmltted.improvements will be at our expense.'
Signature of all owners:
�O�VsTRvcTio� aCi/yIiL 7-o �.�T�!-c�ojr ter'
Please privide as much detail as possible so that the
Committee may consider approval without delay!
�O,ulreuCn� �iyliu'/t� A -rate) 102c/t""
oP�O Vd1� �2 /�'vi o f«,5r /llFi X T 00
L,6 A, .
The above proposal has been reviewed by the A:chit.ectural
Committee and 1 been:
APPROVED REZECTED PENDING FURTHER
INFORMATION O
Comments:
Pr l