0209-046 (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 .
584656 P,
i `
Date �` � 'Signature of Contraciorf
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 COb4MhRC.4&1, f4PU,.J Policy No. 19r`'C:9d9•?.x1'93
(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 w,9rkers' com ensation provisionslof.Section 3700 of the Labor
Code, I, ha I for�hayith corr> y wsGtrhdse pro�i�ions./�`
Dater�� APplicaht�:_,.•� � •4 . ('....�.��" �
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 lis=
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 for inspection purposes.
Signature (Owner�Agent)`�t ':a- "f �� �' Date
BUILDING PERMIT PERMIT#
02.0••W6
DATE VALUATION $293,'52 7 10 LOT B-5 TRACT 299109
JOB SITE
ADDRESS 50-'72.0.SAINI'"1A 1"0t8A PT�.EiZA
APN 770-021dD-001
OWNER
CONTRACTOR/DESIGNER/EN (NEER
CASUA,k; I.AH R08AS iI,C
M-WKEY C. STONE l'.a:Ei,� ui3:h,9:IvTI.i BUlWIM
P.O. BOX 1503
4700 VC)N7t ATOAAN AVRO.100
LA t,pjftA `1'A CA 9225-1
A3EWPDXII BRACT -1 CA 92,660
(949)1.503 9961
USE OF PERMIT '
SINGLY-
Lif. ILVINGif.4 TYPE Jk, SMSA F. iS•llhiITS. PERAOT C3(.)ESIdOT
1NCI. UDIZ BLOCK WAMS OR POOLS, 13% REDUCED PLAN CIS FXK KK FOR
IMMIX t {i IX PLAN CHECK SAMB TYPE
s
POR,OWP,p,TIO 940.00 31;
APARTI MT',"s" 1%-N 5,47L Of) SIF
EnDIAT i CC)F.4':.3F CONSTWUrC.110K
291152.7.20 ..
Ct'AASTR.UC,TION FTSE 101.4700.418-000 $4318.50
PLAN C1=1C FRE 101-000439-318 $321.17
'
MECk3ANIC.AL FPR, 101 •-000.421-000 $20.00
r
E ECTF;K;.11 , FEY 101-000.420-000 $37`.1.06
'
P1.t7MOTNO My. 101•.000-419-000 $3€9,00
STRONG hit7'P10N FLU - MID 101-000-241-000 929.3.5
WN"11APF„R. IMPACT MIR $16,00.kft
ART 1N PU15LIC PLACID` • PEME M-00.0,445-•000 $x33.22
10
SUB-'!`OTA:T., 0D.tIM'RUCrr(0X AND ry.:gSigi9�/,."rK
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$10 5
OCT 0 41001
CITY OF LAQUINTA
FINANCEIDEPT
RECEIPT
DATE /
BY
DATE FFALEDf
SPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Y
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
,p
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
. p
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior LathZ•p
75 '57
Drywall - Int. Lath
3_3.0 3
�►
-e Z57
t.Q 6R.c te-9 .5
o - y v
Final.
Final //�/ 1_7
BLOCKWALL�AFfV' R0 ALS
POOLS -SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines3
ers gT
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
- , p 57
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
- 1. o-0 3
Pool Cover
Encapsulation
Gas Piping
_ .- S
Gas Test
�j
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
GF.I.
Smoke Detectors
Temp. Use of Power
Final AVf
Utility Notice (Perm) p S
COMMENTS: �✓�
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Certificate -of Otcupancy
TarV .ry
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K of T 9 - ~ Ouilfndg & �"Safety TDeparil, nt
This Certificate is issued pursuant to the requirements . of Section 109 of he 'California Building
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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.-720rSANTA-ROSA PLAZA VNITAI
Use classification: SINGLE FAMILY -ATTACHED Building Permit No.: 0209-046
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: -VC
Owner of Building: CASITAS LAS ROSAS LLC.
Building Official
CON
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City$ ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
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Cal; Certifi�cato of OccupanCY
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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 compliance with . e
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provisions ,of the. 'Building Code and the various ordinances of the City regulating building
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construction and%r use.
