9708-048, 9206-160 (SFD)t LICENSED CONTRACTOR DECLARATION
H
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 "
Date Signature of Contractor
OWNER -BUILDER DECLARATION ex ~
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" . •rt Signature of Owner J-' _')+��✓'
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.
`�7'A.`1'1 r."U1�1;7
(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, l,shal,Lforthwith comply with those provision§''
Date: it ' Applicant r jre JY 2; e;zn
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. I
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, indemnifyr,�
& 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 forinspection purposes. n `
4.
--signature (Owner/Agent) 'V_ Date ( `
w4 .f r
PERMI <#. -WIN CONTROL# - f1
BUILDING PERMIT P`�
,
DATE VALUATION $12.9,332.40 LOT 12 TRACT
JOB SITE - 79,440 U-sV R HOCK -. .-TPN
7omm.1-01:i
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER,
NVIN.GS'('li.� l;�,IJ,40r^13`I'I �';''1 Cove, r i f' . .
&i h : Ii i 'rt'T $ 43 ' i 1/13 iw` •'
�f•€w A C �Uh+ a'�tIN S:H3AiDOl+i�'S RD
1A QlPffVA, • A ' 422.33
t
�...�.Q��E��.Ct,I�1`TA CA 9225311,
7 71.. rtrt
(7 60)5 4491t;i CBL h _
USE OF PERMIT.
BLOCK WALLS 0A P001--
TRA R Citi.", iiUC1,111;01%
0A.RA,e`3VC A.RM.Wr 440,00 S#
AJ.��.�EM
kxwe, •3 XFiDC0..
Gi o$.i
3
s'43�.'i,'t�i�fiilifr f-.Eix ilii-;3f);�^�;2.1••�!:31? �?.int)
s'L.610110'k"At, FES; 101-000-420-000 Wrwd• sg
s 1ik'• it�C°:1`k`? 101-000-419-000 t�1^Ufa
¢"1x0, Nt31iXO`('1t°TNF1'iF-1USSID 10:1.,MO-241-0M 3i1,-94
c'Fj%i1J::�1`N�a'1�'L.h;3Csl•'i)t�f�••=1`l�-CI�3l) '$:1,U:C3r�}
,(N-PR.A;;: ftclt `i`u-ka ti is 225-1000-44-3,1ia �'.,8=�1. 6
AJRT'M PU Lkt,:PLACT(N - 3.ilt".' 10.1 -2
X),
X),
?�. 11f:fIN flN1V--'LAN 111 C:
��O
r�
S4,23sA!F
ULIFEE
S0.00
>3 to �S 1y$T�,:i!`t W $4,245,4c
lk
RECEIPT
DATE NilBY
DATE FINALED
INSPECTOR
q
t
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.Q.
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 I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX 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.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
ItGLAQ18RPOF LA QUINTA
BUIING &SAFETY DEPARTMENT
0 8 ]9§i 777-7012
INSPECTION REQUEST LINE
FINANCE DEPT 777-7153
Owner MINISTRELLI CONSTRUCTION
Contractor MINISTRELLI-PAINTED COVE
Permit Number 9708-048
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-040 RIVER ROCK
SFD -PERMIT DOES NOT INCLUDE BLOCK
WALLS OR POOL.
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEELERE
MAIN GROUND SYSTEM
GROUND PLUMBING J ;
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB cl
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST lid
HEATING & VENT -A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP 2 -
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION _��_ 7/
PRE -ROOF
COVER NO WORK UNTIL' ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH ,
POOL PRE PLASTER I
L� ENCE &GATE
SEWER,ISEPTIC TANK
PLUMBING
FINALS
H EATING - A/C -------------
HOUSE NUMBERS 7
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
1/22/98 CITY OF LA QUINTA I
INSPECTION SUMMARY REPORT
Permit Number 9708-048 Site Address 79-040 RIVER ROCK
Rereference Number Site City
Location of Project
Date Applied for .8/8/97
Date Approved 8/8/97 Owner Name MINISTRELLI CONSTRUCTION .
^ Date Issued 8/8/97
50-445 MOUNTAIN SHADOWS
Date Finaled
LA QUINTA CA 92253
Date Expired
Contractor Name
MINISTRELLI-PAINTED COVE; INC.
