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0004-002 (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 # Lic. Class / Exp. Date Date ([ Signature of Contractor 1� 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. (<l 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 FREMONT COMPENO Policy No. SB50Q60019320 (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 prisions of Se�tiora 3700 of the Labor Code, I shale rthwith comply with those provisions Date:�ApplicantWarning.Failure to secure Workers' 0 ensation coverage is unlawful and shall subject an employer to cpminal pealties 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 autF�orize representatives of this City to enter upon the above-mentioned property,for 19s, ecti , urposes. /I f Signature (Owner/Agent)/. 1 Date_' BUILDING PERMIT PERMIT# DATE VALUATION LOT 0(*4 -002 TRACT O6/07120C $27'3,601.90 39 X886? JOB SITE .; APN ADDRESS ti -92.'5 C..T."?`i.. CE)'Vi. , ''I 70 -.VO -033 OWNER AMIREW RW—RCE CORPORATION 44835 DINP CANYON RD PALM DWWf CA 92251 USE OF PERMIT MNGLE FAM1.L.Y I)VTM-.�.INQ CONTRACTOR / DESIGNER / ENGINEER ANDREW P10CR CORPORATION 44€135 DiP CANYON RD PAI 1A DESIRPI ' CA 92261 ('760)346.3228 CBL4 03031 SED- PERMIT DOES NOT INCLUDD: BLOCK OR FOOL CUSTOM( CONSTRUCTIO'N 3,3",0,00 8F PORCHIPAT'IO 405.00 F 0- ARACfI' CARPORT (8F) 19,452.40 NY..T'dM.t M. COST OF C0.K9 7.R'UC':1T01q _ 2'JS,6OA.9i3 iPEMal,17E &'�T[►43mI� iii . CONSTRUCTION FFX, 101-000.418.000 $1,269,30 PLAN CHECK FEE 161-0100-433-3 t 8 $1,043.40 FEI? DEPOSIT 101-000-439-318 411000100 MECHANICAL FES 101-000-421-000 t , ELECTRICAL M 101-000.470-000 $201,83 s PLUMBING FEE 101-000-4.14-000 $117.00 MONO MOTION FEE- RESID 101-000.241.000 W196 GRADING FEE 101-000-423-000 $10.00 DWELOPER IMPACT FEE $1,407.00 AWr 114 PUBLIC PLACLu - RESII 701-000-253-000 $199.00 SUD- TOTAL COM3iUC '0N AND PW.T C2 -ICK 55,009.69 IMS PRE -PAID TERS, 41,000.00 .1`O r AL?-T_'RMlT P. S ��: NOW I $440 9,CD RECEIPT I DATE I BY /^.; i '3'") I DATE FINALED I INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts "Forms & Footings. Ducts Slab Grade 17 Return Air Steel Combustion Air Roof Deck !a -050 Exhaust Fans O.K. to Wrap - -p a F.A.U. Framing Compressor Insulation 45P7 Vents Fireplace P.L. -(B' -�o -j Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final L 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 zHeater Final Water Piping it Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Latera! Pool Cover Sewer Connection 7 Encapsulation Gas Piping Q57 Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Factures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final / Utility Notice (Perm) 17,11 1 F017- COMMfNTS� `73t \ \ -^s+r'ti.r:•,J•�1'�-•,:•,c:•.,�.r-v�r'Tl;s,^,��,-`:�{.:T',r,.:.,.�T'4;:.('74y",.'.:c�,-�wi,%,`-i`�'a+:T,c�;ryS'�t�•�3�:.�i.;��c�..f yfl7, "-"'•.;k: $"'i.: �. .a-.++Yc.;i�;,�••.sr :�„f�•� :i7=1�-"��:.. ".r.+rvx,-'= -.. T.Y. 01 Vim{/ - • u,r�, Pq I ® �DG� P.O. BOX 1504 AWLY(33 f 1(WQNLY Building�J 78-495 CALLE TAMPICO y Address 5� / �S C 6LA QUINTA, CALIFORNIA 92253 •+I , T of � QUINT t Mailing .Address • "lily " 27f3Sd��i� yir7 /J/i 41 Z 7/7"' �I�� j 13�� a8 State Lic. City & Classif. 2, 3 Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # ,�,,..�� LICENSED CONTRACTOR'S DECLARATION I hereb f irf rfii thit I am (cense—d"u de provisions of Chapter 9 (commencinb with S coon 7(XKI).gf'Driv'i one3�d�t¢e�usii eesssss•5�rPLrd�;Pif�offee�sS on/s/.