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Home My WebLink About0304-285 (SFD)va, r Warning: Failure to secuFe 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 employee D2. Any permit issued as a result of this application becomes null and void 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 cancellation 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 building construction, and hereby authorize representatives of. this City to enter upon the above -menti for inspection purposes. Signature (Ow er/Agent) ,t �{+,1t✓'`'��--�^� �' "°""' Date, �! '''`� 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 1640934 -~` � � 0UriDiu Dater 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: ( ) 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). ( ) 1, 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 NW OVAL, UIRON F Policy No. 709009 (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the woryor 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 we"rkers' compensation>prov_isions of,,Section 3700 of the Labor PERM' BUILDING"PERMIT DATE VALUATION LOT { TRACT $177,040.00 .1 S1 _ 70023 JOB SITE ` ADDRESS S 6 0L.304 PO NSM r:!'A P1..ACF- I APN 764-270--01 l OWNER CONTRACTOR DESIGNER / EN (NEER p�w 60.311 TP2,0G Y PARICWAY 81-260 AV1`XUR 6Z 1AQUDTfA CA 92253 f, 11R' Mt AL CA 02WI p (909)$33.8996 (MIX W16 USE OF PERMIT (011f3•L1; I?AM-R Y DWFj LT. TG 51F0 w WT 193, PLAN 5515B. PERWIT DOES NOT INCLUOV, 8J OCK 'WALLS„ P0018 .IPA, OR DRIVEWAY APPROACH CUSTOM GON13TRUC'f'ItYN 2,122,n SF PORCHII4 A,TIO 17S.00 S1? 0P A00CAit1't3RT 473,00 eF T'MKIT 191KE SU1 WITARY CONSTRUCTION FRE 101.0013-,418.000 ��aia,SS PLAN CHECK FEE 101-000-439-3113 $732.50 M E frH.ANICAL PIER '101 -000.421 --LSD Sfia.5l3 R'.L,1r..f�:TR1CAL, FEE 101 -AERO -420-000 1b;4ti�i131?i4a�� •1U1-L�3flr�19�pQ0 $t3tS:9D ,yTRONG MOTION FEE = RESID 101.000-2A i -000 $17.70 GRADRIG 01-000.423-000 $15.09 D'evE1.OPE-R, IMP',A , T F'E RUB-TO.1AL C;Z9i.1';0RUC' 1014 AND PL' AW CNUX $4,404.93 LW3 PRE -PAID FSS $0.00 • YOTKAL.D.yF.°.d.M'i:9f7 DUE d!'L+9y $4,4N.9 31 APR 2 8 2003 CITY OF LA WNW FINANCE DEP% RECEIPT DATEBY / 19 DA FINA D j "0. INSPECT 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 OX 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 — BLOCKWALL APPROVAL 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 - ep. Heater Final Water Piping Plumbing Final Plumbing Top Out - Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection . . o 'Encapsulation Gas Piping Gas Test a- UZU 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 NzU Utility Notice (Perm) -COMMENTS: _t 1-chella Valley Unified Si .)ol District f This Box For District Use Only P.U. Box 847, Thermal, CA 92274 DEVELOPER FEES PAID (760) 398-5909 — Fax (760) 398-1224 tDATE7RECtEIWPT AMOLINT : MITIGATION AMOUNT: COMWIND. AMOUNT: CHECK # MITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Date: �3 Owner's Name: Shea La Oui n _a - L C Phone No. 777- 32 Project Address: Trilogy. La QUinta, CA 92253 Project Description: 5 single fami 1 v homes APN: 764-270-017 Tract #• 30023 Lot #'s: 91-93, 185-186 Type of Development: Residential XXXXX Commercial Industrial Total Square Feet of Building Area: _ 9,375 sq. ft. Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on be of the owner/developer. Dated: ( 3 Signatur . -&C SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code Project 65995 Approval 9,375 $ 3,187.50 Building Permit Application Completed: Yes/No By: Carey M. Carlson Asst. Supt., Business Serv. Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Note: Adult Qualifying Resident (55 yrs +) Certificate issued by: E1yi ra' Mattson Signature: Office Technician -4z� NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions (i°Fees"), of the 90-day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. M V:c/mydocs/devfees/certificate of compliance 09/30/02 4/24/2003 15:01 FAX 760 777 6039 TRILOGY 1� 003 rim s � II► �V P.O. Box 1504 78-495 CALVE TAMPICO (760) 7 7 7 - 7 0 0 0 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101 PERMIT FEE SUMMARY Date: April 24, 2003 Owner: Shea La Quinta, LLC Builder: Shea La Quinta 60-31 1 Trilogy Parkway 60-311 Trilogy Parkway La Quinta, Ca 92253 La Quinta, Ca 92253 Prniert- Trilnnv I a niflntn 5 CFI) T,.,-* 7nn99 I .,*. 01-01 lar;-*ua Lot Plan Sq. Ft. Address APN Permit A' Fees 93 5505A 1,843 60-365 POINTSETTIA PLACE 764-270-017 0304-281 $4,257.21 92 5505C 1,821 60-343 POINTSETTIA PLACE 764-270-017 0304-28 $4,244.07 91 6210B 2,208 60-321 POINTSETTIA PLACE 764-270-017 0304-28:,, $4,489.08 186 4210E 1,381 81,8� PRISM DRIVE 764-270-017 0304-2841 $4,016.84 185 1 5515E 2,122 60-304 POINTSESTTIA PLACE 764-270-017 0304-28! $4,404.93 Total Area 9,375 Total Permit Fees 527,412.13 (760) 777-7012 - Building & Safety Department - Fax (760) 777-701 1 ��