0209-042 (SATT)LICENSED CONTRACTOR DECLARATION
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
1fiA 1%
Date ' 7` f ' Signature of Contractor. `( g
7 t
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. -.
(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
Code,I $half fortliwith comply with those provisions.
Applicant
Warnirig F Ilure 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
the above -mentioned property for, inspection purposes.
Signature (Owner/Agent) =',L r _�.� C .,, �t
r"fF':> Date ^r
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
JOB SITE
APN
ADDRESS "v/'fie f.°d Sb ,i ".•.; s
-
OWNER
CONTRACTOR / DESIGNER / EN INEER
CASUM 1JW RR: SM I..l is
>IEYPVk'Y C. Z;1': INE- 013tl f. lw1iE'x s� txi Lii+:. ,
Rt:>, t3OX 1;503
1700 V()1MhR:M! N ,h1.T*1(K)
.A. 'Ci A CA 97�.S;3
iak<'W1,1'�:��e°]Ci3EAt::IIA CA 9266"?
USE OF PERMIT
3114G1..;1?`,1�
H VIi..I4l O 01 TYPE 'ATI, ;1,F, 914,11TS. 6'i~ RMI f f:lOYS 140T
INC:t UDY BLOCK WALIZS OR F(X.A.14
.t!'F'.N.Riis�tiV`1'y�+"•'fd �,d��,0(3 �,�
EN1!`.tlMlx1.013) C'oyr OF CONYMMlC;''I7CM
M311527,2()
H-%llbu"Ry it
(Tj)?i,!T1't3CTKfN YKE 101-(K)0-419-(}00
PLAN C HYCK Me 101 000-4 39-3 1 1� s1,ni,69
MECHAWCty1.<rKY, 101.00( -471.000 U61,00
Ff-.? TR.1CAf. frFY 101440-104 0-000
I1110l, H NG "Y' # C71-WO-419aEl{3(1
STR.E)NOAdOT3C;N YFF1 itl SID 101-000-241«tVO $29.35
11' PACT FFF 116,004-W
,,A,33?f' fN f'Ltit3.ie Pl. Af:'3fs , RES,11 '? 10-000-4 5-WO VIK01
IT %)f+.:POSIT 101.000-4"39. fi 18-$I,Ooon ou
c
O`aTIA-T( AL, 0� 9M. ".DMnX AUT.) Y1.4,004
S1
1 s3 ?"RIf
Y
.t AL YE'IR;Ii.1;1.'' . ') UV
t0 i- 0 �: tuul
CITY OF LA QUINTA
FINANCE DEFT.
RECEIPT
DATE
BY
DATE FINALED
� . Q y�3
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms& Footings
p•
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
/ .OZ
•$T
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
(• 0 3
�Z
/
A, Li
! • ! .o i
5
Final
Final 57
BLOCKWAL A ROYALS
POOLS -SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
w
Underground round PI . Test
g b9 t
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
s'
Ste.
Heater Final
Water PipingfQ,Z•l��E�-z
Plumbing Final
Plumbing Top Out
$
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
03
$7
Encapsulation
Gas Piping
Gas Test
a q ,
Appliances
40. •*f Gela
A/- 2 .a
Final
COMMENTS:
0477 watt �.�5� j' S%rit•t, /.t 9 ?-- a= -
�� E� i't� dP sj /'-�3.v•3 ST ��
�``'°`' "�'`� �"xa �,_�,•os�
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
0
Final
RUtility Notice (Perm) GO
Tom Tisdale
Fire Chief
Proudly serving the
Unincorporated
Areas of Riverside
County and the
Cities .of:
Banning
Beaumont
q.
Calimesa
❖.
Canyon Lake
Coachella
❖.
Desert Hot Springs
4.
Indian Wells
Indio
:-
Lake Elsinore
La Quinta
4.
Moreno Valley
.g
Palm Desert
1.
