0004-050 (RER)LICENSED CONTRACTOR DECLARATION
t ` y aY, rm under,�enalty oflcperjury that I am licensed under provisions of
^Cha tar 9 (eommenc�ing with SE ` tion 7000) of Division 3 of the Business and DATE
. Professionals Code, and my Lice a is in full force.and effect.
License # Lic. Class Exp., Date
JOB:
d' ADDF
C,r
pee- Signature of Contractor
OWNER -BUILDER DECLARATION
1 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).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to, the project (Sec. 7044, Business & Professionals
Code). a . ._
( ) I am, exempt under Section B&P.C:,for-t i reason
Date • 'Signature of
WORKER'S COMPENSATION DECL`ARATIION
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.
(This* section need not be completed if the permit valuation is for $100.00 or less).
N 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, aaand-agree,,`hat if I should become
subject to the workers' compensation provisions -of Section 3700 of the Labor
Code, I shall forthwith comply,witfi those,provisions.
Date:. �r 7 iApplicant`�
Warning: Failure to secure Workers�-Gompensation 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 property461 seet)en•purposes.
Signature (Owner/Agent) F Date '
OWNER
BUILDING PERMIT
VALUATION LOT
04105a(x MX0.od
78-084 SAN TIMC17 .0
PERMIT #
Qui -W TRACT
26
APN
CONTRACTOR/DESIGNER/ENGINEER
IaiC'M3JARD ORR. UWM;lalE3 IMEIZ.
78.0€34 SA' MgM0 78-084 JA I' TMOT -0.
LAQIiWA CA 92253 LAQIM4T'A CA 9.2253
(760)771-0095 CBL#
USE OF PERMIT
RPS.IDEWTIAi,
INTFPJORAI'TERAT/ON='PERIOR. MODIFICATION PER.APP».Ci1iRD PLANS
014LY
VALUATION
50,000,011 LS
ES°i'i1VX,AM COST OT' CONS')R[IMON
MMUFEE SUMAURY
PIM CHECK FEE
101.000-439.318
S20,43
CONSTRUCTION PEE
101-000-418-000
$414.50
MECHANICAL FEE
101.000.421.000
$19.50
ELEC'TR]CA1 FPE.R
101.000-420-000
$15.25
PLUMBING FLEE
101-000419<-000
$31.00
STRO140 MOTION ",Z - RESID
101-900-241-000
$3.00
SUB-MTAL CONSTARTYG°Y'JtON PJAM Mr." CECK
'LESS PRE -PAID . , E"s
RECEIPT DATE
------------
INSPECTOR
V7a,1S
moo
$7'75.10
INSPECTION RECORD
I. OPERATION
-
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
- Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
..
Exhaust Fans
O.K. to Wrap
F.A.U.
�.� Framing
spa
Compressor
1S. `" dation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
2 2
Drywall - Int. Lath
Final
Final
BLOCKWA
_
�/
L PPROVALS
POOL$ - S AS
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 4PPROVALS
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) Loe
COMMENTS: E'rL
-
Community Azzoctat i on
P. 0. Box 162
La Quinta Ca 92253
Telephone: 760/564-2177 FAX: 760/564-4882
April 3, 2000
Planning Department
CITY OF LA QUINTA
P. 0. Box 1504
La Quinta CA 92253
RE: REMODEL
LOT 26-2
Ladies and Gentlemen:
The Architectural Committee of La Quinta Golf Estates has reviewed the plans
for remodel of Richard and Susan Orr's home at 78-084 San Timoteo and find
these plans to be in conformance with the guidelines established by the CC&Rs.
Please consider this letter as our approval for Mr. and Mrs. Orr to proceed
with this remodel.
If you have any questions, please contact the Office.at the number listed
above.
Yours truly, .
BARRY CHOOLJIAN
Chairman
BC/at
20 September 2000
Mr. Gary Hartman
Building Inspector,
City of LaQuinta
Building & Safety Department
78495 Calle Tampico
LaQuinta, CA 92253-1504
Dear Gary,
In that we began taping the sheetrock in the bedroom and bath areas of our house prior to your inspection,
we, as homeowners, will take full responsibility for proper nailing and screwing of the dry wall.
Thank you for your cooperation.
Sincerely
Richard J. Orr
78084 San Timoteo Street
LaQuinta, CA 92253
11
OWNER / BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as ','Owner/ Builder" you are,the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work: if your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of variuus trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors,`then-you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker s -compensation insurance.
For more specific information about your obligations under. Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally -,orf through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760)777-7012
4FAX7-7-7Q11�'
GR'S SI RE /DATE
7 -0,11�)a _2\K] TI MOTS'0
PROPERTY ADDRESS
PERMIT NUMBER(s)
N
P
I
O.N .
78084 San Timoteo Street
LaQuinta, CA 92253
26 March 2000
City of LaQuinta
Building and Safety Department
PO Box 1504
78495 Calle Tampico
LaQuinta, CA 92253
Dear Sir:
Plans are hereby submitted for renovation and modification of our residence at 78084 San Timoteo Street
in LaQuinta. This initial request for a building permit is for the interior modification of the main house
only. As you can see on the plans our long range goal is to update the exterior of the main house and
renovate the guest house and garage as well.
Enclosed please find original and revised plans for framing, foundation, site plan, electrical, mechanical,
floor plan and elevations. Some changes have been noted on the plans. The following items may be
helpful in your evaluation of our proposal:
1. All windows and sliding glass doors (currently singlepane)will be replaced with new
insulated glass units.
2. All exterior walls will remain as built—no increased square footage is requested.
3. The roof (tar and gravel) will be replaced with a sprayed polyurethane roofing system
providing an increased insulation value of R-10 to R-13.,
We are anxious to proceed with this initial phase while plans and engineering for exterior parapets, guest
house and garage renovations, and beams connecting the main house to the guest house are being finalized
Time is becoming critical since we are part time residents and contracting the work ourselves. We will
extend every effort to make your job as easy as possible and will be grateful for any assistance the Building
and Safety Department may be able to offer.
If you have any questions during your review of our submittal, please contact us at the phone numbers
below.
Thanks.
R. J. Orr `
760-771-0095 phone
766-771-3576 fax
L a 2 c..c-&"]Cz 4G.01 -4F4& Z Z ,°
Commun.Uy Azzoc-.atZon
P. 0. Box 162
La Quinta Ca 92253
Telephone: 760/564-2177 FAX: 760/564-4882
June 15, 2000
Planning Department
CITY OF LA QUINTA
P. 0. Box 1504
La Quinta CA 92253
RE: REMODEL
LOT 26-2
Ladies and Gentlemen:
The Architectural Committee of La Quinta Golf Estates has reviewed the plans
for remodel of Richard and Susan Orr's home at 78-084 San Timoteo and find
these plans to be in conformance with the guidelines established by the CC&Rs.
Please consider this letter as our approval for Mr. and Mrs., Orr to proceed
with this remodel.
If you have any questions, please contact the Office at the number listed
above.
Yours truly,
BARRY CHOOLJIAN
Chairman
BC/at
r�
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