0204-195 (SFD)LICENSED CONTRACTOR DECLARATION
I he
xeby 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
744091 B - 12/11/2(
eel
r
1D ate�_) ),w
�!^ "%^-� Signature of Contractor ~
OWNER -BUILDER DECLARATION"' V f
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.
-S ) 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 OTATE FUND Policy No. 329-02-00.20714
(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 prgv,) sions of Sect''i n 3700 of the Labor
Code, I shall forthwith comply with pfoyisjons. /
Date: /iA..•. -. 1 Applicant � �� � t X
Warning: Failure to secure Workers' Compens tioln co erage 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 a(--
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! V
2. Any permit issued as a result of this application becomes null and void IJ
work is not commenced within 180 days from date of issuance of suc
permit, or cessation of work for 180•days will subject permit to cancellatio .
I certify that I have read this application and state that the above information I
correct. I agree to comply with all City, and State laws relating to the buildin
construction, and hereby authorize -representatives of this City to enter- upo
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) :
BUILDING PERMIT PERMIT#
DATE ///VALUATION ' LOT TRACT
gg aa-pp
1 5 24890-4
JOB SITE
ADDRESS 78-81K-5.�.��*�Fs }d,
APN 772-.070-003
OWNER
CONTRACTOR / DESIGNER / EN INEER
AN-iR.f FAli1w.PU9
ISI31>1 'Vff'A.D1AVJ!.i.(y.PZV21L 7 CORP 1
6737 S.? WA.`1-RKGr1rJJ-T 131,V)
PO BOX 114.4 ....
CA 90040
1A QUN, ,rA CA 92,253
,760)772-2626 r!Ri,a 539.3
USE OF PERMIT
43N S. IF. Slffn- LOT 55, PERMIT DOFS NOT INCLLl;13E BLACICK'VVA1,A,s,
POOL, SRA, OR I>FtIVEWA' APPROACK
CUSTOM CONSTRUCTION 4,,3" o'Do SY
POACH/PATIO 1,143.00 SIV
GARAOFICARPORT 3F
ESITI 'M) Cs�• ;rf OF C 0fl7 R7UC1'10N
;s�7ti�� u ss3
CONSTRUC"fIC N FF.L 101.000-418.0-00 V,rr..30
PLA14 CHLCK ftR4 101-000-439-318 $E,28rt.d�f
F1�F.Ca CM 1011-000-439.3113
1Ut Ez G Y1f.23 LCA L FM 101-000-421-000 $ 19x.00
91,ECTRIC'.AL FEE 101-000-420.000 $234,62
PLUMBING PE:E 101-(50%419-000 $201.50
8111RONO l+nc;`1 KYN ft?lF - KmiD 101-000-244-000 06173
C!r" kD AU I?ZY( 101-000-423-000 $4.N.00
DEVELOPER IMPACT &E SJ,f3 Y10b1
ART 114 PUTiUC PLACE"; - )r ESIZ:.'L70-000-445-0045 S413.30
NS P &,P.AID RELKS
41,000,00
TOTAL PE-ItMl: F.W.S DUE NOW
�0i '
CITY OF LA QUINTA .5
FINANCE
DEPT ---
RECEIPT
DATE
BY'"
DATE FI ALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE J77INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
-- z
Return Air
Steel
_ [9,
Combustion Air
Roof Deck
--
Exhaust Fans
_
O.K.toWrap
-�
F.A.U.
Framing
_ / —
Compressor
Insulation
g
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
-
Exterior Lath
Drywall - Int. Lath
O a
Final
- 7 -
-Final
Final - - S
BLOCKWALL APPROVALS
steel
POOLS - SPAS
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
49—Af—
Heater Final
Water Piping
y _
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
3=2
Appliances
Final
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) V
COMMENTS:
Date
10/4/02
No.
