0209-047 (SATT)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 -,I r -r5' •.�
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.
( ) 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. 'WC;%"J� '4` 1
(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 pro--v-isions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Dater Applicant.
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 1
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 for inspection purp"oses.
Signature (Owner/Agent).r '
PERMIT#
BUILDING PERMIT
DATE VALUATION &.X)1,40 1: i jy LOT TRACT �.
ITE
ADDRESS ss .:1TA 1?0&AFLA7,1:�..
APN 7A140-0-i?.I
OWNER
CONTRACTOR/DESIGNER/EN INEER
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USE OF PERMIT
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PER MIT [)oF.9 Mr)l' 11 CI., ME DIAXK WA LW OR ?'tAA_4:_M% Ill?011090
PLA14 CHECK FN.F F(WR MI,1ITfPLI? PLAN CHIt;CK 3.AAf1? `YY)'TF
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CONPTRU(`-1` OA W1, I01-000.4 )8_000 124,15kfto
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Pl.l1MISINO MR 101-(1( 0.419.111 V.49.00
3 T ROHO MOT10N FEM, - RKAILI 101-000-241 •.000, t14o.7A
DKV F:1.01IMP IMPACT ffI41 K $16100R,90
li? III PUBLIC PLAC FS R011: 270-000--1145-0M silid.fo
s 1}�-'f'!`f'I' ru i<1'<t';'I� 1. ➢�'"1 r(�.F1 1s1J1) I'J.m `:HI�,I !X
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C1iY OF LA QUNTA
FINAHCEDEFT
RECEIPT
DATE
6Y
DATE FVAL.Eq
INSPECTOR
_
Z
INSPECTION RECORD
a
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSP EC
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
ca
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
�, p��
Exhaust Fans
O.K. to Wrap-lD
. cz
F.A.U.
Framing
-1-7Compressor
Insulation
,� g
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
, o
Drywall - Int. Lath
3 - t d • O $
L Fvt,. S
l - •o Z. g7
/�
sO Z 7
LoiVe,c Gt•p 4.vF f
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Final
Final cC
BLOCKWALL A ROVALS
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 �/
Water Piping
Heater Final
Plumbing Final
Plumbing Top Out
Shower Pans
l . le • O -A 57
Equipment Enclosure
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
— t o -4 11-S
Encapsulation
Gas Piping
-[ O - p -p.7
Gas Test
Appliances
Final
COMMENTS:
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) 0 3
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DEC -24-03 WED•.12 44PM RIV;. C'.0' FIRE .P.&E INDIO "FAX P:O; 1. 760'-863 7:072 P. 2
RIVERSIDE COUNTY FhR E .DEPARTMENT
In cooperation wr h he
Colt ornla De' rtment ojForestry and Frie ProtectioII ..
f P�
iq,;.
2 est_;San aceto venue;: Perris; a ifor a •?sO •: axL.
94
Tom Tisa:a
'Fire::Chlof _,
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`.Proudly serving the I)etnier, 24, 2003
Uninoorporatod .
Arer
eas of Rivside
Courcy and the City. of LaQuinta .
Cities of:. BuildinDepartment
Bunning
4.
i;caetno�t Re:`Fire and Life Safety Clearance
Calimesa
fi
Canyon Lake
i' The Riverside Count Fire De artmen6 rantin Afire and life safef.. clearance
t^oachclia
Y P- g - g ., Y
�. for..the following project Casitas.Lasd osas for pha>e I and'II, located°50920
Dcsert Ilot Sprints Avenida Bermudas; U`Quinta: Please -calUif•you=should have and Questions.
A
.0% SAnrIA' /?cav1 PGazA "'• g' gdt. Qt.A39,3.
Indian Wells
ro
Indio
�r3ke flsicxx�
P. -
La Quinta Respectfully
Mmno Valley
°..1 RANK KAWASAKI
Palm Ihscit
•f Chief' Fire.Department
Perris
Rancho Mira
G
San Jacinto
S,. _r\,
Tcin&ula. By
Terry DeS cy
Board of supervisors
FireSafety Inspector.
J30bi1ustvr,
District I
John Tevngtionc,
putria z .
Jim Venable,
District 3
. Rcy W itwn.
t)iguia 4
Marion Ashley.
IN. riot 5
EMERGENCY SERVICES DMSION,• PLAIINING SECTION- INDIO OFFICE
82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Faz (760) 863-7072
Certificate of Occupancy
T4&t 4 XP Q"
Building &Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at -the time of issuance, -this structure was in compliance with the
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provisions., of the ,Building Code and the various ordinances of the City regulating .bciildin9
construction and/or use.
