0301-242 (AR)LICENSED CONTRACTOR DECLARATION
I .h`6reby 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
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:
(V. ) 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
r 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).
(j, 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 ofSection 3700 of the Labor
Code, I shall forthwith comply with those provisions.
o/bate: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for •a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application.is made & each person at
whose request and for whose benefit work.is performed under or pursuant t
any permit issued as a result of this applicator agrees to, & shall, indemnif
& hold harmless.the City of La Quint a., its officers, agents and employees. D
2. Any permit issued as -a result of .this application becomes null and void i
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
Correct. I agree to comply with all:Ciiy' and State laws relating to the building
t f
construction, and hereby authorize representas7of this'City to enter upon
the above-mentioned property for inspection puurrppposes.4.- d
Signature (Owner/A ent) y" ' `u' "� e�% Date����r.
pc PERMIT#'
BUILDLNG'PERMIT
d MI- �
DATE / VALUATION.. ry�p� LOT,. TRACT
/
JOB SITE
ADDRESS ;J4-tiS�b 4/'3@.>�IV. Ajwo,
APN p
OWNER
CONTRACTOR/DESIGNER/ENGINEER
- -_- : �' • -
- - _. - - �.
_-
,tF � y �•q> �t�,� T �+
tKlTIC D0111JnF+i..d..d
f '7� •-��y-yip y. Yah}
`s,'✓YGri . €'li.r,F.eda1&:JCY - .
LA QIMTIA (:A 92253
USE OF PERMIT
(PRd"+''/Ir?CJ`+LY tWG+ATS9"RUCTFS1 WITHOUT MWIT) .M"'SR 8 -ATH ADMT10-H
(144 8,F,)WiMECFLA.1.iIICAL
APPROVED -PLAN ZOI CB0
TRACT CONSTRUCTION 144,00 SF
GARAGEICJ' RPORT 40100.07
CONTRACT AMOUNT 21,396.00 1,3
I�►5'11AI IED CM OF CO,I��":�•�1MV,
��, .20
PER.ler�r.+ ' + l!J.CV"Y
CONSTRUCTION 11,89 101.000*418-000
PLI&X CHEM WE 101-00"39-:31$
Mic ITAXICAL ME 1011,000-421-000 S101
iv"iw=Tpic>.01XPEP, 101-000-w420-0 0 $20.94
Mmull a PER 101-000-419-000 $33.50
S T ROI G A:4I7'1 OW )PI; - RM113 101 -OW -,41-000
100 PRE -PAT) VERS
00
:���a Alf VIIKRA `� VU NOW
JAN. 2
92003
CITY OF LA QUINTA
FINANCE DEPT.
RECEIPT DATEa/ DTE FINALED INSPECTOR
Y i4 i I YY
�
%,rl
INSPECTION RECORD
4 OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
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 Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final 2 ti
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
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
✓✓
j CITY OF LA QUINTA SUB -CONTRACTOR LIST d
JOB.ADDRESS C4o�& � �ti.lrG� PERMIT NUMBER . OWNER1;�"L�"-'Vz-'� BUILDER d(.� ���"yV_ l�
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade /Classification Contractor State.Contractorslicense : Workers Compensation Insurance. City Business License
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
Ixx/xx/xxl
Carrier Name
(e.g. State Fund, CalComp)
Policy Number ,
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-42). `
CONCRETE (C=8)
FRAMING:.lC-5} .: ` : `. _.
(►,�'Q,� a��arJi�j .•
;
STRUCT.STEEL
MASONRY (C-29):
PLUMBING (C -36j:.
_ a .
LATH;..PLASTER (C.=35)._::
DRYWALL (C,9)
ELECTRICAL (C-1 Of
W
Q1� 4 �/C:F/1d.L
'�—D O �:
/1503
G o� �3
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j 6 T,c��
ROOFING 1C -.39h..
tt
SHEET.METAL (P743):
i
'
FLOORING (CAW
GLAZING:
INSULATION: IC=21`
SEWAGE DISP. IC 2) .:.
t� q -o L
Gf Z 4r C
Z ('jsZl
a
S ><v,✓7
3 F6
PAINTING IC -33)"
i t �6H1p}i
CERAMIC;TILE.(C-541`.
N
CABINETS (C=6) >. '
FENCING(C'=T3)
LANDSCAPING (C'=27► ..:..:'.
e ( •Mi )� LI/
POOL (C-53) :.'
'� '
r
ac�E.Oc
F-
Y
C'TY OF LA QUINTA
BUILDING & SAFETY DEPT.
'
APPROVED
i
FOR CONSTRUCTION
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Buildings undergoing construction, alteration or demolition shall
be
in accordance with Article 87. CBC
xxx
JOB: 072002
PROJECT:
SITE ADDRESS:
DATE:
12/12/02
revisions:
'Velascd
Demo FIPIan
54-066 Avenida
-
SCALE:
1/8" = 1'-0"
La Quinta Ca.DRAWN:
Bob Sipovac
(760) 567-2347
SHEET: OF 1
y
La Q' copy
i y
c&t 414
Quba
OF rt��
Field Inspection Summary Report
Date: 9/13/02
Project Address: 54-066 Avenida Velasco
Project Description: Single Family Dwelling Un -permitted Remodel & Addition
Status: Special Field Inspection
Owner:. Daniel D. Morris
54-066 Avenida Velasco
La Quinta, CA 92253
Special Inspection by: Daniel P. Crawford Jr.
