Loading...
0209-150 (AR)H _N U) W O M �� oZt� coo O. Io — cO wW� ►- a U) Z M LO N ON U °) CL Q Z Lo Q O LL Q J J mUU O a a) Z_ co /Z)-) V J 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 521333 la RIC l�'t.JU ,Date Signature of Contractor OWNER -BUILDER DECLA'RA ON I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 1, 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. (k) 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 STAI'Ir19ADO Policy No.4'i�U1 (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 shall forthwith comply with those>provisions. 'Ate: f �In. r Applicant AIX 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. k' 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 inspect on purposes. . t YS gnature (Owner/Agent) / Date i t BUILDING PERMIT PERMIT# if DATE ! VALUATION LOTTRACT JOB SITE APN ADDRESS OWNER CONTRACTOR / DESIGNER / EN (NEER MY,UBAR ca. L. sc"OVE148 CION wtRuCY11014 MOUMAIN CU tUR CA 132561 (76t1)it;S14439 OBLI6 7,483 USE OF PERMIT 140%F. ADDITION W1111 111001W ib;''frflt.A.OES &MISCRU.4=11CAnflm .AMITIM 14MID S D COM" OF C0149)MU .'-'AI�:kN ""(wM— ,. p�,�, �yp��pt� p�; q�y'77� p.� �1y�3v".%"�,R%�'.f�'�"+E+ CONS'1RUCTIt3N?�'r-Z 01.-X000-418.000 aWLECTFttMT, FRE ..,. 10 4OOQ, 421.000 S'P1;01,1%1 R OT11014 1' E , .R19510 101-000-241. -000 �.•P5 ' WWTOTAL (aONK JOTITOU AM :1'Li4 N CHECK, It £fi 2!.6'5' LWSW FRR�PAW EMS $0.00 'AT, rMNITITIFEEN MIX NOW '2002 D OCT 31 CITY OF LA QUINTA FINANCE DEPT. RECEIPT DATE BY DATE FINALED INSPECT INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air .Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap ef<,c_ F.A.U. Framing C.),*-?-- Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath - a G Drywall - Int. Lath - --U Final Final BLOCKWALL APPROVALS 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 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test 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 G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: 14 f Bin #coo City o, La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 9,28�'15� Project Address: , 7 7 8 vem iy4 ror-tAJ o O%v ner's Name: a �, u 3� A. P. Number: ��{� — o �� Address: Legal Description: Cin', ST. Zip:— Telephone: Project Description: / Contractor: -)k-�, L . TC%j ,rw/e-i J 6.,4 Address: ,K 6i (� G 6 A City. ST. Zip: j►`- 11!1r^/ �/ 4�4 q2-5 e. %i <</O J /*/JC Telephone: State Lic. # Cita Lir. Arch.. Engr.. Designer: Address: ,32 q &.M V ie L1 •� City. ST, Zip: `r4. ,,zzi, / W .<3 76 Telephone: State Lu # i Z Name of Contact Person: + a/,r Construction Occupancy: Project typeacirela one New Add'nAlter Repair Din Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: --54 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structg4 ll !y fcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance , Title 24 Cates. Plans picked up Construction • Flood plain plan Plans resubmitted Mechanical 0 Gradin Ian Grading p 2nd Review, ready for correctio !issue /�l�/ 0 Electrical Subcontactor List Called Contact Person / Plumbing Grant Deed Plans picked up S.II.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CERTIFICATE OF COMPLIANCE J�,1FlEDsc Desert Sands Unified School District �~�° 47950 Dune Palms Road ¢ BERMUDA Date 10/22/02 La Quinta,CA 92253 V) RANCHO MIRAGE t7 � INDIAN WELLS ti No. 23764 (760) 771-8515 `yLMDESERT am P LA QUINTA10- INDIO y © •YJ Owner Susan Luber APN # 658-230-056 Address 77170 Avenida Fernando Jurisdiction La Quinta City La Quinta Zip 92253 Permit # Tract # Study Area Type Residential Addition No, of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 77170 Avenida Fernando Unit 2 Unit 3 Unit 4 Unit 5 Comments 140 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 140 S.F. or $0.00 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By EXEMPT -Gary Scrivns Check No. - Name on the check Telephone Funding Exempt By Dr. Doris Wilson Superintendent Fee collected /exempted by Monica Guillen $0.00 Payment Recd Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date ori which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting Pt I `yen. 1'_ X002 08:32RI P1 September 4, 2002 Susan Lubar and Kenton Peters 55 E. Wilson Street 4102 Madison, Wf 53703 Re: 77.174 Avenida Fernando Dear Ms. Lubar and ,Mr. Peters: Your Architectural request dated August 20, 2042 regarding extending master bedroom per plan, removing French Doors and replacing with sliding glass door per plan, installing two (2) skylights per plan and installing an courtyard entry gate has been approved with the following stipulations: .rr! • Actual modification must conform to the plans and specifications submitted and approved, Competent and licensed professionals shall do all work in a workmanlike manner. e All work is to be in compliance with local building codes and ordinances. • Ali exterior stuccowork trust be painted to match existing stucco (Sherwin Williams, Super Paint Satin • Ail electrical wiring, if applicable, must be contained within approved conduit painted to match the surfhce it contacts. Any damage to the cotnmon ares resulting from this modification and its construction shall be repaired at the Owner's expense, e if a construction bin is rented through waste Management it must be beige in color and stored, if possible, in the garage. Any construction bin must be kept locked. All construction debris; is to be removed frena the site by the close of web davday to maintain order and retain the aesthetics of the Santa Rosa Cove. o Prlor to the commencement of any work the contractor and their subcontractors) must provide. the Aswation proof of worker's comp, liability and auto insurance; naming Me Association as additionally imured, Prior w the commencement of any work you or your contractor must provide the names of the scheduled workmen to the sectoity guards at the Mazatlan gate, (564-5414). e Prior to the commencement of any work your contractor must read and sign the Association's Contractor Rules, which has been supplied to them. • Prior to the comm®neement of any work you are required to pay a $ 500 refundable deposit for the patio extension (received with applicatdon). Please contact the Association office once your modifications are complete for a final inspection. A copy of the approved variance wilt be mailed to you after the inspection, If you have any questions, please call. Very truly yours. J eh-� Carl McCullough Association Manager On Behalf of the Architectural Committee THE SANTA ROSA COVE ASSOCIATION 4981 Ewinnowa Delve Ca Qanre, Wkwa 91113 0601777.76ZI n Paw 060) 777.7622 MvUrAAdbrrms 11020 SANTA �ZOSA COVE ASSOCIA.TYO r Noce"Als92213 1'airo DeKer, Gllkunli 9Y3f3