' BUILDING ADDRESS- 50_-710.SA14TA ROSA PLAZA UNIT #1.
Use classification: `SINGLE FAMILY ATTACHED Building Permit No.: 0209-047
;{ Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC
Owner of Building: CASITAS LAS ROSAS LLC
Building Official
Address: JEFFREY.STONE DBA SUMMIT. BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
PLACE
Certificate of Occupancy
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Builaling &Safety Depa►'finent
r
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at . the time of issuance, this structure was in compliance with the
provisions - of the Building Code and the various ordinances of the City regulating -building
construction and/or use.
BUILDING ADDRESS: 50-710 SANTA ROSA PLAZA: UNIT #2
Use classification: SINGLE FAMILY ATTACHED
Occupancy Group: R-3
Owner of Building: CASITAS LAS ROSAS LLC
Building Official
Type of Construction: VN
Building Permit No.: 0209-047
Land Use Zone: VC
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VON KARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
POST IN A CONSPICUOUS PLACE
�- Cerriticate of Occupancy
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G of Building. & Safet Department
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This Certificate is issued, pursuant to the requirements of Section 1,09 of the California Building
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4 ' Code, ceqgy!ng that at, -the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
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BUILDING ADDRESS: 50-710 SANTA:ROSH PLAZA .UNIT #3 r
,�
Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-047'
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC
i
Owner of Building: CASITAS LAS ROSAS LLC Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
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Date: 12-04-2003
Building Official
1�
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POST IN A CONSPICUOUS PLACE
Certificate of Occupancy
4
Building &' Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying:, that,. at the time of ,'issuance, this structure was in compliance with the
provisions of", the Building Code and the various ordinances of the City regulating building
construction andlor use.
BUILDING ADDRESS: 50-710.SANTA ROSA PLAZA UNIT #4
Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209--047
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC
Owner of Building: CASITAS LAS ROSAS LLC
Building Official
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
IN A CONSPICUOUS
By: STEVE TRAXEL
Date: 12-04-2003
Certificate of Occupancy
4
Builaling.-& Szife yDepartrrient
This. Certificate is issued pursuant to the requirements of Section 109: of the California Building
Code, certifying that, . at ,the time of issuance, this structure was in com liance with 'the
provisions of, the Building. Code and the.. various ordinances of the City regulating building
construction ',and/or use.
BUILDING ADDRESS: 50-710 SANTA ROSA-PLAZA, UNIT45
`
Use classification: SINGLE FAMILY ATTACHED
{ ' Occupancy Group: R-3 Type of Construction: VN
Owner of Building: CASITAS LAS ROSAS LLC
1�
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Building Official
POST IN A
Building Permit No.: 0209-047
1'
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Land Use Zone:; VC: '
" .:FIVII
Address: JEFFREY STONE'DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
Certificate of Occupancy
T&r 4 412i&eQ
Building &Safdty Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure .was in, compliance with'
the
...provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 50-710 SANTA ROSA PLAZA UNIT #6
.Use classification: SINGLE FAMILY ATTACHED
Occupancy Group: R-3
r
Owner of Building: CASITAS LAS ROSAS LLC
Building Official
Type of Construction: VN
INA
Building Permit No.: 0209-047
Land Use Zone: VC
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
Certificate.of Occupancy
T40t 4 4 Q9W&
Building &Safety Department
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This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in co If
with the
provisions of the. Building. Code and the -various ordinances of the. -City regulating building
r . construction and/or use, t
t � ,
s k ` BUILDING ADDRESS: 50-710SANTA,:ROSA PLAZA UNIT #7
Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-047
3i
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC
Owner of:Building: CASITAS LAS ROSAS LLC
Building. Official .
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
POST IN A CONSPICUOUS PLACE
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CO �-� of Occupan
- Certificate C
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OF' 9 Building A Safety Department
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This Certificate, -is issued pursuant to ,the requirements of Section 109 of the California Building x
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-:Code; cern fY� m that, at the time,. of issuance, this structure was in compliance with the
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,. i., provisions, of ' .the Building, Code and • the .various' ordinances of the City regulating building
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construction and/or use,
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BUILDING ADDRESS: 50_-710 SANTAROSA`PLAZA UNIT48
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i
`.Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-047
-
�. Occupancy Group: R-3 Type of Construction: VN .Land Use Zone: VC
Owner of Buildin 9'CASITAS LAS ROSAS LLC Address: JEFFREY STONE DBA SUMMIT BUILDERS
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City, ST, ZIP: 470.0 VONKARMAN AVE. #100
By: STEVE TRAXEL
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Date: 12-04-2003
Building Official
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POST IN'A CONSPICUOUS PLACE - -