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9812-054 (SFD)r 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 6.71203 n Vll199 r ,.):)ate 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).: O 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. ' (',.)yl 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: Cartier Policy No. 3"t'+l Ftm 1-144573-9h (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, Ishall 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 provisions. Date.' 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. (.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. Signature (Owner/Agent) G y? ' Date " 'BUILDING PERMIT PERMIT# ` DATE + VALUATION S41_f€ 60 LOT ^t, 7 TRACTJOB ,737. SITE 7?EERLIpnS% PLACEAPN ADDRESS 8-M3 i69 -%M01 OWNER CONTRACTOR / DESIGNER / ENGINEER AXI 1'. EW PIERCE (:>r RPOKA'nON ,!<:fvDt:EW PIERCE CORPORATION 44-835 DEEP CANYON RD 44-8.33 DEEP CANYON R.D PALM DESERT ' CA 92261 PALM DESERT CA 92261 (7661346-3M. C'RUI :3031 , USE OF PERMIT SiNC,,LE FAMILY DWELLING SM-PEi2J.+ T WES Nar INCLUDE &OCK'►jWA S OR. POOL POT) CI.UPA'It0 907.00 Sr. Aic��c+rrartl�oC �i:cw SF ESTINI IA TED COST deli' CON9'If'RUCT11116N 409,-737.60 PERNFIT PRE SUMMARY COhi.,'.°!RUC,"1'10N FF6 101.OW-418-000 p71t1N CHPIK. FRE l01-000-4VA!8 $1.38!.94 F€ - DEIPOSIT 101-000.439--"!S _31,€00.0 WiCfIAN1CAL IEEE 1101-000,-421••tiOtJ S11.68.50 E'LF.CI [CAL F'6P 101 -WO -42.0 -WO SgA3.TI N,o ifb4!,NC3 rF_F MI -N10 -419 -mo $:733.50 S ('1u)74(; &!C?'I I(iN'.1:i3 - 21�sw 101-00€. -241-000 GRA XN0 Fl3f, 101.-000-423-000 `w3..€i.tsia I'NVRASTIatlC I'LfRfi t'is'#i 225-000443-3.42 $6,Oili1.(1ij AR 1' IN Nt)BLIc'' PIl Ar''.E.S- ".101-000-755-00. 0 t SI,cF'=diJ%/1_C. (%)N!1 t'i3LIC CION ANT.) PI_..NN €,:1-{P.cIX $10,572 67 LESS PRETAID FEES sI,omoo � p�]■+ pipp. LL. �►.§A'�{{{ pp..QQ�� j� y 77��ay t�y�I 9r :�•� .�'�''rl1,AL ! Y+.i.LRMIT II`A.` ES OU21 NO ; ^dry, p' 59,5 2,62 59,572,62 kft nil 19 RECEIPT DATE BY 1 p DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR Footings BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Equipment Location Z Underground Ducts Forms & Footings ,q Final Ducts Slab Grade Steel Gas Test Electric Final Return Air Combustion Air Roof Deck Plumbing Final y f' Exhaust Fans OX to -Wrap O.K. for Finish Plaster Sewer Lateral F.A.U. Framing Encapsulation Gas Piping Compressor Insulation I Vents Condensate Lines Party Wall Firewall Exterior Lath o'er Drywall - Int. Lath -/ I t.- 9C Iln I V -r Final COMMENTS: ELECTRICAL APPROVALS Fixtures Main Service Sub Panels Exterior Receptac G.F.I. Smoke Detectors Temp. Use of Prn Notice 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 L Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection -FS7 Encapsulation Gas Piping Gas Test Final COMMENTS: ELECTRICAL APPROVALS Fixtures Main Service Sub Panels Exterior Receptac G.F.I. Smoke Detectors Temp. Use of Prn Notice ccupancy Certificate of O Ci to f La. Qu n�tayr D ,W 11A rtanSafety,rnenepaBuild t: his Certificate ssued :pursuant `to the requirements of Section- 109 of the -Uniform Building Code, ,cerbfyig9 that, at the time of .issuance,. ,this structure . vas .in comp/lance _with the various ordinances of the City.reg►u/atmg. bui/ding construction..or use. For the fo/%wing: BUILDING ADDRESS: , 78=583 PEERLESS PLACE: .Use Classification: SFD Bldg. Pe. -054 Permit No 9812 Occupancy Group: R 3_ Type -of Constructions: VN Land Use Zone: ' RL . Owner of Building:. ANDREW -,PIERCE. CORP. Address:. 44-835 DEEP. CANYON.: RD 7. City:: PALM DESERT,. CA 92261 By: :STEVE TRAXEL- Date: 0.1-24-Q1' Building Official POST IN A CONSPICUOUS PLACE : t Building Mailing Address -1-1 City Zip Tel/ Contractor Address " *BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO QUINTA, CALIFORNIA 92253 City Zip Tel. F .G`� �.-'�' !��� �- State Lic. City & Classif.'' , (r© ' Zt� Lic. # Arch., Engr., Designer 2k 1 &"W_ Te"V1 i rl,2A_ F f "' Address Tel, City Zip. State �f qq r L66 �L'Pfirl l.C�� �' LIC. #v ( 6 LICENSED CONTRACTOR'S DECLARATION I herebyy affirm that,l am licensed underrprovisions of Chapter 9 (commencing with Section 7000) of Oivisioh-3 o):the Busi ess,ariil%Professions Code, and my license i in ull fo cern effect. .f �-!