9707-077 (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
JDate �" Signature of Contractor '`2,1,^A;;_/' t�
OWNER -BUILDER DECLARATION t
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.
NY 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 s Policy No.
,b l dv9
(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 those p''rovlsions/
Date: •r'- 1!1 _ 42 • Applicant y'`jh .••...
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.
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 fonspection purposes.
1 j C.
JSignature (Owner/Agent) A 4/7— 1 ��. -" �~ Date' - �� • � � .
BUILDINGPERMIT PERMIT# CONTROL#
DATE VALUATION fi.i ( 1 i.`I{} - LOT 7 TRACT 65,t820
q
JOB
• l�ei�iFOiS il�l��Bl. dd *;hb,
APN 764--'u61.-.�WR
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
s�11tLi?�",?1l't5""t`E:
4 F'fill,1 :;.1141VD, f'`
.1�ii iCi..WFA'(N S14ADOWS RD -
14(�'AfVAJN SHAH)' W 4tib
1 A t UINNIA: CA 9225;3
LA Qc.lINTA CA, 9�153
tft54S4 iR,?931
1�1 #f. N5
USE OF PERMIT
8,N)
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TO FALL VERN1,11 '01Y 01.1,9NOW
S4,034.'.;0
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:
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
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
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.1,
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
_,3/30/98
CITY OF LA QUINTA I
INSPECTION SUMMARY REPORT
Permit Number 9707-077
Site Address 79-015 RIVER ROCK
Rereference Number
Site City
Location of Project
Date Applied for 7/17/97
Date Approved
Owner Name MINISTRELLI-PAINTED COVE, INC.
Date Issued 8/26/97
50445 MOUNTAIN SHADOWS RD
Date Finaled 3/26/98
LA QUINTA CA 92253
Date Expired
Contractor Name MINISTRELLI-PAINTED COVE, INC.
Valuation $126,877
50445 MOUNTAIN SHADOWS RD
Fees 4,159.80.
LA QUINTA CA 92253
Description of Permit SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS OR POOL. PLAN CHECK FEE REDUCED BY
75% FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE.
INSPECTIONS
SCHEDULED OR COMPLETED
Scheduled Completed
Date Date Time
Inspection Type Inspection Result Inspectors Comments
9/24/97 9/24/97
A2-P-GND PASS
• 9/30/97 ' 9/30/97
AO-FDN PASS
9/30/97 9/30/97
Al -FTG PASS
9/30/97 9/30/97
A4 -SLAB PASS
11/25/97 11/25/97
B5 -ROOF PASS
.12/l/97 12/1/97
137 -WRAP PASS
12/ 8/97 12/8/97
138 -FRAME PASS '
12/10/97 12/10/97
B9-INSUL PASS
12/17/97 12/17/97
CO-DWN PASS
12/17/97 12/17/97
C1 -LATH PASS
1/6/98 1/6/98
Al -FTG PASS BLOCK WALL FRONT YARD
1/9/98- 1/9/98
B6 -BB PASS
2/9/98 2/9/98
DO -E -FINAL PASS
3/13/98 3/13/98
B21 -G -TEST PASS
3/26/98 3/26/98
D1 -G -FINAL PASS
3/26/98 3/26/98
D2 -COMP** PASS
16 Inspections completed.
r
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t
,ate,
fir,
P.O. BOX 1504
Building.� 78-495 CALLE TAMPICO
Address r7q U V 5 i_—I ��d'S Llrp &K LA GUINTA, CALIFORNIA 92253
Owner
MIV11 iRtcti l /►
9ds79ae r7oN
Mailing
Address `D �'1� oU TAI 0`qb US
J t
Zip Tel.
City
LA 0v,a}�y 9-L t S3 S6 y- t84 q
1 A11S7 REtcr
Zip
State Lic. City
B Classif. 6 9 3 f I q I
Lic. #3
Arch., Engr., �G
Designer
Address Tel.
City IZipI State I
Lic. q
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000)0f Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
Uhereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business .and Professions Code: Any city or county which requires a
permit to construct, after, 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 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 or not more than five hundred dollars ($500).
t7 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 L'aw 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.)
1'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 or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
f] 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 Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. 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
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
ame
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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of a0plicant Date
Mailing Address
City, State, Zip
81707- 077
APPLICATION ONLY
BUILDING: TYPE -CONST. OCC. GRP.
A.P. Number 76,f -s-41 Oo(9
Legal Description -oZ 3 T2. 2 (n u,
Project Description+ J F
ZONE:
BY:
Minimum Setback
Distances:
Sq. Ft.2 �O U No.
