9904-218 (SFD)LICENSED CONTRACTOR DECLARATION
I Hereby affirm under penalty of perjury that I am licensed under provisions of
F . Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C w Professionals Code, and my License is in full force and effect.
Z) ch License # . Lic. Class Exp. Date
toLCY -1w y1 h �� 99>9��vi✓'E "
oZ ir� /D to < Signature of Contractors
(D 0-
J U OWNER -BUILDER DECLARATION
Ha I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U3 License Law for the following reason:
•Z ( ) 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).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
ce) () I am exempt under Section , B&P.C. for this reason
O N Date Signature of Owner
rn
Q WORKER'S COMPENSATION DECLARATION
p Er I hereby affirm under penalty of perjury one of the following declarations:
Lo Ia—.O () 1 have and will maintain a certificate of consent to self -insure for workers'
X LU compensation, as provided for by Section 3700 of the Labor Code, for the
O � Q performance of the work for which this permit is issued.
GoQ I have and will maintain workers' compensation insurance, as required by
OU Q Section 3700 of the Labor Code, for the performance of the work for which this
d rn F— permit is issued. My workers' compensation insurance carrier & policy no. are:
`t Z Cartier Policy No.
Cb :i1'Q`Z` i:, 1�1^i;;it� 116tu33 Y'
C)
g (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 wiffi<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, 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
theabove-mentionedproperty for inspection Purposes.
.r
'Signature (Owner/Agent) + �'R ^f� �'` Date I ��
PERMIT#
BUILDING PERMIT
DATE VALUATION �jS ��� LOT ) TRACT
JOBSITE Y
ADDRESS 52.235,LAYFNNW A 6A1ATp
OWNER
CONTRACTOR / DESIGNER /
t y { f
(ENGINEER
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sitl is
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USE OF PERMIT
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UPSTIMATIM fbX:)V1M? CONSTI'VIUC ION'
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Is�t3s3Z<:1m;i3ttfa `l .ftl<. �.ta; 24' CliJ1i 1" I-;; .4-J ; $i,4as` 3.is
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t't)"9'v�'i� �'��=i3P��➢'� �^'C�;��.� �)3ny,; �Ca�'�
S?Po���9.��
RECEIPT
DATE
BY
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
OX to Wrap 57
F.A.U.
Framing -- 7
Compressor
Insulation 8 Q
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath [8 $
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
Final
Utility Notice (Perm) - 2.2 -Q . $= .
COMMENTS:
• 0 4 "
D
BOX 1504
n 78-495 CALLE TAMPICO
Address VC 2 f}Sc LA QUINTA, CALIFORNIA 92253
Owner
Address "� 'C`G 1 ! Lt U ,y
City Zip Tel.
LCrt': I - %. .3', 2L L rtL i,faw
Contractor.
V k"" C 4\ . (_ �� g c� k
Address
State Lic.
& Classif. .�, ` J Lic.4••�
Arch., Engr.,
Designer
Address I Tel.
CityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I herebyy affirm that I am iibensed under provisions of•Chapter 9 (c-P)lmencing with Section
7000) of DlSision 3 of the Business and. Professions' Code, and my li ansa is in full force and
effect. \%G ,� ..a�
\ OWNER -BUILDER DECLARATION
I 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 the alleged 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: 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, 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.)
I 1 I, 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 with a contractor(s) licensed pursuant to the Contractor's License Law.)
17 1 am exempt under Sec. B. 8 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
n Copy is filed with the city. ❑ 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
I hereby 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
ame
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state 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 -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant —Date.
Mailing Address
City, State, Zip
..u,,.-w;.:a..- .
X_��
03-0-e.4-
tJ ul ,
APPLI ION O LY
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number :713 Lq 0113 —:3
lLpgal Description
Project Description
Sq. Ft. L `� No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
i r
ME
Estimated Valuation
PERMIT I AMOUNT
Plan Chk. Dep. '4;
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
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 P,Lrbperty Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation: y
MAR 2 3 1999
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION f
1ATY OF LA QUINT °=
Notice:
.Document Cannot Be Duplicated
Date 5/7/99
No. 18705
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Jurisdiction
Owner NamePacific Trades Construction
No.' 52-285 Street Ave. Velasco
City La Quinta zip 92253
APN # 773-264-013
La Quinta
Permit #
Log #
Study Area
Tract # Lot # Square Footage 1445
Type of Development Single Family Residence No. of Units 1
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 or replacement mobilehomes.
