0209-045 (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 Contfactor
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.
1 have and will maintain workers' compensation insurance, as required by
Secf'ion 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 COIt/?`A. ERCE&INDUIT Policy No. WMONM
(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' compe-sation provisions,.of-Se ction 3700`9f the Labor
Code, Ls all,f �rthwith comply With those provjsions%��'""� r
Date-Zinga.'Failure
Appl&n .✓ r'/ r _ C.- /�r:l;—sem""�•,.
War to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building.and Safety.
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at:
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of thi§ City to enter upon
the above-mentioned property. for inspectio purrposesy, 1 s
Signature (Owner/A t- ✓ �' t' ` Date i
,�f�.�
r�
PERMIT #
' -BUILDING PERMIT
02M_0416
DATE VALUATION :9291315.Z?2() LOT 13.4 TRACT 1914 9 .
JOB SITE
ADDRESS 89AP iAR069APLA✓A,
APN 771�{r�0
OWNER
CONTRACTOR / DESIGNER / EN (NEER
C!IIMITAS IM ia.0 SMA .C. IC
JIDIFREY C. 9'rO E DSA 1 o"filM14A:l.l BUILDER '
P101MY.K.1303
4700 VIDNAARMPN AVE01, 00
I -A QaJlMA CA 92253
NDATO f 131✓,R1Ck CA 92660
(g49>450.9911 CB14
USE OF PERMIT
MTC$ ,-L+ FA1+/lll Y AJ I°/3,CH7Z
f11;1LJ) 'NCx ;04 1-YPE +C, -5479 S.F. &UNITS. PEWMIT VOYS NOT
NUTIPLL PLAN CHECK S.AhOIETYP1L
PORM—F!i°.t 10
.��I�t4it91Ni3d1'w'V•N 5,472.00 SP
EMMA= COST IAF E:{T!MMU MON
!v`ONS`CRUC"•►i'I M FEE 101.00301418-000 $1,3.n so
PLAN CHECK 101-000-439-318 $359.40
'f+r1;ECHAIACA•L• RE 101-01150-421-000 $'ION
E.L.PX11TRIC.P.11.,11,22 101-000-420-000 $3 73.02
FIX M1:4fA0 FEZ 1011-000-419-00 �Td9.QA
STRC?NO MOTION M, - RFSID 101-000-241-000
DEVV110P'I.M.. IMPAC -11 Fes• $16100100
AR_r Iii PUBLIC PLACES - YMIT 270-030€3•-4.4.E-000 Man
A.�
r �y
')TA1. C 8 ftlit �1+TI A,1 PIAN :".�i1 t'
AMB �l` 1 3 FRE M0
p
i t?,fs"1�.I1sv
-PAID
OCT 0 4 2002 1 RYffMT IMES:t E' NOW
CITY OF LAQUINTA
FINANCE DEPT.
$ 8,974.0;9
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
St.Ducts
Slab Grade
O
Return Air
Steel
Combustion Air
Roof Deck
.02 zo 7
Exhaust Fans
O.K. to Wrap
. p
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
, �3
o Ari.!
—t K -o -W_ ,&
Uwo Sir -0
..e � 57
Final
Final lZ
BLOCKWALL P7-ROVAL9
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
(�" 'g�
/
Heater Final
Plumbing Final
Plumbing Top Out
Z .a i
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
;1-. g .
Encapsulation
Gas Piping
Gas Test
A pliances
-7,0 3 sl
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) Ze S
L
Tom Tisda:a
`Fire Chef
'Proudly serving the 1)ccetnber 24, 2003
UninoDrporated
Meas of Riverside 1
County and the City of La Quints
(dies of . Building Department
Tanning
aesumo�l Re: Fire and Life Safety Clearance '
Calimess
Canyon I Ake
The Riverside County Fire Department is granting.i fire and life safety clearance
- Coachella
�. for "the follovtwirig pro�ect'Casitas Las Rosas for pha>e I and'II, located 50920
Dcserlilot Sprints Avenida:Bermudai ;:La Quinn. `Please -call if'you should have and Questions.
p,-4zq
Indian Wells SAMA' jQas�4 .
Indio
A
La Quinta Respectfully
Moreno Valley
FRANK KAWASAKI
Palm Dzscrt
Chief Fite Departinent
Perris
Rancho Mirage
E► ,
Sart Jacirnto
eiuccu;a ' By
V J O fti
Terry;DeS cy
13oard of supervisors:
Fire"S ety Inspector
Bob fluster,
District I
John Tavaglionc,
Dislriet 2
Jim Venahic,
District 3
Rcv Wilson;
i3:g:rict 4
ht5rion'Astdey.
i.)istrict 5
EMERGENCY SERVICES DIVISION•• PW ININGSECTION • INDIO OFFICE
82-675 Highway in, 2n° FI.ondio, CA '92201,- (760) 863-8886 • Fax (760) 863-7072
Certificate of Occupancy
4
-Buildng &'Safety Department
This :Certificate is issued; pursuaWt. 9. the "requirements of Section 109 of the,California Building
„ .. .
Code, cern n that,. at they time 4,c issuance, this . structure -was �n compliance with the
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provisions. of the Building Coale and `the various ordinances of the .City regulating building :
construction and/or use. E
BUILDING ADDRESS:75043.0.SANTA ROSA PLAZA UNIT #1
x Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-045 .'
' Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC `
Owner of Building: CASITAS LAS. ROSAS LLC
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Building Official
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-05-2003 -
N A CONSPICUOUS PLACE
Certificate of Occupancy
Btfilditil"A S06ty
This . Certificate is issued pursuant to the requirements of Section 109 • of the California Building
Code, 'certifying that, at .the time of .issuance, ;this. structuro was in compiiance -with 'the
y - .
%Mnvkhoi
isins of the. Building -Code. and tffe various ordinances .of the City regulating .building
ction and/or -use.
BUILDING ADDRESS: 50-730 SANTA ROSA PLAZA UNIT #2
Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-045
`. 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: .12-05-2003
IN A CONSPICUOUS PLACE
11111131 ".
Certificate 'of Occupancy
T4af 4 4 a"
Buildrgy afety Department
This Certificate is issued-,pursuant.to the'requireqents of'section 1 09,of the California Building
f is wasin ! compliance with the
Codd, certifying that, at. the time' 0 issuance,
'
provision's of: tire.. Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING -ADDRESS':. 50-730 SANTA ROSAP,NIT LAZANIT #3.
J- Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-045
Occupancy Group:R-3
Owner- of Building: CASITAS LAS ROSAS LLC
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: 12-05-2003
A CONSPICUOUSTLACE .
.This :Cert
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Code; ce
provision
Certificate of Occupancy
- ui�,tcv
B ;Wding -.& Safety Department
lcate is issued :pursuant to the requirements of Section, ' 109 of the California .Building
thrs strucfure was in compliance with -the
f fymg that; - at the 4ime . of issuance,
of, the Building 'Code and the various ordinances ' of -the City "regulating building
M' and/orwse: -
BUILDING ADDRESS: 50-730: SANTA ROSA PLAZA UNIT #4
Use classification: SINGLE-FAMILY ATTACHED Building Permit No.: 0209-045
s _ Occupancy, Group: R-3 Type of Construction: VN Land Use Zone: VC
F Ea
Owner of Building: CASITAS LAS ROSAS LLC
Building Official
Address: JEFFREY STONE •DBA°SUMMIT BUILDERS
City, ST, ZIP: 4700VON KARMAN -AVE. #100
By: STEVE TRAXEL
Date: 12-05-2003
A. CONSPICUOUS PLACE
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Certificate- of Occupancy
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/^- Building A: Safety Department
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#` This Certificate is issued pursuant to the requirements of Section ,109 of the California Building
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r ; : Code; - -certi6rn that, . at the time of issuance, this structure- was:: in corn Bance with the
7 provisions of the Building Code and the various ordinances of the "'City regulating ; building
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' construction and%r use.
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BUILDING ADDRESS: 50-730.SANTA'ROSA PLAZA-. UNIT #5'
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Use classification: SINGLE FAMILY ATTACHED Building Permit No.: -0209-045
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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
Date: 12-05-2003
Building Official
POST IN.A CONSPICUOUS PLACE
. . of Occu ancCertificate p Y
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ofT -Building-& Safety,De artinent
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This Certificate is issued pursuant to ,the requirements of Section 109 of the California Building
Code; certifjiing 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
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construction and/or use.
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.. BUILDING ADDRESS: 50-730 SANTA ROSA°PLAZA UNIT #6
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Use classification: SINGLE FAMILY ATTACHED Building, Permit No.: 0209-045
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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
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City, ST, ZIP: 4700 VONKARMAN AVE. #100
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By: STEVE TRAXEL
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Date: 12-05-2003
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Building Official
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POST IN A CONSPICUOUS PLACE
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� Certificate of Occupancy
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9F YDe mnt
California -
This' C,erki�J.te is'-issued,p!4,rs,qqfttolthp.rpqy!rements-of,Secti6h,169.6f the Building
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Cadecektifyg, at the p,,Jssyqpce this Sthicture was ccm0ance with `the
pro &.4he Building, Code and I b (various -ordinances of. the Qty regulating. building
construction an dlbilbsie.
BUILDING ADDRESS: SANTA ROSAPZALA' UNITS 7
,_�.6643.0
Use classification: SINGLE: FAMILY ATTACHED Building Permit No.: 0209-045
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Occu'pancy Group: R-3 Type of Construction: VN, Land= Use Zone: VC
Owner of Buimlding:,CASI'tAS LASROSAS LLC Address: JEFFREY STONE DBA SUIV!Mlf`BUILDER S
City, ST, ZIP*- 4700 VONKARmAN -AVE. #100
6
By: STEVE TRAXPEL
Date: 12-05-2003
Building Official
POST IN A CONSPICUOUS PLACE
•
31
11111
2
Certificate of Occupancy
T-iht4. #
Building & Safety �v.epartmenlt
.
This 'Certificate is issued pursuant to the requirements of Section 109 oFthe California Building
Code,:;, cerf fy ng'. tha , of the` tihie of issuance, this structure was -in compliance with the-
p�ovisons of the ;Budding Code and the various ordinances of the City regulating building
corisfruct�on and/or use:
BUILDING ADbRESS:.50-7.30 SANTA ROSA.PLAZA UNIT48 r
4.
Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-045 ikL
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Occupancy Group: R-3' Type of Construction:. VN. Land Use Zone'. VC
Owner of Building: CASITAS LAS ROSAS LLC
Building Official
POSTIN A CONSF
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Address: "JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #1.00
By: STEVE TRAXEL
Date: 12-05-2003