Loading...
0010-265 (SFD)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 ?40145 09nCw1 f ,.Date9� 6—`o Cont Signature of ractor - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, 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. I'PdD29MI'T7 INSi OF' C44044` 439 (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 thn'ose proVisions. Dater Applicant- Warning: pplicant 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, 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-mentioned property for inspe flon purposes. 1 Signature (Owner/Agent) * - Date1 )--.L� BUILDING PERMIT, PERMIT# r- r+l DATE VALUATION LOT t�° e#y TRACT r'.(....`!...!/ems"!"`0 ,��� �.i., ii.i+ �� •�}atDCSw3 ' JOB SITE APN r ADDRESS f OWNER CONTRACTOR / DESIGNER / EN INEER C AP1.?. 00, :# AC -IRC" :tlOWS 41>1C: CAPITAL PAC;7%' CJt0MES TNC~ 41 QO MAC: ARM C%? Bs.VT *200 4:00 MAC A?M47I. BLVD02-00 • (949W2� 8400 C".dX.A. ' 1503 . + USE OF PERMIT "fes - PIMMIT r ORS NOT INC.1.,� Lf E D1,C)CK 1;'yr'►i..ZlPOOf..d"sP.�S471Z.4t��.l� �C - CUSTOM CONSTRUCTION 3,337.00 Sir IaC')lidZWR1iTIO 96.00 Sir C#ARAORlC.AM++: RT (SF) 13,0531010 , ES TMATND tCOEW OF C 0,111!5s` ii'Ce'I' OPT i 31, 7,127.709 COINSTRUCT10114 FEE 101-000-418-000 S),4010 PLAN i:l-0PICK Pm. 101-.000-439-3 18 $1,13G.26 FEE Mi"OO T 101-000.439-;> 18 -$15000 M.IC3.3.Al IM, ly'1f: ' 101-di£1C2 2: ^Ufi1 $92.UJ XLEC'T13„ICA FRF 101-NO.420.0040 8286.x' PL.C9MB1.t40 F'Li? 101-0170-4.19-000 $225.00 STROM MOTT014 FEE - 'RER11:* 101-0004,41-000 $31,71 a "I D THG I'M t 10) -000-4231.000 $20.00 PEV ELs PER 91wi1bAC°'t; FEE 331907.40 At,f IN PUBLIC PLACES . PLSIl:'i`01-0J£7=,°._53-•0.00 "t33S.'S 7`r ,i,E� I '3 ITC`°rit7 rANIS x./+,idCa111? "t< , 1.32.96 1J501 iy"1f1 S'41,500,00. r r RECEIPT DATE By I : DATE FINALED INSPECTOR INSPECTION RECORD OPERATION j DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings f U. GQ Ducts Slab Grade Return Air Steel j Combustion Air Roof Deck g �. Exhaust Fans O.K. to Wrap Framing I — F.A.U. Compressor Insulation t Vents Fireplace P.L. 1 Grills Fireplace T.O. ► Fans & Controls Party Wall Insulation I Condensate Lines Party Wall Firewall ] Exterior Lath 1 Drywall - Int. Lath i i I I Final Final POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs I Electric Bond Footings 1 Main Drain Bond Beam } Approval to Cover I Equipment Location t Underground Electric t Underground Plbg. Test Final ► Gas Piping PLUMBING APPROVALS Gas Test Electric Final _ Waste Lines 1 �(� , % W G Heater Final Water Piping ] Plumbing Final Plumbing Top Out ] Equipment Enclosure Shower Pans I Sewer Lateralf _ _ Sewer Connection I�v L7 -GJ O.K. for Finish Plaster Pool Cover Encapsulation Gas Piping j Gas Test 1 Appliances ] Final D COMMENTS: - ] I Final l Utility Notice (Gas) ] , ELECTRICAL APPROVALS Temp. Power Pole ] Underground Conduit I Rough Wiring ] Low Voltage Wiring I Fixtures ]- Main Service 1 Sub Panels 1 Exterior Receptacles G.F.I. I Smoke Detectors I Temp. Use of Power ] ] Final ] Utility Notice (Perm) 1 . GZ� Building 9 Address 7/9, Owner nn f114\A 1'f'1C%L - P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Mailing Address I I ©1 ,C A f>= AJC ST I I City Zip Tel. 00znNA I qa E�a [:ic-)- Contractor Address II I 1C, t A nr ,C Avl 45:-T'1O 1 City Zip Tel. ( C;V CfJa q C) -r�l E*� l GI c, -:T - c) -)q - of tial -7 State Lic. City & Classif. -7 407 Lic. # Tf w', Arch., Engr., Designer ��c ��-fsIL (' A1r-t.r jA)C- Address a -7-T- j oU 'Tel. l,S' 14- t'r1q4G-44 b7-91-3c)O City Zip State 1 Tv�rJ LSO . �Mi ("Is Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I afn licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of "the ' a!n/d,Professions Code, and my license is in full force and effect. `�►iG(h/ X I-14'OL SIGNATURE o '� DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, ausiness and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to'fts 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 that. he 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). I: 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.) 11'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 contractof(s) licensed pursuant to the Contractor's License Law.) i 7 I am exempt under Sec. B. 8 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 hereby 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. 