23701
Owner
John Farkas
Address
City
La Quinta Zip 92253
Tract #
24890-4
Type
SFR Mitigation
CERTIFICATE. OF•COMPLIANCE
Desert Sands Unified School District
47960 bune'-'Palms.,Road
La Quhjrta *CA'92253
(760) 771=8515
Lot # No. - Street SX.
Unit 1 55 78885 Pina 1 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
%W�c
po
Q BERMUDA DUNES
Cn RANCHO MIRAGE
�r 'INDIAN WELLS
PALM DESERT y
LA QUINTA .�
�INDIO y71.
i'
APN:# 772-070-003
Jurisdiction 'I'La Quinta
Permit # 0204-195
Study,Area
No. of Units 1
Lot '# No: Street
Comments Single family dwelling - 4,320 sq. ft., under grandfather agreement of $628
S.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 structures (spaces that do not.contairi facilities for living, sleeping, cooking; eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exerriptfrom payirig 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 S.F. or $628.00 have been paid for 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 Cash - Erin Kerr Check No.' n/a
Name on the check Telephone
Funding Mitigation
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green $628.00 $o.00
Payment Recd Over/Under
Signature C-111A41:—I'll-, 1
NOTICE: Pursuant to fovernment Code Section 66020(d)(1), this will serve to°notify you that the 90 -day approval period in which you may protest the fees or
other payment identifi6d above will begin to run from the date on which the building.orinstallation permit for'ihis project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document -NOT VALID if Duplicated
Embossed Original - Building Department/ApplicantCopy - Applicant/Receipt Copy - Accounting
09%30/2002 08:11 FAX 323 722 2812
WIIIA%�5�vdtlanub_n w"
- 1 l 1 fw""alagaii"!
i
R4
'Septeml er26, 2002
I\'TERSTATE: T�I�RE;'..z'. ft7j 002
y.•,#
N.fr. & Mrs,.- arkgs
Re: A-rdut= a .-for 7888-5..P.h-o L'a .Q. C,A- 92253
Members ofihe Ar-cbtectur& Committee e resew your wed set f.rilms-t,
�vrere.subziaitted and feed that te'frant entry gate set 5aek now meets the.25't hack
requirement. The Cdiu ttee i :., vare of the additia. $uz :t i' ver s. tided. c�
the plats to
drain.tothe street and is cored :into:the
We vnderkand1hat;a:deYailed pool const;uctiwill be.subao 4.;foa approval under
sept cover,
Z'r0od hicks with your project!
• hcerely,. .
� r A
n Behalof the Baard of73irectors
C' s :>i #3ot s1;�rs ci
Byi Trm idMullahy; Association 11i{aa
bey,. •
P.o BOX4772 •. Pates n `aA 9-
734SSOMessaridiro, Suite S + Pahn Desert 6a4ifornift _! 760i,Yui 161,; ► .760, 346.MB
.-�n9e1R; �1'i1]Qdrrrl)rs�r}10t�ili a :Vii0r1llV6lfrnttRf�t.GA�IS
Summit Structural Engineering
January 9, 2003
Sun Vista Development, Inc.
P.O. BOX 1144
La Quinta, CA 92253
Attn: Rob Capetz
Subject: Structural Observation
Lot 55 @ The Citrus (Farcus)
La Quinta, CA
i.
a
P.O. Box 813
270 North Main Street
Donnelly, ID 83615
(866) 862-8148
(208) 325-8148
Fax (208) 325-8149 -
Dear Rob,
Per your superintendent John's request, we visited the subject job site on January 9,
2003 to perform a structural observation. While. we were at the job site, we found several
omissions and deviations from the plans. These omissions were repaired while we were
at the job site, and we performed a final back check to verify each item on the punch list.
At that time we found the structure to be in general compliance with the design concept.
If you have any questions, please give me a call.
