9901-155 (RER)'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
343335 B C36 C8 2/28198
Date r7 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:
() 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. a
S1 Ai.F'LL Ff..iNDD ::29•39 W147,57
(This
(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.
/Date: _ Applicant •—�> —�
Warning: Failure to secure Workers' Co pr�i ensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
—.any permit issued as a result of this applicaton agrees to, & shall;. indemnify. _.
& hold harmless the City of La Quinta, its officers, agents and employees."
i Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
1-919nature (Owner/Agent).--" Date
BUILDING PERMIT PERMIT#
DATE VALUATION r . ' LOT TRACT
1129/"JOB SITE
ADDRESS 7"32 CH.LUE, NORTE �. APN
OWNERr�t ] CONTRACTOR /�DESIGNER
r/ENGINEER
M D'1�1.1
79.032 CALLE NOH` T 543%10 AVE Ni.DA JUAREZ
LA QUJl.NTA C.A 922-53 LA QLW- [.'A CA 92253W
(760)5644,147 C814 20.5?
USE OF PERMIT -
;it S.i1::1t..lrPl IAL �L kSAB.Ul3 .i
WCLOSEMSTWO 1$WM=fi ADD PAS,-- THROUGH WTNDOW, .[2 .N( VE
NION BE-AR,fNG WAJ:,1..
V j't" I ATi3Otd
p �.{ R Al,pdf 1A .4 / i., V �.Y .. E �... 1 Y F;4 3 i. J , !✓l'! L e. !�
1°E.�2ti I t'-FP&1:. SUMMARY
AYiVN CHECK i" -A. E1tJl�t3t�f?-tf -3133 ;i iu.a
4,e^ir.TkFFRUCTt0NME'; -00-0-•4jk-QfH1
t,;:.Lc;ITEUCAL [4LE 101-000420-000 $17.73
S7T,t0NG+ tvl%3 i' ON l MM-12ub3Tu 1.01 -1000 -241 -Ow, $.50
511 4T Ct1 �. (:Ole SIFRUCIIO'LV �.� 13. P .AN.C_REQ . _ - _ � _ ... � .,_.-.$1.22.18
LIESS PREIPAID FEES 0'
jj TMA:#: $122.18
RECEIPT DATE ` BY DATE FINALED INSPECTOR
INSPECTION RECORD
OPERATION'
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Fors & Footings jo,7 3, Z
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
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—(
Final
Final —
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . 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
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final .r.
Utility Nmwe (Per)
COMMENTS:
January 11, 1999
Villa Vista Homeowner's Association
c/o Robert Beatson; President
78-030 Calle Norte `
La Quinta, CA 92253
Dear Sirs: 1 i
We are pleased and grateful for your pror t approval of our planned improvements to 78-032 Calle
Norte (Unit 9 of Villa Vista.)
To ensure proper. disclosure of all plans, this letter is written notice and description of each planned
improvement.
• Improvement A - Move existing exterior living room wall (south wall) out approximately eight feet
to meet existing breakfast exterior wall.
See Attachment A.
• Improvement B - Remove interior den wall. .
See Attachment B.
• Improvement C - Construct black iron fence and gate to attach to west exterior kitchen wall and
adjacent Unit patio.
See Attachment C.
• Improvement D - Extend current south patio to wall line of Unit 10 and western most structure point
of our Unit.
See Attachment D.
Improvements A,B and Care to be started at the close of escrow and completed by March 1, barring
complications. Improvement D will be started at a "To Be Determined" date and notice will be given to
the Villa Vista Homeowner's Association.
If there are any questions please contact us at 760-564-0109 or 760-564-6866.
Thank you. again for your prompt response and we look forward to being your neighbors.
ch Wetzel