Perris
ye
Rancho Mirage
.1
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jim Venable,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In.:cooperation .with the
'California Department of Forestry and Fire.Protection
210 West San Jacinto Avenue • ems, California; 25/ a (909) . ax(�9) 10
December 24, 2003
City of LwQuinta
Building Department
Re: Fire and Life Safety Clearance
The Riverside. County Fire Department is granting.a fire and life safety clearance
for the following project Casitas Las Rosas-forphase T and II, located 50920
Avenida Bermudas, La Quinta. 'Please call if you should, have and Questions.
Respectfully
FRANK KAWASAKI
Ci iefFire Department
By
Terry D'Sattcy
Fire Safety Inspector
EMERGENCY SERVICES DIVISION'*! P.LANNING SECTION a INDIO OFFICE
82-675 Highway 111-, 2n° FI., Indio, CA 92201 (760) 863-8986 *;'Fax (760) 863-7072
S.a,C f Occupan
CCe'rur tate oY
a
OF �w Building & Safety D6A&trrment
} 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
ti
Pyflvisions of the -building and the various ordinances of the City regulating building
construction and/or use. .
BUILDING ADDRESS 50-760 SANTA•..ROSA PLAZA UNIT #1
f Use .classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-042
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
! dot
Ile -
Building Official
POST IN A
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
•.
r.'; s;: :. ..,+...x:..: ,.., � .. , xt.. y.;r v a : - . Yv# - i §i::. ..... {w : ., v r'. . ,-: -.01
Certificate Occu anc
.of
may:
Ir:
a
� i
x
ofB u�l a & 8�irkk_bepartment
This Certificate is issued pursuantxto. the of Section 109 of f the.. California Building
? i
`
Code, •certifyingthat; of the time 'issuance, this structure-- was in . ,compliance with the
provisions of =the Building Coded and the various,,ordinances of the City regulating building
construction and/or use:'
BUILDING ADDRESS:.50-760 SANTA ROSAPLAZA- UNIT #2
f s
t
'
". Use classification: SINGLE FAMILY ATTACHED Building Permit No.: 0209-042
i
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC
` }
..
#
It
Owner of Building: CASITAS LAS ROSAS LLC Address: JEFFREY STONE DBA SUMMIT BUILDERS
i 3
tx
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
--7—.4, Ale -
t5 3
a
Date: 12-04-2003
t
Building Official
i
POST IN A,CONSPIC000S PLACE
r
Certificate ofOccupancy-
,
Bu ld�ng..:& Safety�Departmen .
Y
This.. Certificate' is issued pursuant to: the requirements kofYSect�on.1'09 oftheaCal�forniaBuilding
Code,�',certefying that,. at the t�rrte of issuance, 4thes atructure was ren �complJance with, the
provisions=f'th
oe Building Code` and the various.:or finances of fhe City regulating building
construction and/or use.
BUILDING,iADDRESS..50-760`SANTA ROSH>PLAZAf-UNITS:#3
2 .
Use.classification:.SINGLE FAMILY ATTACHED.
Occupancy Group: R-3 Type of Construction: VN
Owner of.Building: CASITAS LAS ROSAS LLC
3 ,
i� i •
I Building Official
Building: Permit No.: 0209-042
Land -Use Zone: VC
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700-VONKARMAN."E. #100
By: STEVE TRAXEL
Date: 12-04-2003
E
:0j,
rt��ficato of Occu anc��Ce p Y0
c of 9: Bufld ng & S56f6f Dep'
arfinen#
ficate is issued pursuant to 'the requirements of Section 109 of the California. Building
This Certi'the.
Code, cer#i in `that, at the - time of ossuance;
this structure was in -compliance with t e .
fY . g .
44 provisions` of the Building', Code;*and the .various ordinances of the City regulating building
vr consfruction.and/or use.