/'r1�'�'�L1'1/S�. / IS �.C. /fi/ria OWNER -BUILDER DECLARATION I hereby affirmthat I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a permit to construct, alter. Improve, demolish, or repair any structure, prior to 'its Issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis for the alleged 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). l; 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, 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.) I'I 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 contractors) licensed pursuant to the Contractor's License Law.) 1-1 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation nsurance, or a certified copy thereof. Sec. 3800, Labor Codey Policy No ,� - Company?�'-��N� Copy Is filed with the c ty O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work. for which this permit is issued, I shall not employ any person in anyamanner so as to become subject to the Workers' Compensation Laws of CA "0cnia. Oate0'ner NO7'ICE'+TO- APPLICANT: I!, offer making this Certificate of Exemption you should become subjC fo the Workers' Compensation provisions o! the labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant —Date— Mailing ateMailing Address City, State, Zip BUILDING: TYPE'CO//N--ST. / OCC. GRP. A.P. Number 7(0q — 1& 2 - 601 Legal Description 1 3-7 ! IQ!-F� 29elln' % Description Sq. Ft. No. No. Dw. Size Stories Units New O Add O Alter O Repair ❑ Demolition ❑ / i - /J 1 / PERMIT AMOUNT Plan Chk. Dep.0 U V Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line it FINAL DATE INSPECTOR Issued by: Date Perm t Validated by: Nny 3()-199$ Validation: 6 1 -�V i Y 0 i LA, i1 1 Ti WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDI`NG DIVISION Desert :Sandi Viiif ed School District ` -.47 950YDune Palms Road: Notice: La'Q1dmta,CA;92253 Document Cannot Be Duplicated 760 -Iii -45,15 CE1jkTIEICATE OF COMPLIANCE Date 2`/23/99 APN'#762-162-001 No. 18383. '. • .. Jurisdiction 'La Quinta Owner NameAndrew Pierce Corporati011 Permit # No. 785:83 Street . Peerless Place Log #. City La Quinta zip`; ".92253 Study Area Tract # Lot # Square Footage 4775 Type of Development Single Fainily Residence No. of Units 1 Comments 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 stru6- ills or"`replacement:mobilehomes. ,;. 1.. ;�., ., It has been determined the above-named owner is exempt from paying schooi fees at'this time due -'to' the following reason: 1_ � j •' is . V. .. . EXEMPTION NOT APPLICABLE This certifies that school facilityfees imposed ursuant to -Government Code 53080; in the amount of P P 1.93 X 4,775• . or $ 9,215.75 the,prope'rtyaisted above and'that building - - permits and/& Certificates of Occupancy for this square footage, in this proposed project may now be issued Fees Paid By cc/PDNational Bank/A. Pierce Corp. Telephone 564-7915 Name on the check By Dr. Doris Wilson Superintendent': , Fee collected /exemptedby Adriana Oauto Payment Received $9,215.75 Check.No.,, 74660 Signature) NOTICE: Pursuant of Assenibl Bill 3081 CHAP 549 STATS: 1996 this will serve to not h y ( ) notify';36166t the 90 -day approval penod,ih which ybu may protest the fees or. other payment identified above will begin to run,from th' dale on which the bwldmg of installation permit for_i iii project is.,sssued or on which they 'are pald,t&the District(s) or to another public entity authorized to collect them on the Dislrict('s)(s) behalf, whichever is'earlier.'' Collector: Attach a copy of count or city PIan check a `Plicafion form to district co'P,y. for all waivers. Embossed Original- Building Dept./Applicant Copy:- Applicant/Receipt Copy,- Accounting` f 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 stru6- ills or"`replacement:mobilehomes. ,;. 