9707-078 (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
Date 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:
( ) 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.
Y9 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.
.1♦ 'J A 1 -;,Tl
(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
1Code, I shall oithyyJh comply with those provisions. .,
Date: rE, 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, 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
e above-mentioned property,forinspection purposes.
Signature (Owner/Agent) /'-� Date��
BUILDING PERMIT PERMIT#
CONTROL#
5810
DATES ei VALUATION��b�>�;� LOT TRACTJOB
SITE
ADDRESS j9_0f b .4Z1V laA. ROM,
APN
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OWNER
CONTRACTOR / DESIGNER / ENGINEER
MINISM"011 P:iMITOCr VY,t>W
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USE OF PERMIT
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+1,6 1
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
I INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs 0- '�
_
Underground Ducts
Forms & Footings o.
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 AX
Electric Bond
I
Footings2
1.41
Main Drain
Bond Beam z —
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
r teral
(,(,�
Pool Cover
r 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 C4 4�7 Q1
Utility Notice (Perm)
COMMENTS:
2/12/98' CITY OF LA QUINTA I
INSPECTION SUMMARY REPORT
Permit Number 9707-078
Site Address 79-065 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 2/12/98
LA QUINTA CA 92253
Date Expired
Contractor Name
MINISTRELLI-PAINTED COVE, INC.
Valuation $126,877
50445 MOUNTAIN SHADOWS RD
Fees 4,621.85
LA QUINTA CA 92253
Description of Permit SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS OR POOL.
IN SP E CTION S S CHEDULED
OR C OMPLET ED
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
12/1/97. 12/1/97
137 -WRAP
PASS i
12/1/97 12/1/97
135 -ROOF
PASS
12/8/97 12/8/97
138 -FRAME
PASS
12/10/97 12/10/97
139-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 BLOCKWALL FRONT YARD
1/9/98 1/9/98
B6 -BB
PASS
2/9/98 2/9/98
DO -E -FINAL
PASS
2/12/98 2/12/98
B21 -G -TEST
PASS
2/12/98 2/12/98
D2 -COMP**
PASS
15 Inspections completed.
P
Notice:
Document Cannot Be Duplicated
Date 8/25/97
No. 16008
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Jurisdiction
APN # 769-541-010
La Quinta
Owner Name Ministrelli Construction
No. 79065 Street River Rock
City La Quinta zip 92253
Tract # Lot # Square Footage
Type of Development Single Family Residence
Comments
Gr—andfathered 2070 sq. ft.
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:
0
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 s uaie footage in this proposed project.may.now`be.issued
Fees Paid By cc/First Community Bank/Ministrelli Construction" Telephone ► 564-1849
Name on the check y
By Dr. Doris Wilson �^ '
Superintendent f�.
Fee collected /exempted by Pauline Pearson Payment Received $628.00
Check No. 74002
Signature
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
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
bllect 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
August 14th, 1997
ESI%FME, Inc.
STRUCTURAL ENGINEERS & CONSULTANTS
MINISTRELLI CONSTRUCTION
50-445 Mountain Shadows
La Quinta , California 92235
ATTN: Ken Schmale
RE: Roof Truss Calculations and Layouts on " Bajada - Lots 9 and 11 " for 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,
STRUCTUR
By:
1921 EAST CARNEGIE AVENUE, SUITE 3J • SANTA ANA, CALIFORNIA 92705 � (714) 261-1811 • FAX (714) 261-8506
FROM : SOUTHWEST ELECTRIC CO
360-1866
PHONE NO. 772 6998
Aug. 14 1997 12:04PM.P3
Lic. #651498
LOADUCALCTILADOWS
SOTTHWEST ELECTRIC COMPANY DATE: 8-14-97
77-734 COUNMY CLUB DR. SUITE K
PALM DESERT, CA. 92211
JOB: PLAN 1 BAJADA CONTRACTOR: MIlVISTRELLI
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 PFRTONS
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 77P-R44R