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0310-288 (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 . 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: (0.) 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. fot is reason 'bate 1,9' ?J. 0 � Signature of Owner �s����_ .r WORKER'S COMPENSATION DECLA2ATO 4 F 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 Sectlon 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. (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 sub' to the workers' compensation provisions of Section 3700 f the Labor Code, I shall forthwith comply with Jse provwsions. Date: zu!..'31.03 Applicant -17 ��fi'✓'. � _� ' 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 she above-mentioned property for inspection purposes.,_ Signature (Owner/Agent) i"A Date. ll% BUILDING PERMIT PERMT# DATE�,,,� VALUATION LOT TRACT �11t0, 4 23SV 63 JOB SITE ADDRESS st^320 A. 1T.L)A a A0C0 APN '7'/."�- , 1404 OWNER CONTRACTOR/ DESIGNER/ EN INEER TRO Y PUTUM I'ii ALLYMMI © ] r2l6Za CJ7c"R LA Q1.'PiAl"1'A CA 92.253 . pla USE OF PERMIT 1`!{ }+D17 f Y W` G 1760 SY, SFD PL+1'LMIT D093 NOT rwi.'(=11LOC3. wAL4 POOUS PA . OR DRIVEWAY APPROACH TRACT CONSTRUCTION 1,760,fl0 S PORCH/PATIO ' 443,00 SP GARAMYCt RPC7RT 474.00 SP ESSUSIA17-D COSH OF C-OMM1f?C."!It)N 21t3•'7�,�0 CONST)tt1 T10144 FRE 10),-000-418-000 S673.00 . PLAN ClIECK FEE '10 of -000-439-318 $557.29 N"UZDEPOSIT 101.000.439-318 42S0100 MECHANI ,I. FRE 101400-421-000 $52.50 ELECTRICAL 1.01-000.4.20-000 $110.13 Pl:. )MB1t14.1 FEE 101-000-419-000 $115.00 ST)"n,+(i1Xi41viOM.N nF, • mnm 101,,ow-w .000 S)1.08 opA1'ING PSE °1431-000-423.000 $13.0 X �2,4b5.g0 DWELOPFA IMPACT FIX P:RFZ11SK PLAN 101-000-441-345 $1Qt►.00 . S'i E-T'©TAI. C,0MRTJC":tkOK AND PLAN C`,yiF X $4,056,45 IS -8 l PRE -PAID 1W.33 _$250100 (� TOTAL PPMM r 1!'EWS D1M.9 NOW 53„!506.4.5 OCT3 1 2003 QJJ INT' RECEIP ftKA(fu E. 0 _ 'BYY7 DATE FINALED INSPECTOR 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 F.A.U. Framing Q Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath L 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 D- G 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) (J� COMMENTS: Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patioshmalkways, 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 h Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of . $2.14 X 1;760 S.F. or $3,766.40 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/Citizens Business Bank - Wallace Miles Check No. 498587 Name on the check Telephone 760/771-4824 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by S n M Gilvrey ` Payment Recd $0.00 $3,766.40 mer/Under Signature - c NOTICE: Pursuant to Government Code Section 66020(d)(1), this will s e 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 CERTIFICATE OF COMPLIANCE Desert Sands Unified School District �_47950 �%wo) . Dune Palms Road Z4 ¢BERMUDA DUNES r Date '10/31/03 La Quinta CA 92253 RANCHO MIRAGE d ILLS No. 25154 (760) 771-8515 PALM DESERT �.� PALM DESERT LA QUINTA_�7 aINDIO �� O Owner Rory Putman/Wally Miles APN # _ 773-091-004 Address P O Box 604 Jurisdiction. La Quinta City La Quinta Zip 92253 Permit # 0310-288 Tract # BLK 63 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 4 51320 Avenida Velasco 1760 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 patioshmalkways, 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 h Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of . $2.14 X 1;760 S.F. or $3,766.40 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/Citizens Business Bank - Wallace Miles Check No. 498587 Name on the check Telephone 760/771-4824 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by S n M Gilvrey ` Payment Recd $0.00 $3,766.40 mer/Under Signature - c NOTICE: Pursuant to Government Code Section 66020(d)(1), this will s e to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting Y; u� S A 0 fi ov, 7 • - Oct . �- 1' ♦-� �� , ;=�. ­ -� Clortifica.0 0 4 "' te_ of_ Occu ancy_ ' � 'J ��'s,_ c - = TAF.