0108-354 (SFD)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 # I Lic. Class Exp. Date
451035 B 01/31/2(
Date Signature of Contractor
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:
O 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 o_t the work,for which this
permit is issued: My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
EXEMPT
(This section need not be completed if the permit valuation is for $100.00 or less).
O I certify that in the-performarice.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' conipensatiori.provisions of Section 3700 of the Labor
Code, I shall forthwith comply with1hose 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
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) Date
BUILDING PERMIT PERMIT #
DATE VALUATION LOT 0108-354 TRACT
$155,060.40 188 DCT U5
JOB SITE
APN
ADDRESS
51-305 CALLE PALOMA
770-174-088,
OWNER
CONTRACTOR / DESIGNER / ENbINEER
BYRON & JODI PUETT
AL DURRETT CONSTRUCTION
23-315' SYLVAN STREET
51-52�18 AVENIDAN1ARTiNEZ
WOODLAND HILLS CA 91637
LA QUINTA CA 92253
(760)771-4368 CBL4 1463
USE OF PERMIT
STEPHEN R NIETO
SINGLE-FAMILY DWELLING
-82723 DR CARREON BLVD '
SFD - PERMIT DOES;NOT INCLUDE BLOCK WALI,•POOL OR DRIVEWAY
APPROACH,
TRACT CONSTRUCTION 2,406.00 SF
PORCH/?ATIO .. .72&00 SF
GARAGE/CARPORT 733,00 SF
ESTIMATED COST OF CONSTRUCTION
155,060.40
PERMIT FEE SUAMARY
CONSTRUCTION FEE 101-000-418-000 $835.30
PLAN1. ,HECK FEE 101'-000-439-318 $691.76
FEE DEPOSIT 101.000-439-318 -$230;00
MECHANICAL: FEE 101-0007421-000 $98.50
ELECTRICAL. FEE 101-000.420-000 $147,77
PLUMBING FEE 101-000-419-000 $131.25
STRONG MOTION FEE - RESID 101.000-24T 1-000 $15.31
ORADINO FEE 101-000-423-000 $20.00
DEVELOPER IMPACT FEE $1,907.00
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$3,847.29
LESS PRE -PAID FEES
-$250.00
TOTAL PERMIT FEES DUE NOW
$3,597.29
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
' __0 TAt�W
P.O. BOX 1504
Building ?yi f�l
I �. 78-495 CALLE TAMPICO
Address / ! �� r`,Al LA QUINTA, CALIFORNIA 92253
Owner iF T7I PUMailinS
Address 233 15 5AVAJ 4 '?
City, Zig
PILLS
nt°7-3r/
APPLICATION ONLY
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number �� — 04 'o oo
Legal Description ) fl �f ✓� ����
4'_120111%&t4 Project Description SFR �r O� 5n
v v r
Cit Zip Tel. e s
1 _ no , ,- 9 � 21, I -r I.A .1,7114- y 'Z
State Lic. City
& Classif. d.f s , O 35 Lic. #
Arch., Engr.,
Designer
Address. Tel.
11-12-3 Wo X12- 655
CityZip State
�Nb�v 922PI Lic.#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby 'affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to. construct, alter, improve, demolish, or repair any structure, prior to 'Its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than fivehundred dollars ($500).
I."" 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, Bussness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
I'1 I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
F) Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred dollars (E100) valuation
or less.)
I certify that in the performance of tho 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.
Date Owner
NOTICE TO APPLICANT: 11, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with'all city and county ordinances and state laws relating to building
con s truction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
Sq. Ft. 2 bj 6
Size f
No. No. Dw.
Stories Units
I Newx I Add ❑ Alter ❑ Repair. ❑ Demolition ❑
>timated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructur
TOTAL
REMARKS
AMOUNT
LV
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Desert Sands Vnified School' District
47-950 Dune Palms Road j
Notice: La Quinta,:iCA-92253
Document Cannot Be Duplicated 760-771-8515.
CERTIFICATE OYCOMPLIANCE
Date 10/22/01
No. 22603 Jurisdiction
Owner NameByron & Jodi Puel
No. 51-305 Street Calle Paloma
city La Quinta Zip 92253
APIC# 770-174-008
La Quints'
Permit #:
Log #
Study Area
Tract # :Lot # 188 Square`Footage 2406 .
Type of Development Single Family Residence ''.No. of Units 1
Comments
By
At the present, time', the Desert Sands. Unified` School District does :not ;collect fees. on, garages/carports, covered
patios/walkways, rekdential.additions under 500 square feet,.detached'accessory*structures or replacement mobilehomes. It
has been determined the above-named owner is exempt from paying schooHees at this time due -to the following reason:
EXEMPTION NOT. APPLICABLE`4Y"
Thi's certifies that school facility fees,imposed pursuant to, Government.Code 53080 in -the amount of
2.05 X 2,406 or $ 4,932.30 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in thisproposed'project may now be issued
Fees Paid By CC / Bank; of America; Stephen Nieto �TeMph ne 760-342-5555
Name on the check
Dr. Doris Wilson
Superintendent
Fee collected /exempted by Annette Barlow
� U1�
Signature
Payment Received $4.;932.30
Check No. 20;1.0021567,
NOTICE: Pursuant of A'ssembly'Bill 3081 (CHAP„ 549, STATS: 1998) this will serve to notify you that the 90 -day approval period ihwhich you may protest the fees or other payment identified
above will begin it) run from the date on which the building or instal'lation:permit for this project is'sssued or on which they,are paid to tfieDistrict(s) or to'another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form.to:districtcopy.for all waivers.
