Loading...
0305-200 (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 634981 13 01131i'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: ( ) 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. (, ) 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 vrA`fR 1w Policy No. 1$4245? -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 shall forthwith comply with those provisions. ` Date: 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, indemnity 'r& 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. ,. I Signature (Owner/Agent) Date BUILDING PERMIT PERMIT# MIS-= DATE VALUATION LOT TRACT r j 994,697.50 1? • DLK 2,,35 / JOB SITE " APN ADDRESS 77-536 CALM MLL011 974-11514124 OWNER CONTRACTOR / DESIGNER / EN (NEER Ci11EOMiLEW'C2fiMSES C.01: ONFZ, CION'Trillulln, 0Y P,01 BOX 389 $1-105 AVENJDA V11LA 010 i LAQilJNTA CA 92253 ,LAQLT3NTA C.4 9225.E (160)a64.4604 Ck3I41, 2261 USE OF PERMIT BUGLE RAJ4W�'1' 13WFELLING 1514 S.F. SY?D. PER IrF DOMNOT INCLUD9 BID= WALL, POOL OR DRKrWAY APPROACH TRACT CONSTRUCTION 1,514.00 SP PORCHIPATIO 149.00 SP OAR AWC.ARPORT 936.6►► BP VS'1:f.N1b"R"I COST 01`r C%tjl'1WROCTICZN 1'1�,'�21v91:T VKE 9UAW. AR`s C0148TR'UCTION YZE 101-000-418.000 Ort,," PLAN CHECK FEE $515.33 FEE, DEPOSIT 101.000.439-318 4250100 ACKH.ANICA1. KIP; 101-000-421-000 $.52.50 ELECTRICAL FEE 1Q1-000.420>000 $112.21 - PL13I15BIND ME 101 -000419-000 $136.010 ST` ONO MOTION REE • RW'i3 101.000-241.400 $9.0 ORA2 ING FEEZ J01-000-423-000 $15.00 DKV&LOPER IMPACT FEE W09.Qo PRECISE PLAN 101-000-441-345 $100.00 13'l'31;3 -TOTAL C0NffM1:JCrr1014 SWT-) PLA14 MIECK X3,963.31 LESS PRE -PAM FFM •$250,00 TOTAL PJ9R11T rn9 ]YUE NOW $3,713.61 JUN1 g 1003 RECEIP'C F NANO INTI► { /' B � f �` DATE FINALED 2. 0 I10141 INSPECTOR I INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS `MECHANICAL APPROVALS Set Backs — Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Ul Combustion Air Roof Deck Exhaust Fans O.K. to Wrap /Q 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 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 l] Final 17 Utility Notice (Perm) COMMENTS: CERTIFICATE OF COMPLIANCE 'S F s Desert Sands Unified School District zq�:��o 47950 Dune Palms Road Q BERMUDA DUNES r Date 6/18/03 La Quinta, CA 92253 rn RANCHO MIRAGE b No. 24566 (760) 771-8515 INDIAN 1 'Cl-� PALM DESERT y LA QUINTA �INDIO © v Owner Coronel Enterprises APN # 774-161-024 Address P. O. Box 389 Jurisdiction La Quinta City La Quinta Zip 92253 Permit # Tract # BLK 235 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 12 77530 Calle Chillon 1514 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments 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: 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 $2.14X 1,514 S.F. or $3,239.96 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/Valley Indpendent Bank - Ish Coronel Check No. 287272 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by S Signature McGilvrey $3,239.96 Payment Recd $0.00 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 District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting �. • v ..,_ -_ •Y: P..:"« r:l.• . `M ..!:w,-..W.).Ar: %e.:i�'KR;nas:.4•�:`7:. ,'l_•:�.-q:�7. ., '�;,• 'Y,.' i "--4-�.., RER0R-T-..O'F `FIELD. C"OMP/k.0 :oVaREPdATNo. CLtD+T - ;is �-:•.a PROJECT:�'Q %� �..�.�•-._ ' ".SOIL 10 T VISUAL CLASSIFICATION Or SOIL I MAX- DRY DENSITY, PCF OPTIMUM a.101STURE, q; Tc5T ELEVATION °NVCLEAA GAUGE WOAMAYION ANO�-1ARD FCALI7AA710N 2Z-0 CALIBRATION NUMOEiLS -P.TiON, PERCENT•?/- GAUGE AOJUSTMEITT % YAAIATION iNOM PCF I PROM SHEETS' OF TEST CONTENT, LAsT USE iG-,•VCc TYPE: ?.MPB DLL I MOISTURE: MOISTURE; NOISTURF: MOISTURE; I .MODEL NO.: �. C� ` OENST': DEC -08-2003 07:24 AM I STALLA.TION CERTIFICATE CF -6R Site .-Address Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS _ DUCT I-EAKAGE REDUCTION Ilrc'is:irtzauon'Fes( Results (CFM n 25 PA) Test Leakage (CFM) .� Fan 'Ivt, is Calculated as 400 cfrNton x number of tons, or as 21.7 x Heating Capaciry in Thousands of Bvdhr, enter calculated value here �y ' If fan now is measured, enter measured value here Leakage fraction = Test Leakage/(Measured or Calculated Fan Flow) = Pass if leakage fraction 5 0.06 ( [] Pass Fail D Fur .kE.ROSOL TYPE SEALANTS ONLY - The following diagnostic testing wus completed,. Duct Fan Pressurization at rough -in measured leakage (CFM) t:. H U.'K AF'T'ER FINISHING WALL: ❑ l cs ❑ o ❑ Pressure pan test or House pressurization test ❑ 1' s No ❑ Visual Inspection of Duct Connections �%�J� ❑ ❑ Pass Fail YTHERMOST'ATIC EXPANSION VALVE (TXV) Vp Thermostatic Expansion valve (or Commission approved equivalent) is installed and Access is provided for inspection ;E( ❑ Yes is a pass Pass Fail ❑ DUCT DESIGN ❑ 1'es ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches �l )SQ plans. / T7 [] Yea ®?•10 TXV is installed or Fan (low has been verified. If no TXV, verified fan flow matches design from CF -1R. Measured Fan Flow = ❑ ❑ Yes for both 1 and 2 is a Pass Pass Fail I, the undersigricd, verify that the above diagnostic test results and the work 1 performed associated with the test(s) is in ,-o-v .trmance %vith the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -tiff ,neo by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for :iunpliance cre[::t.� ignature, Date Installing Subconrractor (Co. Name.) OR 'r't •` General Contractor (Co. Name) (",P)' fULt,,ilc!inP Ueparimem HFRS Provider (if applicable) 3u:ldingg Owner ac Occupancy L•- Certificate of Occupancy c� OF 'T1 Building y p & Safety Department This Certificate is issuedpursuant 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: 77-530 CALLE CHILLON Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0305-200 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Owner of Building: CORONEL ENTERPRISES Address: P.O. BOX 389 City, ST, ZIP: LA QUINTA, CA 92253 By: KIRK KIRKLAND Date: December 11, 2003 Building Official POST IN A CONSPICUOUS PLACE