Building Inspector H
(760) 777-7027
A special field inspection was conducted at the above mentioned residence for an un -permitted
remodel and addition under construction. My field and office investigation has confirmed that
the single family dwelling addition and remodel as built has been constructed without approved'
plans, permit and required inspections, in violation of LQMC 8.01.060 Permit Required. The
following information is provided to identify existing conditions and additionally, assist in
identifying the specific requirements to properly permit and approve the existing un -permitted
construction.
1. A Remodel and Addition Permit is required. (CBC 106.1) Please inform the owner to submit
a building application and Plans with specifications to the Building Department for review and
approval.
2. Information on Plans and specifications shall be required to approve the as -built
construction/structure at both the remodeled and addition areas. Plans and specifications shall be
drawn to scale upon substantial paper and be of sufficient clarity to indicate the location nature
and extent of the work proposed and show in detail that it will conform to the provisions of the
1998 California Building Code. (CBC 106.1) The structure as observed (non-invasive) does not
meet the prescriptive provisions of CBC 2320 for light frame construction, therefore, a design in
accordance with CBC 1605.2 will be required to be prepared and provided by a licensed
professional.
3. The following observations are noted:
*Several interior walls have'been removed. A non-invasive observation of the structure
would indicate walls may have been structural which requires the owner to verify walls removed
were not structural bearing walls.
*Bedrooms 1 & 2 have been remodeled. Required light (5%), ventilation (10%) and the
means of egress (emergency escapes) are not present as constructed.
*A bathroom addition is constructed at the rear of the structure, approx (15'-0" x 9'-0").
Records do not reflect a permit for the structure. The bedroom door swings over a 8" step down
into the bath. An exterior entry/exit door does not have a required light and switch. A sauna is
constructed in the bath. The bathroom is constructed on a masonry retaining wall, creating an
exterior pit where a portable spa is installed.
*The kitchen has been remodeled. Electrical wiring is exposed and incomplete. An
exhaust fan is partially constructed at the range/micro wave oven installation.
*Electrical wiring is exposed through out the structure.
*An existing detached structure has been remodeled. Plumbing fixtures have been
relocated to construct a separate bath and bar sink, plumbing is open and incomplete.
*Existing windows have been enclosed or changed out to french door construction.
*There is no dead front on the main electrical service panel. -
5. All Construction or work for which a permit is required shall be subject to inspection by the
building official and all such construction or work shall remain accessible and exposed for
inspection purposes until approved by the building official. (CBC 108.1) No further work shall
be..permitted without approved plans, permit. and required inspections. Imperial Irrigation has
been contacted for electrical meter removal as directed by Don Whelchel, Code Compliance
Officer II.
In summary, extensive construction has been in progress on this structure. The'structure will '
require proper application for a permit, plan & zoning review approval and observation of
required building code inspections. The observation and verification of required inspections and
design will be extremely difficult in both the performance of comprehensive plan review and
thorough field inspection to approve this structure as it is constructed to date.
Respectfully Submitted,
anie r/40.
or r. ,
Building Inspector II .
dpc .
I
= M E T R O S C A N P ROPER T Y P R O F I L E=
Riverside (CA)
*
*
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<<< OWNERSHIP INFORMATION >>>
*
*
*
Parcel Number :774 215 005 S: T: R• Q:
*
Ref .Parcel # :000 000 000 Pos Interest:
*
Owner Name :Morris Daniel D
*
CoOwner
*
Site Address :54066 Avenida Velasco La Quinta 92253
*
Mail Address :54066 Avenida Velasco La Quinta Ca -92253
*
*
Telephone :Owner:760-771-1869 Tenant:
*
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<<< SALES AND LOAN INFORMATION >>>
*
*
Transferred :09/25/1996 Loan Amount
*
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Document # :368181 Lender
*
Sale Price Loan Type
*
Deed Type :Interspousal Interest Rate
*
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o Owned :100 Vesting Type :Sole And Separ
*
*
*
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<<< ASSESSMENT AND TAX INFORMATION >>>
*
*
Land :$22,557 Exempt Type
*
Structure :$621037 Exempt Amount
*
Other Tax Rate Area :20-015
*
Total •:$84,594 Taxes :$1,189.08
*
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% Improved :73
*
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<<< PROPERTY DESCRIPTION >>>
*
*
' ` *
Map Grid :879 F3
*
Census :Tract:451.04 Block:9
*
Land Use :RO1 Res,Single Family Residences
*
Legal :LOT 5 BLK 281 MB 020/050 SANTA
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:CARMELITA VALE LA QUINTA UNIT 26
*
*
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Sub/Plat :Santa Carmelita Vale La Quinta Unit 26.
*
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Book :20 Page:50
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<<< PROPERTY CHARACTERISTICS >>>
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Bedrooms :2 Stories :1 YearBuilt:1974 AgPreserve
*
*
BathFull :1 Units :1 MiscImprv:No
*
Bath3Qtr Bldg SgFt:1,216 Street :Paved ADDITIONAL
*
BathHalf' Gar SgFt Waterfrnt•
*
Fireplce :No Gar Type Elect Svc:Developed RmAddtns :No
*
Cntrl Ht :No Lot Acres:.11 Gas Svc :None RmAddSF
*
CntrlA/C :No Lot SgFt :4,791 WaterSrce:Developed AddGarType
*
Pool :No Roof Type:CompositionSewerType:None OthrPkng
*
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Information compiled from various sources. Real Estate Solutions makes no representations
or warranties as to the accuracy or completeness of information contained in this report.