Embossed Original- Building Dept./Applicant Copy -Applicant/Receipt Copy Accounting `
MrR-05-01 MON 09:V4 AM FGA-kE'rL STATEACh.IN FAK tip, 31U> ;J>; tulb: F.
"CORJINC 1RL0=0ED BY:
wmzw RECORDED mm T?. Tw
BYRON D. PGFrTT.,
'JOD I L . _ 91!ffi'I'T
22666 Ingosr
west I4zlls;, ca. 9110474622
SPACE A8'OV8 TA B, LIffi3;: FOA' RACOiUiER' ® 78 , ._.o
! y4 VD�� .
she and rsig=s c3zsator (�) doe ar®(a) cusaeAtarp tsrmiiifaz :tax is $ :59-. a0
1�88�SS0lt=�s3 B iRC$T+�I�IO.:N T70:j7`4=008 {9C) coaputad, oa f tl value` of propazty conveyed, or
aITL:Ofbz*-NO:.:�R 'ooaiputed on ttiQ'.'luil value .lea® limens or
EBCFt00P NO.: 2063793R' . en.Ctitlbrances .romniaiaq,. at tae time cit sala
FOR A VIQUA $ • COt111IDVAT;qN, receipt af' which' ` v her®by •acknowledged I
ROBJbW J. ROGGRR .asci NUBA 1 HOS®*R hiisbaad;. and 'wife,'
hereby GRAM (S) to BYRON. A.. B acid 'JIGH. -L. 3W19FYT hesbind -&Ad wife an joint tentbts.
The follawinq real Property in the La Guinta,-Rivorsid6 co.slsty;, state of California;
described a®.t hot 188 of. ])*sort C1tib ftaot, • as •hstwa;: F. -map Gi, le it: $ook 11,
PAg*(a) 61-62, is t8e Office of the COMO Reco�®r�ot ` ®raidt��C y.
Date: May 216, 2000
J R� fj'D
v'
COtA�Y -07. ) Boom ROSSER
pere�xnal.�y �ihoan tq: m� '(vr provad'.to°, mta ,om the'baa�
of sat ataator,y civ deaev) to .b® ehe:;"persoa(s). whoa®
name'(S•) is /Ar®` subscribed to,. t2ie within, ingtruu pt-
and ackno4l, c44®a to to that helehe/they ®x®cuted .the'
GAM in
hia7hez/taeir. aaithoriz®d -LIP !,Y
that by his her/their'sigaature(-e) oa t inbtrtimemt
the •pertson(s) or the entity= czg►oa b®kalf'.of aii eb 'th'
per®on(s) acted,• executed- the instrument.•
witness gay hPI and 'oifibla+ sma .
signature
(This area for o'.ficial notarial Seal)
3QZL T" TOt 22664 Ingemar, Went Villa; Ca. 91304-4622
jj�
78-495 CALLE TAMPICO
LA QUINTA, CA 92253
(760) 777-7075
APPLICATION
i�
FLOOD PLAIN DEVELOPMENT PERMIT
BUILDING SITE LOCATION
FLOOD ZONE `AO" - DEPTH 1
Sl 305 Gw{X f Al v %'\
COMMUNITY- PANEL NUMBER
060709 0005 B
Map Revised: 8/19/1991
APPLICANT INFORMATION SECTION
APPLICANT NAME
') > { �
APPLICANT
��� i��• C*Wo W -
ADDRESS
L q„312,M.
312,M
(MAILING ADDRESS, NOT THE BUILDING SITE)
DAYTIME TELEPHONE NO.2
INSTRUCTIONS
1. A Flood Plain Development Permit is required by LQMC Section 8.11.040(A). The Applicant should complete the
Applicant Information portion of this application and submit it to the Engineering Department along with the
required documentation noted hereon at the same time the Precise Grading Pian is submitted to the Building and
Safety Department for plan checking.
2. Documentation required for STEP 1 OF 2 APPROVAL prior to receiving clearance for Building,Permit issuance
• Copy of the proposed Precise Grading Plan for review and approval containing all information required by
the checklist shown on the back of this application.
3. Documentation required for STEP 2 OF 2 APPROVAL prior to receiving Flood Plain Development Permit approval.
Note, this approval occurs after forms for the lowest habitable floor are set and before the Building & Safety
Department authorizes foundation construction.
• Submit a completed FEMA "Elevation Certificate" form to the Engineering Department.
• Submit 95% relative density soils compaction certification to the Engineering Department.