Yours truly,
SUMMIT STRUCTURAL ENGINEERING
193
1/03
Benjamin Herbst, P -.E. s
r9oFcnuF�
BH s ,
cAMy Documents\20021 obfiles\Sv-172\172_fieldl oobwalk letter).doc
Residential. Commercial. Industrial. Land Development
Summit Structural Engineering
September 9, 2002
Spates Fabricators
85-435 Middleton Street
Thermal, CA 92274
Attn: Truss Designer
Subject: Roof Truss Shop Drawings and Calculations
Lot 55 at The Citrus
La Quinta, CA
Dear Truss Designer,
2283 Fifth Street
La Verne, CA 91750
(909) 596-0842
i
The roof- truss, drawings by Spates Fabricators for the subject project were
received by our office on September 2, 2002, and are approved. The submittal
has been reviewed for general conformance to the design concept of the project
structural plans. r The fabrication processes,, techniques of construction,
dimensions, and quantities are not a part.of this review. Since the shop drawings
were reviewed only for general conformance with the structural plans, unless
variations from the structural plans have been clearly indicated, .we may not have
listed them. Our review of these drawings does not relieve the truss engineer
and the framing contractor from complying with the structural plans.
Yours truly,
SUMMIT STRUCTURAL ENGINEERING
W
-- --- No. C0541�;-3
Exp. 12/31103
mrq�
Benjamin Herbst, P.E. . F CAl
CC: Rob Capets, Sun Vista ,
BH
cA2002j obfil es\sv-172\172_truss2.d oc
Residential, Commercial, Industrial, Land Development
_ f
W a Em m &I N
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palrn'.. Desert, CA 92211
t
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION,
PERFORMED
❑ REINFORCED CONCRETE flUCT. STEEL ASSEMBLY ❑
❑ POST TENSIONED CONCRETE ❑ ASPHALTOTHER
❑ REINFORCED MASONRY ❑ `FIRE PROOFING _ d
JOB LOCATION
o
REPORT SEOUENCE NO.
TY&E OF STRCTURE,+
PERMIT NO.
D��TT v D Y OF WEEK
VISf
MATERIAL DESCRIPTION
ARCHITECT
I TOR NRS. CHARGED
� — t G��
� -
ENG-�
IN �U Dvotimn o � t
ASSISTANTS HRS. CHARGED
INSPECTION GENEL
. CONTRACTOR a ,
DATE V__
SUB
-_ _ . CONTRACTOR— W-4-tV kG>-S-T L.+�L/- —
lo o'
'DD
MS mei,.-% .S li
s ( "—io lw or -y\ 8
`-ae,
�S b-� Vis. -_ ^.S $
I- '� .3 40
Wetz 4s
COPY SENT TO CLIENT ❑
CONTINUED ON NEXT-PAGE"O' „'
PAGE "OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF W
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.
ST RE NSPECTOR
DA E OF R PORT REGISTER NUMBER
Ll
NATO E OF
_ 1 _
-
Ce�(...�ficato �of Occu anpy
�P
G� OF TBuilding & Safety,Department
This Certificate is -issued pursuant- to the requirements of Section 109'of.the California Building '
Code, certifying. that, at the time, of 'issuarice, ` this. structure wase in -compliance with the
.. provisions of the: BuildingCode and the varim& ordinances of - the City- regulating- building
construction anal%r use. ti .
BUILDING ADDRESS: 78-885,PINA'
Use classification: SFD -' 3 ' Building Permit,No.: 0204-195 -
Occupancy -Group: -R-3,U=1 a. Type of Construction: VN Land Use Zone: RL .
Owner of Building: JOHN PARKAS~.-. „ ,-» Address: 6737 E.'.WASHINGTON BLVD -
r 'City, ST, ZIP: COMMERCE, CA 90040
•:' - .
By: GARY SHOWALTER .
'�-�-ol_ Y Date: 7-7-2003 . *,
- ' BuildingpfficiafN- •�
-
`, POST.IN•A CONSPICUOUS PLACE: :': -