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0308-173 (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 iri full force and effect. License # Lic. Class Exp. Date 4 12 B C20, 091JQ Date % f' �-� Signature of Contractor^''"-""'`='-�1=�-^^ ,J 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 STATE 1 UND Policy No. - 1640909-03 (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 shallrf`orthw•ith comply witth:those�rovisions. r - Date: %d./'<9 Lt 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 fo'Iinspection purRoses. Signature (Owner/Agent)'.t'"✓��/ Date �a PERMIT#- BUILDING PERMIT DATE o� 03M.1113 VALUATION LOTTRACT 19 i{t'r 1 ig3 JOB SITE ADDRESS :z -mw A '1 -7)AjG!Amz APN t74-Ci"'I14*6 OWNER CONTRACTOR/ DESIGNER/ EN INEER 1)311 M?Z Ol?] IT CORP DDH iMk't>Ef,0Pi'+aNT:CGRP 78.921 RUNAWAY, BAY 78-921 RUNAWAY BAY 1 1d UDA DUNES CA 92261 F3E.21vf€ DA I NES CA. 92261 (760)3604106 MI L411 15261 USE OF PERMIT c' S1�1'GIZ FAMMY 1),wa3•.Di 4 16 213,F. 8FD, 1F1'.MIT .D0ES X Cff INCLUD9 EIIACX WALL . P00LISPA. OraDRIV1sE"WAYAPPROACH. 75% REDUCED PLAN CHECK "IME FOR M ULTIPLE HOUSES OF SAME PLA.14 TYPE TRACT C014STRUCTIOW 1,621,00 3F PORCHIPA.T10 $"/.40 SY C#.�C31�r,OCP,3'�FOkt"1° 4,00 911 ',ice AIM C0.TT OF CONSIMUCT ON CONSTRUCTION47M 101.000.418-000 $623,00 PLA14 CHrXK FEE 101-000-439-318 31131.74 Mi. DEPOSIT 10.1.000-4329.318 &y011,0U M 7Lf.'iF ANICAt; 1131-000-+421-Q0Q $�h.0a . ELECTRICAL PZ& 101.000.420.000. $114.64 PLU mBw rt FEF, 101-b00-419-000 $111.+00 STRONO NOTION FIi_ - RFX1D 101-000.241.0090 $9.51 . OIC D1140 ra, 101.000-423.000 $15.0 ► � DEVELOPER IMPACT FEE PRECISE PLAN 101-000.441-34 5 $100.00 3111-T.'C'1'.i L C033STfZ.LTMON AND PLAN' CHWi r $4,088.19 a NESS PT&F'AIDNF. 9 $0,00 D - .. PF..RMtT TRIES 8111 S4,088.19 OCT 0 6.10 03 CITY OF. LA QUINTA - FINANCE IZ . P7 RECEIPT DATE, f f�. ' By `� DATE FINALED INSPECT `— , INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs - Q Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck - .0 Exhaust Fans O.K to Wrap ell F.A.U. Framing Compressor Insulation 471 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS 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 - (9 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 d Appliances Final COMMENTS: Final . Utility Notice (Gas) r-71-2 v 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) bate 9/3/03 No. 24908 Owner DGH Development Corp Address 78921 Runaway Bay City Bermuda Dries Zip 92261 CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Q BERMUDA DUNES rA RANCHO MIRAGE rJ INDIAN WELLS PALM DESERT ,y LA QUINTA �INDIO �^ O J IWIMINE11111 Jurisdiction La Quinta Permit # - 0308-173 Tract # BLK 183 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street Unit 1 19 53360 Avenida Juarez Unit 2 Unit 3 Unit 4 Unit 5 S.F. Lot # No. 1621 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 Comments Overpayment of $619.25 to be issued as a direct pay mailed to address shown above. Street S.F. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, reside al 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: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,621 S.F. or $3,468.94 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 CC/Palm Desert National Bank - Art Lambrose Check No. 086962 Name on the check Telephone 760/360.8706 By Dr. Doris Wilson Superintendent Fee collected /exempted by S on McGilvrey Signature Funding Residential Payment Recd $619.25 $4,088.19 Over/Under 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 on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the Districtfs) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building DepartmenUApplicant Copy - Applicant/Receipt Copy - Accounting rs 4� CHARLES D. GARLAND C„991 2 February 2004 REVISED: 9 FEBRUARY 2004 The City of La Quinta Department of Building and Safety 78.495 Calle Tampico La Quinta, CA 92253 Project: Single Family Residence for: D. G. H, Development Corporation at: 53 36.0-Avenidauarez=:=�' La Quinta, CA Regarding: Project Observation and Field Revisions To Whom it May Concern, Architecture, Interiors, Space and Land Planning Structural Calculations On 30 January 2004 1 visited the noted project site to perform code required structural observations. I noted only minor blocking, nailing and strapping issues that were resolved at the time of my visit except for the following. Shear wall "F” was not provided with the required 3x PTDF sill plate required in the construction documents. Attached please find my remedial detail to correct the missed 3x plating and studs. Please note that no special inspection is called for at the retrofit anchor bolting because no uplift forces are applied to anchor bolts, only base shear forces. Therefore, once the remedial detailing has been provided, I hereby state that the project's structure is in substantial conformance with the structural design intent as represented in the construction documents. If you have any further questions regarding this project please do not hesitate in contacting me. 74.854 Velie Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340-3528 ❑ Facsimile: (760) 340.3728 CHARLES D. GARLAND. C„997 Architecture, Interiors, Space and Land Planning Structural Calculations 2 February 2004 The City of La Quinta Department of Building and Safety 78.495 Calle Tampico La Quinta, CA 92253 . Project: Single Family Residence for: D. G. H._c[5aDevelopment Corporation at: 53=360-rAve Juarez La Quinta, CA Regarding: Project Observation and Field Revisions To Whom it May Concern, On 30 January 2004 1 visited the noted project site to perform code required structural observations. At the time I noted only minor blocking, nailing and strapping issues that were resolved at the time of my visit. Therefore, I hereby state that the project's structure is in substantial conformance with the structural design intent as represented in the construction documents. If you have any further questions regarding this project please do not hesitate in contacting me. Mrcrntect 74-854 Velie Way, Suite 5 11 Palm Desert, CA 92260 ❑ Phone: (760) 340.3528 ❑ Facsimile: (760) 340-3728 Certificate of Occupancy T4hf 4 4 a" Building & Safety Department 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 provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. Use classification: SFD Occupancy Group: R3. BUILDING ADDRESS: 53-360 AVENIDA JUAREZ Type of Construction: VN Owner of Building: DGH DEVELOPMENT CORP • • • IN A CONSPICUOUS A Building Permit No.: 0308-173 Land Use Zone: RC Address: 78-921 RUNAWAY BAY City, ST, ZIP BERMUDA DUNES CA 92261 By: KIRK KIRKLAND Date5-17-04 Certificate of Occupancy L IM L -=A G� OF�ti Building & Safety Department 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 provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53-360 AVENIDA JUAREZ Use classification: SFD Building Permit No.: 0308-173 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Owner of Building: DGH DEVELOPMENT CORP Address: 78-921 RUNAWAY BAY City, ST, ZIP: BERMUDA DUNES CA By: KIRK KIRKLAND %�• Date: 5-17-2004 Building Official POST IN A CONSPICUOUS PLACE S