BUILDING ADDRESS: 50-720 SANTA ROSA° PLAZA UNIT. #2
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Use classification:'SINGLE FAMILY ATTACHED Building. Permit No.: 0209-046
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Occupancy Group:. k-3 Type of Construction: VN Land Use Zone: VC
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Owner of Building: CASITAS LAS ROSAS LLC Address: JEFFREY STONE DBA SUMMIT BUILDERS
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City, ST, ZIP: 4700 VONKARMAN AVE. #100
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f- By: STEVE TRAXEL
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Date: 12-04-2003
Building Official
POST IN A CONSPICUOUS PLACE
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Certificate of Occupancy
Tar
F�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 � t
provisions of the Building Code and the various ordinances of the City regulating building ' E
construction and/or use. > ;
BUILDING ADDRESS: 50=720 SANTA'ROSA-PLAZA*- UNIT #3
' Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-046 r
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC,oil
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Owner of Building: CASITAS LAS ROSAS LLC
Building Official
INA
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
Certificate of Occupancy
T-Omf 4 4 a"
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 and/or use.
BUILDING ADDRESS: 50=.720 SANTA ROSA PLAZA UNIT #4
Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-046.
Occupancy; Group: R-3 Type of Construction: VN Land Use Zone: VC
Owner of Building: CASITAS LAS ROSAS LLC Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
.-� By: STEVE TRAXEL
Date: 12-04-2003
Building Official
4
Cal,.�� Certificate of Occupancy
Wei
4 412*
oF:9Building.& 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 and/or use.
BUILDING ADDRESS: 50-720. SANTA ROSA PLAZA UNIT#5
$ Building Permit No.: 0209-046
Use classification: SINGLE FAMILY ATTACHED 9
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
t7.0.00100
Certificate of Occupancy--
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This Certificate is issued pursuant to the requirements of. Section 109 of the California Building
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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. building
construction and/or use.
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BUILDING ADDRESS: 50-720 SANTA ROSA PLAZA ,UNIT #614
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Use classification: SINGLE FAMILY ATTACHED Building Permit'No.: 0209-046
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC
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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
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Building Official
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POST IN A CONSPICUOUS PLACE
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Certificate of Occupancy
4
Buff -A S06ty, UdoadMe'ni
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 vof i�6arious brdin4hces City re9 ulating building
constructioh'andlor use.
BUILDING ADDRESS: 50-';720.SANTA-A0Sk PLAZA UNIT #7
Use classification: SIINGLE'FAMILYATTACHEQ Building Permit No.: 0209-046
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC
Owner of Building: CASITAS LAS ROSAS LLC Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN.AVE. #100
By: STEVE TRAXEL
Ale—
Date: 12-04-2003
Building Official
POST IN -A
Certificate of Occupancy
T-,emf 44-aw&z
Building&�5afety�Department
.4 ' .5
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 50-720 SANTA:ROSA PLAZA: UNIT #8
Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-046
Occupancy Group: R-3
Owner of Building: CASITAS LAS ROSAS LLC
fib'"' f Te'
Building Official
Type of Construction: VN
Land Use Zone: -VC
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
IN A CONSPICUOUS PLACE
-r.
1'om Tisda,a
"Fire COef
'.Proudly serving the j ce inber 24, 2003 i
Uninoorporated
An* of Fiverside
County and the
Citics of: .
Banning
r'
:aL2U[nO�1
t;alimcsa
Canyon Lake
Coachella
Dcsert Clot Springs
t•
Iridian Wells
ro
Indio
take Usinorc
La Quinta
fi
Mote -no Valley
PPIL m Desai
v
Perris
Rancho Mirage
San Jacinto
Te;nccu; a
Board of Supervisors:
Bob fluster.
District I
John Tavaglionc,
Dislriet 2
Jim Venable,
District 3
Rcv Wilson,
tMuict 4
Marron Ashley.
I.)istrict 5
City of La Quints
Building Depart>f1cnt .
Re: Fire and Life Safety Clearance '
The Riverside County Fire Departmenils granting` fine and life. safety clearance
for the following:project Casltas>Las Rosas for_pha3e I and iI, located 50920
Avenida Bermudas; i.a Qu>nta ::Please catl:if you should have and•Questions.
.S/41�lTA 1 :'P'i '• C;: ,8O:6L"I:at�9,s
Respcctfully
FRANK KAWASAKI
Chief Fire Department
]3y 0 (It
Te:A,
.,y
. a
Fire' Safety Inspector .
.EMERGENCY SERVICES DIVISION • PW INING SECTION • INDIO OFFICE
82-675 Highway.111, 2n6 FI., Indio; CA 92201• -,(760) 863-8886.• Fax (760)863-7072