16 nf_­% Company n Copy is filed with the city. ❑ 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 thg 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 Ihereby 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. 1 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 applicant Date Mailing Address City, State, Zip Q.� APPLICATION ONLY UILDING: TYPE'CONST. 1" OCC. GRP. n3" U .P. Number a egal Description T (E- 1- k? 00' roject Description Sq. Ft. No. No. Dw. Size 46G 7 Stories Units New ❑ Add ❑ Alter ❑ R Demolitl n-❑ PL -&1 tc-zv- i�-94o C I rc� (4,-- Pe 4 og--- > f I /PIA41C Al"(14.Lr oJ9 IP -20't- 37E 8447 Estimated. Valuatio L„G n ` cD7 2 ll 7 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. w 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 CenterLine n v Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified, School District 47-950 Dunef-alig's.Road Notice:,La Qu;inta;'CA 92253 Document Cannot Be Duplicated 760-771=8515' CERTIFICATE OF CGMPLIANGE Date 10/26/00 API # 772-070-002 No. 21141Jurisdiction L'a Quint' Owner NameCapital Pacific Homes,. Jnc. Permit# 0010-265 No. 78-875Street Pina Log #-., o, City; La Quinta Zip 92253 Study. Area Tract # 24890-4 Lot # 54 Sgua're Footage 1 " Type of Development . Single`Family Residence , No. of Units 1 Comments Citrus - 3',887 square"feet At the present time; the Desert Sands Unified School Distract 'does hot' 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 atthis�time due to the following reason: Ai 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 that building permits and/or Certificates of Occupancy for this square footage inthis proposed project may pow be issued Fees Paid By Capital Pacific Home,'Ine. ` Telephone 949-622-8400 Name on.the`check By Dr. Doris Wilson Superintendent " Fee collected /exempted by Vickie'Durrett Payment Received, - ,. Check No. = 0643Q,Q3103 N. Signature n/1S1. ,x NOTICE: Pursuant of Assembly Bill 3087 (CHAP 549, STATS. 1996) this will serve to notifyyou.that the 90-day approval period in.which,you'may protest the fees or otiiei payment identified above will begin to run from4ie date on-,which the building or installation permit for this project is sssued sok on which they.are paid toithe District(s) or to another public entity authorized to collecF.them on the District('s)(s') behalf, whichever is earlier. ,e• ,r.- -.., .. .. ,:... SMV _ f• '. a• gooe- Attach a copy of county-or city, Ian checl 'ipplication formto districtcopy:for all-waivers. ._ Embossed Original- Building Dept./Applicant _, Copy - Applicant/Receipt,,,. Copy- Accounting �i� ow CIT' 'OF LA QUINTA or•n � BUILDING & SAFETY DEPARTMENT 777,;7012 s' INSPECTION REOUE 04D 777-7,.153 I .26 2009, Owner CAPITAL PACI bQ4kQM, S:LLC„� Contractor CAPITAL PAC'jFTC. HOMFS Permit Number 0010.'.2'5 POST ON JOB IN CONSPIC000S PLACE, INSPECTOR MUST SIGN"'!ALL .000CABLE SPACES JOB ADDRESS 78-875 PINA SFD - PERMIT DOES NOT INCLUDE BLOCK WALL/POOL/SPA OR DRIVEWAY TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING -STEEL" 2 C' MAIN GROUND SYSTEM GROUND PLUMBING PRE=GI)NITE:` DO NOT POUR CONCRETEUNTIL.ALL ABOVE:iHAS BEEN SIGNED CONCRETE SLAB JOISTS & GIRDERS ELECTRICAL GROUND WORK. DO NOT POUR CONCRETE UNTIL ALL,'ABOVEHAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT -A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP GROUT 0'4', 0 S' FRAMING c7 INSULATION p PRE -ROOF COVER NO WORK UNTIL ABOVE WAS:BEEN:SIGNED DRYWALLINTERIOR EXTERIOR LATH POOL PRE PLASTER POOL•FENCE & GATE S ER SEPTIC TANK lCi. FINALS ELECTRICAL PLUMBING FINAL GAS TEST HEATING - A/C HOUSE NUMBERS , JOB; COMPLETED TEMP POWER ABOVE.APPROVAL• S DONOT INCLUDE RIGHT TO TURN ON UTILITIES.OR.OGCUPY. BUILDING- Certificate of Occupancy City of La Quinta : t_pBu4ldin e arent ' . -This'' -ert ficate . ssued -pursuant to the. requirements -of Section 109 of fhe'Uniform Bui/ding Code, certifying that, ff.the tune of issuance, this structure .was in compliance with.:ttie various ordinances of the City ;regu/sting; bui%ding,constrOction or use. For the fo/%wing: BUILDING ADDRESS: 78-87'5 PINA Use Classification: SFD Bldg. Permit No.: 0010-265. Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: CAPITAL PACIFIC HOMES INC `7.6"t Building Official Address: 4100 MAC ARTHUR BLVD.# 200 City: NEWPORT BEACH CA.92660 By: KIRK KIRKLAND Date: 7-25-01 POST IN A CONSPICUOUS PLACE