Size Stories
No. Dw:
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Side Street Setback from Center Line x
Side Setback from Property Line "
FINAL DATE
INS!Et( I
Y-
Issued by:
Permit
Date—Permit
Estimated Valuation
71997
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
4
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 x
Side Setback from Property Line "
FINAL DATE
INS!Et( I
Y-
Issued by:
Permit
Date—Permit
Validated
71997
by:
fr 11
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Date 8/25/97
No. 16005
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
APN # 769-541-008
Jurisdiction La Quinta
Owner Name Ministrelli Construction
No. 79015 Street River Rodk
City La Quinta zip 92253
Permit #
Log #
Study Area
Tract # Lot # Square Footage 1
Type of Development Single Family Residence
Comments
sq.
No. of Units 1
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 or replacement mobilehomes.
It has been determined the above-named owner is exempt from paying 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 or $ 628.00 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
N -
Fees Paid By cc/First Community Bank/Ministrelli Construction
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Pauline Pearson
Signature
Pf , /V
w
Telephone
564-18,49
-w -
,r -s •v
7,,
Payment Received L $6rr.:0
0
Check No. 74002
40TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
.,,act them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
MINISTRELLI CONSTRUCTION
50-445 Mountain Shadows'
La Quinta , California 92235
ATTN: Ken Schmale
RE: Roof Truss Calculations"and Layouts on " Bajada - Lots and 10 foe MINISTRELLI
CONSTRUCTION CO. to be built in La Quinta Ca.(ESI/FME 794-6536)
Dear Ken:
We have reviewed the calculations and layouts by SPATES FABRICATORS for gravity loads
and drag loads, they appear to comply with the requirements of our calculations and plans.
The review of these drawings does not relieve the contractor from compliance
with the drawings and specifications. This check is only for review of general
conformance with the design concept of the project and general compliance
with the information given in the contract documents. The contractor is
responsible for confirming and correlating all quantities and dimensions,
selecting fabrication process and techniques of construction, coordinating his
work with that of other trades, and performing his work in a safe and satisfactory
manner.
Thank you for your attention to this matter, please do not hesitate to contact us if
we can be of further assistance to you on this project.
Sincerely,
ESI/FME,
STRUCTUe
By: ��``%
Danny M
for ESI/FE. �,4
1921 EAST CARNEGIE AVENUE, SUITE W - SANTA ANA, CALIFORNIA 92705 • (714) 261-1811 - FAX (714) 261-8506
a
rp'hIM
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• 1 1- T-. ,� _ r3 4i. i � •c, s c� T't S 4 �?hnt t•3 [ y I�rE;.��,,���aF S �
� .- ' �.�N � � � C �a,-t �• i t r h `0. � � ♦ HT: # ^�. tl Bir+Z� t }��.r ,,Al /Oj �C t i �.
�' .. /,r' -. t L'A'�4b ♦ l�w ;�c� �~ Ei t } 1±P P�1 �1PPP0 N w.
i � /,t � .AVyTr� `-�<.. "�L �1{ -4a}i� r.'j"�, �!-'7r�Q•' a'r����.fi•. '-,
..n iq/ ..•i,1..'3 ......;; .�7?: 11 C:u:Y�..k MiL._s�.-..54.!a.(.Ytzi�j.
t. �.. ....-.
FROM SOUTHWEST ELECTRIC CO PHONE NO. 772
6998 Aug. 14 1997 12:04PM:P3
360-1866 S'outluaMt
L'ltctt[c
Co.
Lic. #651498
LOA AL.CIILATIONS
SOUHWEST ELECTRIC COMPANY
DATE: 8-14-97
77-734 COUNTRY CLUB DR, SUITE K
" PALM DESERT, CA. 92211
JOB: PLAN 1 BAJADA CONTRACTOR: MII�TISTRELLI
GEN. LIGHTING, SQ. FT. 2700 X 3
8100
2 APPLIANCE CIRCUITS @ 1500
3000
LAUNDRY CIRCUIT
1500
DRYER
4500
RANGE
0
OVENS - COMBO (6500) SEP (4000)
6500
COOK TOP
1500
TRASH COMPACTOR
1200
DISHWASHER
1200
DISPOSAL
800
MICROWAVE
_ 1500
EXTRA KNOWN CIRCUITS (0)
0
POOL EQUIPMENT
0
TOTAL LIGHTING LOAD
— — ----
TOTAL = 29800 '
FIRST 10 KW AT 100 %
10000
REMAINDER AT 40 %
7920
.A/C 9 TONS'X 2000 PFR TONS
18000
35920 TOTAL LOAD/ 240 VOLTS
_ 149 AND LOAD
'RECOMMEND 200 AMP SERVICE* * *
77-734 Country Club Dr.. Ste. K - Palm Desert. Ca
92211.0473 FAX 772-R99fi