STEP 1 OF 2 APPROVAL
STEP 2 OF 2 APPROVAL
The Precise Grading Plan submitted for this application has been
All requirements have been satisfied. This Flood Plain
reviewed and found to contain all data required to satisfy the
Development Permit is approved.
requirements of LQMC 8.11 The proposed dwelling is eligible to .
receive a building permit upon satisfying all other Building &
Safety Department requirements.
AUTHORIZED SIGNATURE DATE
La Quinta Engineering Departmen
AUTHORIZED SIGNATURE DATE
La Quinta Engineering Depa
ILE: Upon Step 2 approval, original goes in "Flood Plain Development Permit" file; copy goes to Applicant
9
GRADING NOTES
C 'HALL
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1_T_-__ - --------------- ......
f �y
STRUCTURAL AND CIVIL ENGINEERING _
DENISE R. POELTLER-INC... .
73.661 Highway 11.1 i Suite.G • Palm Desert, California 92260
01- October 2001
Mr. Tom Hartung, Building Director .
CITY OF LA 'QUINTA -
Department -of Building,and Safety
78-495'Calle Tampico
La Quinta, CA 92253.
RE: Puett Residence
:Job Site Address:. 51-305 Calle Paloma
Lot 188, Desert Club Tract -
Subjec.e Truss Acceptance Letter
Dear Mr. Hartung: .
I have reviewed the total deflection, live, dead, and drag loads used for the design of the
gang -nail roof trusses prepared by TRUSSWORKS (dated &23-2061), and -found them
within.allowable tolerances. The tile roof dead loads were revised to a lighter weight
system by omitting the 20% mud boost. Dead -load used for the design of the trusses -is
21.0 PSF..
Respectfully submitted;
e, OFESSio�,q`
�ccuQ \g�C R P®F! F2
%� rn�
Denise R. Poeltler No. 33 6
R.C.E:33446 1
Ezco f-3,: 2 as
civi ..
W.O. 01-148
cc: Mr. Steve Nieto, Southwest Concepts °-
(760)'779-0405 •. FAX (760) 779-1317
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE
O POST TENSIONED CONCRETE
O REINFORCED MASONRY
O STRUCT. STEEL ASSEMBLY
❑ ASPHALT
O FIRE PROOFING
O
O OTHER n 0
J08 LOC`TIO 1-
(��/� ^ Pb � r,\A LA -q ( .m
�J�/
REPORT SEOUENCE NO.
TYPE RE
POE -TT-
PERMIT 4Q, w���J���
cxo�
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT
HRS. CHARGED
EN
ER /)
ASSISTANTS
HRS. CHARGED
INSPE
DATE CTION
CONTRAGENECTOR
CONTRACTOR+; • C)�L.0
l A
A
0 ww4
N� .
l Arflv¢- USk vkSt w-- .S o^, S -o -Z
C -1b,".-
COPY SENT TO CLIENT O
CONTI D ON NEXT PAGE O
PAGE
OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY'
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED,
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS. _
l
GU RE OF REGISTERED PECTOR
I, —
nAIhp OF REPORT REGISTER NUMBER
S ADDRESS
� �,W,7 - VCITY OF LA QUINTA SUB-CONTR CTO IST PERMIT NUMBER 0201 - & D N E R •�/�r! S�. �,;1!;-1/
j
• � -�
us Torm snail be posted on the job with the Bu" din` Ins ection Card at all times in a cons icuous lacy e. Only
persons appearing on this list or a loyees are authorized to work
n this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a sto Daae of work and/or the voidance
of building permit. For each aoDlicable traria all A ,_ _ .
Trade /Classification
EARTHWORK (CA2)
Contractor_
Company Name
1cyuesleu oeiow must De completed
State Contractor's License
Classification License NumberExp. Date
(e.g. A, B, C-8) (xxxxxx) (xx/xx/xx)
by applicant. licant. "On File" is
not an acceptable response.
Workers•Compensation
Insurance
City Business
License
Carrier Name
(e.g. State Fund,. CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
CONCRETE (C-8)
FRAMING (C -5)--
STRUCT. STEEL (C-51)
/V
Al
IV ,j C c w5 80
o
I r! ��
MASONRY jC-29)
PLUMBING (C-36)
^ LATH, *PLASTER (C-35) .
iG Uy
—�j
iLf�(��C
'v'
�',`i�'I�G �v,✓f
LLUL>>>>$
DRYWALL (C-9)417iJ2/t/I7,
HVAC. (C-20).
.-�
ELECTRICAL IC=101VO
ROOFING (C-39)':
d
C 170
-
i7)(1-7190
7 31 0
S%?�i� �
g
/ , 5&X7
Z117, G
SHEET METAL (0-431
FLOORING: (C-15) .
GLAZING (C 17)::.
INSULATION JQ2)
SEWAGE •:DISP. W,-42).
G^
11 A11
PAINTING IC -33)':
CERAMIC TILE (C-54)
CABINETS (C-:'6).
FENCING (C -13)X1
Ile.
7
ZZ2
A-
LANDSCAPING (C-27)
POOL (C-53).
LK