1.. ;�., ., It has been determined the above-named owner is exempt from paying schooi fees at'this time due -'to' the following reason: 1_ � j •' is . V. .. . EXEMPTION NOT APPLICABLE This certifies that school facilityfees imposed ursuant to -Government Code 53080; in the amount of P P 1.93 X 4,775• . or $ 9,215.75 the,prope'rtyaisted above and'that building - - permits and/& Certificates of Occupancy for this square footage, in this proposed project may now be issued Fees Paid By cc/PDNational Bank/A. Pierce Corp. Telephone 564-7915 Name on the check By Dr. Doris Wilson Superintendent': , Fee collected /exemptedby Adriana Oauto Payment Received $9,215.75 Check.No.,, 74660 Signature) NOTICE: Pursuant of Assenibl Bill 3081 CHAP 549 STATS: 1996 this will serve to not h y ( ) notify';36166t the 90 -day approval penod,ih which ybu may protest the fees or. other payment identified above will begin to run,from th' dale on which the bwldmg of installation permit for_i iii project is.,sssued or on which they 'are pald,t&the District(s) or to another public entity authorized to collect them on the Dislrict('s)(s) behalf, whichever is'earlier.'' Collector: Attach a copy of count or city PIan check a `Plicafion form to district co'P,y. for all waivers. Embossed Original- Building Dept./Applicant Copy:- Applicant/Receipt Copy,- Accounting` Dear Builder: 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 report and 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: . 21FL4^7 0 - 1 LOT: ?J" 3 3 PUBLIC WORKS AUTHORIZATION ATE F:IPWDEPTXDOCSkFORMSIPW CLEARANCE LETfER.ss COMMENTS: IMI 4 1iz !�� 09 P' - ��® r REGISTERED INSPECTOR'S WE AY j0N 'ANDY RECD 37630 Medjool Ave. 13UILDte�IG '. Palm ` , D"e' rt, CA 92211 timv oAF�E lu _' +< =` tit Office`^4 (:760) 772-7192 Fax;; {760) 772-7193 . Pager '(760) 776-3338 :KLYREPORT,` x t TYPE -OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ,. ❑'STRUCT. STEEL°.ASSEMBLY ❑ POST TENSIONED CONCRETE ❑'ASPHALT p, ❑ REINFORCED MASONRY' ❑FIRE PROOFING ❑ ❑ OTHER JOB �9/ o ` G'� REPORT SEQUENCE NO. T T ICTURE ' T PERMIT N0. '; '13,1 DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT Y: A lr, IN CTOR HRS. CHARGED • ENGINEER' •+�GT� V U� ASSISTANTS I ` HRS. CHARGED INSPECTION DATE SUB GENERALopt CONTRACTOR t e.t CONTRACTOR - V V7s.v t - Q(Av -neuCrGJ r . y i f. [ 7 { COPY SENT TO CLIENT Cl' CONTI ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE -BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND -THIS WORK TO COMPLY WITH,THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING - LAWS. .. NA RE qFg STERED SPECTOR IT DATE OF. REPORT REGISTER NUMBER ` cls OF I -A �JON TAN DY g rr„„�� 37630. MedjooI Ave. m 6 REC'0Palm • Desert, CA 92211 r, '' •_ ^ t'`Office. (760) 772-7192 � .,;.'BUILDING. �Cyd � _ Fax . (760) 772-7193 INSPECTION Pager (<760). 776=3338 .-: ; ':te • J•s !,'1,. i"� it -f ;r � � !_7 Y . . 4 � i �-� - REGISTERED INSPECTOR'S, WEEKLYl;REPORT -s TYPE OF." REINFORCED.CONCRETE', ' TO STRUCTSTEEL�ASSEMBLY. ❑" INSPECTION T100, POST"TENSIONED-CONCRETE ❑ ASPHALT:'>" ' ❑ OTHER , !PERFORMED REINFORCED MASONRY.. ❑ FIREPROOFING JOB LOCATION," ,' ;,y,.+ r`.eit` 4'd'REPORT•SEOUENCE NO. TYPE OF STRUCTURE � .. PERMIT N0. �� -, � DATE QQ DAV OF WEEK MATERIAL DESCRIPTIONrya ARCHITECT +� h.. • )NSP E OR - HRS. -CHARGED - ^`\� - - +� •^ ;h, ENGINEERS �, ASSISTANTS - HRS. CHARGED __ _ __...�- •� _ _ .__ ... .__-`�^_-C-.:.._...:..>.. .r-�•. __ ._':.as acrd :=c'-----„` INSPECTION GENERAL ` Ytl i��t yy SUB TOR CONTRACTOR DATE - CONTRACr1 LJ, .7 �b s C 0CaLEv- oFi—Ec` o Co�� ' ILvvZ C ftafos cxs k4lo • 4 = C.c - +��� �` r' as c<e.� � i w� � e�o l c, �w� E�1•'All, - ." 1 $ . • A , 6 C'. o, -N e r I ' GDC S'0 t �+� p►� f''k T o r .0 y "NE. 'sc o 3 'coN2 �.Ei Jr 6• > 4 • iI -i COPY SENT TO•C LIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF'COMPLIANCE I HEREBY CERTIFY THAT I HAVE•.INSPECTED TO'THE BEST OF MY KNOWLEDGE ALL OF,THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO.COMPLV•WITH THE APPROVED . a PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. 'SIGNATURE OF REGIST RED INSPECT • v D'•A®T�OF� REPORT REGISTER NUMBER