��ode, and my licegpe�is1' ull fo c%bpd/, SIGNATURE /" DATE - OWNER -BUILDER DECLARATION 1 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 thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). [] 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, Buisness 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 orimprovement 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.) 1 1 1, 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 will, a contractor(s) licensed pursuant to the Contractor's License Law.) 17 I 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 r7 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 ($100) valuation or less.) I certify that in the performance of thg 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: If, 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 Ihereby 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 stale that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this city to enter the above- mentioned property for inspection purposes. Signature of a0plicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST. OCCC. GRP. , A.P. Number /� 550 7K -78 / Legal Description/0 7432 7K -78 Project Description Sq. Ft. No: No. Dw. Size Stories Units Newx Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT �1J AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure I TOTAL REMARKS 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 'Tradition ARCHITECTURAL DESIGN REVIEW May. 24, 2000 Mr. Jody Jones ANDREW PIERCE CORPORATION Post Office Box 3420 Palm Desert, CA 92261-3420 Re: APC, Lot 39, Tract 28867, 52-925 Claret Cove Building Permit Dear Jody, / /e city 0 � A '7. MAY 31'4 Bl1d�Otr��, �v�wc;; , Via First Class Mail and facsimile This letter will serve as authorization from the Tradition ARRC to obtain a building permit for the above referenced residence. As we discussed today, all architectural and landscape corrections must be addressed within the next 30 days or construction of the home can be stopped until all items have been received, reviewed and approved. I understand that the landscape plan is being changed and will be submitted for review no later than June 1, 2000. If you have any questions or need additional information, please do not hesitate to call. Thank you. Sincerely, Christina J. Dores Architectural Review Coordinator /cjd pc: Greg Butler,City of La Quint_ a, via facsimile J Gary Lohman, APC, via first class mail 78505 OLD AveoA 52 ^- LA Qw1rA - CA 92253-1120 - PHoNE 760/564-3355 -- FAX 760/564-2356 McGEE -SURVEYING, INC. 73-301 Country Club Dr.; Ste. 102 — Bermuda Dunes, CA 92201 Phone (760) 345-3828 — Fax (760) 772-5705 Friday, June 30, 2000 City of L- a;Q-umta 78-495 Calle Tampico La Quinta, CA 92253 Re: Pad Certification — Lot 39, Tr. 28867 Pursuant to your request a field survey was conducted on the above referenced project to determine the vertical location of the building pad. The above mentioned was found as follows: LOT ADDRESS PAD (DES)- PAD (FIELD) 39 5.2925 Claret Cove 90.0' 89.9' L.S. 5479 10 0 CONCORDE CONSULTING GROUP, INC. 722 FREMONT AVE, SUITE # 9 S. PASADENA, CA 91030 PH: ( 62 6 ) 403 — 7461 FAX: (626) 403- 7459 FACSIMILE TRANSMITTAL SHEET TO: FROM: GORDON STEIN KREPA COMPANY: DATE: STEIN AND ASSOCIATES 05/11/00 FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER: 1 PHONE NUMBER: SENDER'S REFERENCE NUMBER: RE: YOUR REFERENCE NUMBER: LOT 39 TRUSS REVIEW X URGENT X FOR REVIEW X PLEASE COMMENT X PLEASE REPLY ❑ PLEASE RECYCLE notes/Comments Dear Gordon: Just a note to inform you that as structural engineer of record on this project, I have reviewed the structural calculations provided by the truss manufacturer. The truss calculations satisfy the intent of the roof design for the referenced project. Sincerely K. M. Kripanarayanan SE "' No. � L S2654 Exp. 6103