Valuation
$129,582
50445 MOUNTAIN SHADOWS RD
Fees 4,245.46
LA QUINTA CA 92253
Description of Permit SFD -'PERMIT DOES NOT INCLUDE BLOCK.WALLS OR POOL.
INSPECTIONS
SCHEDULED OR COMPLETED
Scheduled
Completed
Date
Date Time
Inspection Type Inspection Result Inspectors Comments
.8/13/97
8/13/97
C5 -SEWER
PASS
8/13/97
8/13/97
A2-P-GND
PASS
8/19/97
8/19/97
Al -FTG
PASS
8/19/97
8/19/97
A4 -SLAB
PASS
8/19/97
.8/19/97
AO-FDN
PASS
9/18/97
9/18/97
B5 -ROOF
PASS
`9/22/97
9/22/97
B7 -WRAP
PASS
9/25/97
9/25/97
B8 -FRAME
PASS
9/30/97
9/30/97
B9-INSUL
PASS„
11/25/97
11/25/97
B21 -G -TEST
PASS
1/22/98
1/22/98
D2 -COMP**
PASS
11. Inspections completed.
Building
�
'/ 9
P.O. BOX 1504
.0 600re 78-495 CALLE TAMPICO APPLICATION ONLY
LA OUINTA, CALIFORNIA 92253
Owner��
-Iotoo 100,
Mailing
Address
Contractor
Zip
State Lic. City
& Classif. 693 Lic. 06Z
Arch., Engr.,�
Designer 4e_—
�G V -V17SA*fP fto�
C -rt State 46 �Seg1
C Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby 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, 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 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).
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 issold within one year or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose or sale.)
VI 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 contractor(s) licensed pursuant to the Contractor's License Law.)
I'7 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. 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 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., Il, alter 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 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 aOplicant Date
Mailing Address
City, State, Zip
LDING: TYPE'CONST.S 10 OCC. GRP.
A.P. Number f
Legal Description 04 / / , 4 Z1�
Project Description
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep. ,10
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Validation:
OF LA OUNT,
WHITE = FINANCE YELLOW ,= APPLICANT PINK = BUILDIN%DIVISION
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setbadk'from Center Line
Side Setback fromPropertyLine 3
FINAL DATE INSPECTOR PA I
Issued by: Date �U@rm61Zt 7 1JJnn7
Validated by: NN
Validation:
OF LA OUNT,
WHITE = FINANCE YELLOW ,= APPLICANT PINK = BUILDIN%DIVISION
Notice:
Document Cannot Be Duplicated
Date 8/11/97
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
APN # 769-541-013
No. 15926 Jurisdiction La Quinta
Owner NameMinistrelli Construction
No. 79-040 Street River Rock
City La Quinta zip 92253
Tract # Lot # Square Footage
Type of Development Single Tamily Residence
By
Comments
2208 SquareFeet
Permit #
Log #
Study Area
1
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
Fees Paid By Cashier's Check/First Community Bank Telephone 564=1849
Name on the check
Dr. Doris Wilson
Superintendent
Fee collected /exempted by Ellen Patino
Signature
Payment Received $628.00
Check No. 072730
40T CE: 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
ibove 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
xiIlect 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
V
�Ay
T ^
6
Payment Received $628.00
Check No. 072730
40T CE: 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
ibove 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
xiIlect 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
CARLOS ELIAS
REGISTERED CIVIL ENGINEER
38825 Charlesworth Drive
Cathedral City, California 92234
Telephone (760) 328-7271 '
July 22, 1997
City of La Quinta
Department of Building & Safety
78495 Calle Tampico ,
La Quinta, Calif.. 92253 sy
Gentlemen.
This letter concerns the residences to be constructed at*
79020 River Rock and 79040 River. Rock', La ,Quinta, California''.
I have reviewed the layout' and ,bearing points -.of, the•;
roof trusses designed by Spates •Truss'z`Company and find that
their design is in conf,ormance'with my design intent. "
Very truly yours;.
` �IjE.SS/pN ,�' �G�/l /J
Q ,
SOS F qlF•
Carlos Elias,`
C E : j e Uj
#16839
`ref.
� OF C,,L1F� i " .