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Home My WebLink About0208-143 (SFD)'LICENSED CONTRACTOR DECLARATION yl 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 Date f Signature of Contractor OWN ER-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). - ( ) 1, 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 9XIMPT 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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with'those provisions. Date:`/..,pr Applicant Warning: Failure to secure�orkers' 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 td 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 the above-mentioned property for.. inspection purposes. Signature (Owner/Agent) '� ^�' _. Date° `<" BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT r t 'ra) )7"OW,.l# r-11' r` 2"914 47-1 i' JOB SITE ADDRESS APN �i�3.5•. ��'IkYC�F!'�i7#�:IfIrest1 t � _ OWNER CONTRACTOR /DESIGNER / EN INFER VffMOPFr FlKTI&MIS % 1;,. -C XAF?'WLf..A CONUM;Mn'[Olq.IWC $1 _1 1 kiE1E171•!' 13E BOX 366 .T.A �)UINT k. C�i. 92233 LA QiJUMA LA 92253' ("i'E+t3�S�4a4E�:�2 Cr'iF 323e USE OF PERMIT SM) - LOT 117 PLA 14 38—PERMIT IT IDES NOT 1-NCLUD--'t~ 11IrC?C X WAI_,IA P004 SPA OR DRIVEWAY APPROACH C US"I0M CON S7RUCT'1UNJ 0,13,00 O PORCI• IP.A` IO 90&63 SP c. AR.AMUMPORT MIA* 1114F awr=A= con cep gaffs ttm 407,IX110 PIER ST FRE €ii7 �+l, tib •.. Cr014STRUCTI0N PER 101,000-418-M SIM7.59 PLAN CHECK ME '101-060-439-318 .S1,285.3.5 1E 101-000-421-OW p�g+}j\EI49.S9 a� y�NT�t,i�1��I N121'IC,AL ME/�; w ffLUMA3I; OFe.L'+ 101.000-419.000 $153.75 S1170NO MarIaON lti'1EE � MID 1011-000-241-000 $40.71 ORA.T)NO F'E'E 101.000.4123.000 $15100 OM.t f3PAR IMPACT FEE 00 ART M. PUBLIC PLAC- RESIE 270-000.44.5,-001 $517,63 "sLww1AL cdimiR TC''noN AND PY.Am C:1my, $6,710.54 $1100 Q A. YERMr 11:S DM now Qiir, � � 2002 • . - CIYY OF LAQUINTA FINANCEDEPT RECEIPT DATE = BY DATE INAL INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs U de ground Ducts Forms & Footings u s Slab Grade'Return Air Steel Combustion Air Roof Deck „� _ Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation2 L 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 POOLS -SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Eo_ RC YND_312 Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines _ Qp 2 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection _ Pool Cover Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: �t> �6�{'%�O/L !/jil"W4 !�� /,S� /" Y . Final Utility Notice (Gas) ELECTRICAL APPROVALSTemp. Power 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 ocs Utility Notice (Perm) H Coachella Valley Unified Sch 'N District P.O. Box 847, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 I This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/IND. AMOUNT: DATE: RECEIPT CHECK # INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Date: November 1, 2002 Owner's Name: Wei skopf Partners Phone No. 777-8070 Project Address: 81-135 Shi nnecock Hills, LA Qui nta, PGA West Project Description: Addition to House Under Construction APN: Lot #'s: Type of Development: Residential XX Total Square Feet of Building Area: 16 Industrial Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sig,p+n behalf of the owner/developer. Dated: �+ 19L Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE VE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project 17620 65995 Approval Number of Sq.Ft. 16 Amount per Sq.Ft. $ 2.16 Amount Collected $ 34.56 Building Permit Application Completed: Yes/No By: Carey M. Carlson Asst. Supt., Business Serv. Certificate issued by: Marcela Valdez Facilities Clerk Agreement Existing Prior to 1/1/87 Note: Signature: Not Subject to Fee Requirement Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District providWa written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. MV:c/mydocs/devfees/certificate of compliance 09/30/02 Cert� icato ofoccupancy.. 7 G> o44 f9ti Buildin - & =Safet De artment g Y p This Certificate -is issued pursuant 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: 81-135 Shinnecock'Hills . Use classification: Single Family Dwelling 'Building Permit No.:.0208-143 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: Weiskopf Partners I, LLC ;' Address: 51-161 Southern Hills City; ST, ZIP: La Quinta, CA 92253 By: Daniel P. Crawford Jr. Date- 7/30/03 . Building Official - POST IN A CONSPICUOUS PLACE `