+ ��, � ,� ; � � t•�`i{ OF T� Bu•ildin �& ��•Safet: � De ate_ rr"ient �- •� � F1 �•..� .. d'$+ � .,,¢ {; r .t -J - _ Y r This Cerfificate is •issuedpursuant to the requirements sof Section 1,09V of the California Building 'Code`,. `certifying -that, at, the•+ time -o f •` .issuance; ' this. atr'ucture 'wasw in compliance with the ._ • . provisions`r.of 'the •Building•��Coale �and''the.,variou's-� o'rdiriancesof `-the° City �aregulating £building . coristr"uction and/or use: •�. -h .. ter, - F +- :" '.-, p�, •J,� _ ~•t t"� �' � ..,a'� � 1,_ t:: � 'E � r a r,s �' r r•k _ y ',3 ` i � '- — � � �,� 'JL i" ,, ��, .. �� - y'' ry_ a . � - `•'r'i � ►,� r�i �� .. .] . �.. of . ..."l , 7 n,� � �. .' � ,, �;�-, �:•�;.1BUILDING'ADDRESS .51,=320-�AVENIDA VELASCO• -_-. e"Y .wc 4'`� ^°. 4` •�, .,.. «• 4� ice', rV V' •y `l ., ,.. � �, r �, y � .,J �- �• ]ie , Use clas`sifi�cation:��SFD = . �� Building,Permit.No.: 0310-288 - "� ` Occupancy Group R3`Type of Construction:.VN � � - - �'-� ,'••',� Land>Use Zone: RC� Y� . �v _' ,y f. 'v r • �,�� a .. � i '� J -M � ! E•iCcrf `�,. ti. y t ,� '7 � .y. � f- � .-.'- Jik « ,. _ � � , r '4,�, ., �• ;; ' .a .r - W � :• �< � % ^ �� A. � _ Y- . � w' - *` Y.i 1 i a R d i , '�-*'-Owner of. Building: RORYit ,PUTMAN]WALLY-MILES Address:�P.O: BOX 604 City,`ST,:.ZIP: LA QUINTA,CA 92253' "r� �) �� �� �-�, " K ' `1�:�•i '� - By: -KIRK KIRKLAND -. �� -� ,� •�;," ��:,� " .: � �r _ k �`'- a" - - Date:'7-26-2004 ' �� s, ;z`• . €� Building•Off .. � ,- ,- "' � 'Jrr ,fir _ .. • w - .:y F.91 .. ._ � J ; ,.r -' - 7 y icial r :� _ .. • POST IN A�CONSPICUOUS PLACE Y; u� S A 0 fi ov, 7 • - Oct . �- 1' ♦-� �� , ;=�. ­ -� Clortifica.0 0 4 "' te_ of_ Occu ancy_ ' � 'J ��'s,_ c - = TAF.+ ��, � ,� ; � � t•�`i{ OF T� Bu•ildin �& ��•Safet: � De ate_ rr"ient �- •� � F1 �•..� .. d'$+ � .,,¢ {; r .t -J - _ Y r This Cerfificate is •issuedpursuant to the requirements sof Section 1,09V of the California Building 'Code`,. `certifying -that, at, the•+ time -o f •` .issuance; ' this. atr'ucture 'wasw in compliance with the ._ • . provisions`r.of 'the •Building•��Coale �and''the.,variou's-� o'rdiriancesof `-the° City �aregulating £building . coristr"uction and/or use: •�. -h .. ter, - F +- :" '.-, p�, •J,� _ ~•t t"� �' � ..,a'� � 1,_ t:: � 'E � r a r,s �' r r•k _ y ',3 ` i � '- — � � �,� 'JL i" ,, ��, .. �� - y'' ry_ a . � - `•'r'i � ►,� r�i �� .. .] . �.. of . ..."l , 7 n,� � �. .' � ,, �;�-, �:•�;.1BUILDING'ADDRESS .51,=320-�AVENIDA VELASCO• -_-. e"Y .wc 4'`� ^°. 4` •�, .,.. «• 4� ice', rV V' •y `l ., ,.. � �, r �, y � .,J �- �• ]ie , Use clas`sifi�cation:��SFD = . �� Building,Permit.No.: 0310-288 - "� ` Occupancy Group R3`Type of Construction:.VN � � - - �'-� ,'••',� Land>Use Zone: RC� Y� . �v _' ,y f. 'v r • �,�� a .. � i '� J -M � ! E•iCcrf `�,. ti. y t ,� '7 � .y. � f- � .-.'- Jik « ,. _ � � , r '4,�, ., �• ;; ' .a .r - W � :• �< � % ^ �� A. � _ Y- . � w' - *` Y.i 1 i a R d i , '�-*'-Owner of. Building: RORYit ,PUTMAN]WALLY-MILES Address:�P.O: BOX 604 City,`ST,:.ZIP: LA QUINTA,CA 92253' "r� �) �� �� �-�, " K ' `1�:�•i '� - By: -KIRK KIRKLAND -. �� -� ,� •�;," ��:,� " .: � �r _ k �`'- a" - - Date:'7-26-2004 ' �� s, ;z`• . €� Building•Off .. � ,- ,- "' � 'Jrr ,fir _ .. • w - .:y F.91 .. ._ � J ; ,.r -' - 7