BUILDING ADDRESS: 50-760 SANTA ROSA PLAZA UNIT #4
WT
Use classification: SINGLE FAMILY'ATTACHED W
w
i Occupancy Group: R-3 Type of Construction: VN
Owner of Building: CASITAS LAS ROSA. S LLC
Building Official
Building Permit No.: 0209-042
Land Use Zone: VC
a r
Address: JEFFREY STONE DBASUMMIT BUILDERS
City, ST, ZIP: 4700 VON KARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
A CONSPICUOUS
i
Certificate of Occupancy
T,vf 44a�rw
Building &rySafety =Department
This Certificate is.is., pursuant to the requirements of Section 109. of the California Building
Code; .certifying tha , a't the time, of 'issuance, this structure was gin.. 'compliance with the
s s # provisions ` of:`:.the Building Code and the various , ordinances of the City regulating -buil ung
x construction `anaUor use. 3
P i
t
i BUILDING ADDRESS: 50-760;SANTA ROSH PLAZA .-U.NITI#5
a
Building Permit No.: 0209-042
Use classification: SINGLE FAMILY ATTACHED g
f Occupancy Group: R-3 Type of Construction: VN Land Use Zone: VC b
�F —
Owner of Building: CASITAS: LAS ROSAS LLC
y,
Building Official
Address: JEFFREY STONE QBA:SUMMI.T BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
N A CONSPICUOUS PLAC
Certificate of Occupancy
& Safpty'D. ��rtment
Buildin
OF
This Certificate is issuedpLisy4n
t e reqyirpments,
of Section the California o
Building
certifying that ai etime issuance, this,strdctUr6:;Was, in compliance- qnce- with t
e
provisions jtps ofthe .Building
Oildi
ng Code an the various. ordinances of! the City re
adiating building
'
vist�unan"r u e.
-:
BUILDING ADDRESS: 50 -760 -SANTA ROSA PLAZA: QNiT.#6
Use classification: SINGLE FAMILY ATTACHED Build.ing Permit No.: 0209..6042
Occupancy Gfdup: R-3 Type of Construction:,VN Land Use Zone: VC
OWner of Building: CASITAS-LAS ROSAS LLQ
Tt
3i i
Building Official
Address: JEFFREY STONE DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE TRAXEL
Date: 12-04-2003
M
ISM
Certificate of Occupancy
4;ui�,tc�
-
86.ildifi `Depai
S i W 7 tment
'the bmia Building
This Certificate is issued pursuani-to the' requirements of Section 169 -of C61if
the time I e o . f, issuance, s structure4 was in-�,conjpfiaince withh-the
Code., ceriif that,,. at.' thi
t
ty
provisions of ' ,the- -,Building -Code and thie,-various drdihand6s''.of he Ciregulating building
construction and/or use.
t
BUILD - A
INGDDRESS: 56 66AGs
'�ANTAAAAZA-tN TV
Use classification: SINGLP-.FAMILYATTACHED Building Permit -No.:-02,09-4.42
Occupahcy,Group: R-3 Type of Construction: VN Land Use Zone.. VC.
Owner of Building: CASITAS LAS ROSAS LLC Address: JEFFREY...'ST-ONE'DBA SUMMIT BUILDERS
City, ST, ZIP: 4700 VON KARMAN AVE. #100
By: STEVE TRAXEL
Date: 12;iO4-2003
Building Official
IN A CONSPICUOUS PLACE .,
a,� • .�.� f OccupancyCertificate o
5
..x .I
Bu� ding. &S. Depp,nm:en
it
3. This Certificate: is issued pursuant Loathe requirements of Section 109 of the California Building
Code : cern ming that,time of essuance, this structure was �n compliance with the
fY ..
rovisions of ahe ~Budding:' Code and the. various ordinances of the City regulating building
Pro > A
construction and/or use.
BUILDING ADDRESS: 50460"SANTA ROSA PLAZA .UNIT #8
r:
r s- Building Permit No.: 0209-042;
Use classification: SINGLE FAMILY ATTACHED
Occupancy Group: R-3 Type of Construction: VN
4 Land Use Zone: VC
;
Owner of Building: CASITAS .LAS ROSAS LLC
4!� y
#i t
Building Official
Address: JEFFREY: STONE- DBA -SUMMIT BUILDERS
h .
City, ST, ZIP: 4700 VONKARMAN AVE. #100
By: STEVE-,TRAXEL
Date: 12-04-2003