It has been determined 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 Government Code 53080 in the amount of
1.93 X 1,445 or $ 2,788.85 the property listed above and that building
r
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By CC/Capital Bank of No. County - D. Miller Telephone 9.67-0069, hr''
Name on the check
By Dr. Doris Wilson i
Superintendent
Fee collected /exempted by Ellen Patino Payment Received
..
Check No. 13066.
Signature
t
IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
ollect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
V1,
AP r - 13 1999
I
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RC District P/annina Review Form
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove
Residential) District', in order to determine the applicability of compatibility issues or need.
to require.the filing of Master Design Guidelines by the applicant. It shall be transmitted to
_Building & Safety as your correction list. Please attach additional 'explanations as necessary.
APPLICANT: PACIFIC TRADES
PROJECT
ADDRESS: 773-264-013 Velasco
APN:
LEGAL: LOT 2• 2 • ,.BLOCK 84 UNIT 10 S.C. @ V.L.Q.
STAN SAWA
CK'D BY:
BIN NO: See BuildingCASE N0. 99-51 CHECK DATE: ) q '� L.
Inform -the assigned Building plan checker upon. your assignment to this case. The CDD
Executive Secretary maintains a log book to track applications and assign case numbers.
REQUIRED ITEM Y N COMMENT/CORRECTION.
Case logged and number assigned
Verify legal and APN information V
Consistent with MDG on file. (as applicable)
MDG filing required 15 + filings since 9/3/98)
--- -C-onsistency-wiih-street/surrounding-area:
Colors �l
Materials
Architecture
OTHER REQUIREMENT:
The zoning .code,'.architectural and landscaping manuals, and/or assigned inspector should
be consulted where uncertainties arise. The completed checklist shall be maintained in the
Building :& Safety address file.
• h
` T� tlC-TUJYA L .T;'1_ USS,
28.4.7. Industry Street
P. O. Sox 334
Oceanside,. CA 92054
760!722-7696
I.C_S.O. # AA -513-
2 Angt4 1999
Attn- Pacific Trades Construction and Development
1719 S. Tremont St_
Oceanside, CA 92054
(764):967-0069
For the 570" window header cut-out at the gable end truss on a bearing
wall, remove the 5'0" section of the bottom chord.arnd inlet the 4x beam and
attach wYffi 2 16d nails to ed ;L L12ch e g^�le ;L4d.
Sincerely,
Don C_ Miller, V.P.
19011E p�„ice- �,��z G;rC�r
LUMBER SPECIFICATIONS
SIZE SPECIE GRADE PANEL (S)
TOP CHORDS:
2x 4 OF 02
BOT70H CHORDS:
2x 4 OF 02
WEBS:
2x 4 OF STAND
TC LATERAL SUPPORT <- 12'OC, UDN.
BC LATERAL SUPPORT <- 12 -OC. UON.
TRUSS SPAN 30'- .00'
LOAD DURATION INCREASE - 1.25
SPACED 24.0' O.C.
LOADING Gable end truss on continuous bearing wall.
LL( 16.0I+01-1 14.0) ON TOP CHORD - 30.0 PSF C71,.5x2.6 typical at stud verticals. Refer
OL ON BOTTOM CHORD - 10.0 PSF* to•'Computrus standard gable end detail for
TOTAL LOAD - 40.0 PSF* coAplete specificat'fons.
*5 PSF REDUCTION TAKEN ON
BOTTOM CHORD. AXIAL STRESS ONLY.
Field Repair: 5'-0” section of bottom chord removed.
Inlet 4x beam by others and attach with (2) 16d nails
1 toenailed at each existing gable stud. '
-15-00-00 15-00-00
12 C-44.3 12
4.00 C--- 4 3. x4.00
t;
/Tf
(2)
1)
12)
-
I)
(2)
—1L
-44.3
/
/ C-44.3
0
THROUGHOUT ---
STRUCTURAL TRUSS INC.
<---- CONTINUOUS
BEARING - >
L
<---- CONTINUOUS BEARING THROUGHOUT ----i
—
CERTIFIED INSPECTION
12-06-00 5-00-00
1 12-06-00
ICBO #AA -513
30-00-00
4x beam by others_
IN STRICT ACCORDANCE
WITH UBC 25-17
Scale: 1/4•
pREFASR}GATED
JOB NAME: structural Truss / OBREGON - MILLER
WAM 04.
t. r nw.I It.esass• w..da*• b.ew...rrseu.tl- sf tar.....
OeftwelNot•s,urdsseotlrerwisenotsd: Design conforfbs to UBC -97 AnVer: 1.07(1L) -M
1. Deelgn to etgport [cede r drown.
2. Gull" end .sebn ..resin. -r d.." be .*A d .1 r. Q—W warn -d
2. 0•dpn e•eumes the top •nd bottom chord: to bo MtwWly braced at
2 -0 C.C. end at 12'-0' o.e. respeotively.
DATE: 7/27/1999
W..bw Were ...r.ev.e.. —w --r.
a. 1si o.er*n.den res besbrl row N btwea.d .Aro sirrn ..
e. A* l.t.d for—wdterra r.o.o•.odr -temporary wA row br.A
li
3. 2x4 Impeot bridging or [.torsi bracing recommended where shown ♦ +
4. Irrull�lon or truss Is the nimponalbllity, of the r�p•otive oontr•otor.
pr a.
—M b.#.dv d sed @ sew by *-yr.1 w.gtr..tro .
C•e.r.--- n...w..O ty for—%M.drw
G. Design s•oumes trues— we to be aced In • norr-corrosivenen
ovlrorvnt,
wd w• for 'dry condition' .1 use.
e. Doelgn essumr full bowing et •II supports drown. Shim or wedge ifF,�r-3m
uTrus Inc.
OES. BY: TB
w.I..ddl-Mbe �d t: —y••0 -d-Allw.•.t..d.eand
w. —repro., oft•r — a... sinesAd .ry I.d. V -t. th- •.sign
7. Design ewumes depuote dreinego 1. provided.�d
B. tv roost.• rof r.u..pi•e.d.
rhooves
rr+o ctr.rro �vrvrtn.•.rt..
SED.: 721879
�d
t"WA 1. -
a. Cswprrler hae res o.W.l •o. eN eoeuw ft• rep.rrMly 1N ch.
R— 1-1d. vAth t o 1
rn-edrrst.six.of t.sInInc es
p, Digit. Indlcab aka of plot• In Inches.
fabdoll.t. trona. *4ms of td *rsitMg.a sl-q•r..rt•.10.
For bleb es mrs design values, o1 lir CoputrPlate. Indicated by the prolix
R-726275 TB 08/02/99
TIO. O. •waft r tuwA*A rW.at t. tM andtatl.rr - tees •dons •w t•M
by sir Two plus. ruatut. Will -• r4 weed Iron- ; ws1 •.. cagy .t
'C', dee I.C.B.O. 0.N. 4211.
1 1 . The Computrus Not 6eetbn Rate b indicated by the prefix 'CN', the
designator 11 el IMbetr IS to All 20
.tarh .r0 a -%.Ines.• by c.er„u,,. ,..n,-.-.
ga. m■tww wed, othr. we ga.
te, of Occupancy
City of La Quintal
Building' Safet
y Department.
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure .was in compliance with the various ordinances'
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 52-285 AVENIDA VELASCO
Use Classification: SFD Bldg. Permit No.: 9904-218
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: PACIFIC TRADES CONSTRUCTION Address: 1719 S TREMONT
City: S. OCEANSIDE, CA 92054.
.By: STEVE TRAXEL
Date: 11-19-99
Building Official
POST IN A CONSPICUOUS PLACE
t
O
te, of Occupancy
City of La Quintal
Building' Safet
y Department.
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure .was in compliance with the various ordinances'
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 52-285 AVENIDA VELASCO
Use Classification: SFD Bldg. Permit No.: 9904-218
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: PACIFIC TRADES CONSTRUCTION Address: 1719 S TREMONT
City: S. OCEANSIDE, CA 92054.
.By: STEVE TRAXEL
Date: 11-19-99
Building Official
POST IN A CONSPICUOUS PLACE
t