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Home My WebLink About0310-027 (SFD)U) N WIT', O � M �0LO W OZ�—. 6' H� J Waw U) Z 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 ,[)gate tf 0 "&Sgnature of Contra(tor-��A -� OWNER -BUILDER DE , CLIARATION I` { I hereby affirm under penalty of perjury that m 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: CarrierPolicy 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"pr `v°isions. f pate: f %' ! Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees.. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if f work is not commenced within 180 days from date of issuance of such t permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is . correct. I agree to comply with all City, and State laws relating to the building construction, 'and hereby authorize representatives ev of this City to enter upon the above-mentioned property for inspection purposes. �$igriature (Q`wner/Agent) ,1 Date PERMIT # BUILDINGPERMIT - DATE VALUATION LOT_ TRACT ZWK-304.No 2.3, JOB SITE a• .ADDRESS APN g9J175..9 MIECOM THTIM 761420-4M) OWNER CONTRACTOR/DESIGNER/EN (NEER V5 OPIF FOART7`1: DRS 1, I.7X .. KAHTN .L k Comm1'x`'1' ol"r IaC 81-07o MM'C3. 3XT- v 7S-Y?0 (.:.QUIZ TA QXfbTrA CA 92253 `f t, - i.!T k+I"I'& CA. 92.2. KS rQiU 3b�E�4 .. Gz;I.:d�� 3337 USE OF PERMIT Si?3 G1.Ir &'.Ah .a Y IM, _X; NT0 38. URppq7f D's��+`.r�S T tYt SAL"1S.IJ'DY, R;,L l';F:'o'6`�'si.l .% �? - UDT a,31 �P�I.,.A POOL. SPA 0eti. C119Tw'M C0*311'0`xAVCT1.E)N 4.1011-0113F i13,:iOi�fL'E>e>�tt�31$T:I, 9F T'Mr UTM.". R S1lMMA R C'owm3tC`:'nm 1:13? 101,-000-41C-000 $11,721,00 PLAN CHF -C.3," Fttg sixm ft-tt PRIC:A>E.11�RT' g1•El(1f3�T C�d1�lC3 216.�J PLdi:tfUNG FU i 01 -00105-4 9.000 11233.74 S'Tk3ONO MOTIC111 Pi -t, . i?T'S-I0 101-f1W-241-000 X40. R3 GwIr NO k1 4'g t�PL� IMPACT r2Z $�4t3s.�►t) ART 113 PUBLIC ?.WWZ9 - PIFISA :fes DEPOISPIT ,101-(',00-.4,9-31 fx 41;804..00 RTB-TOTA,1:, f ONWI � 17 i`I 1 A AM `�5. MIX. • — 771 ' ).xan ?np d .I:.si'.f:w ,1'1Cyi. l.'J"e Tio o 20 200.3. 0,47 -OCT CITY OF tSwTA FINANC! puP'f. RECETPT DAT�f BY DATE FINALE[) INSPECTOR ,' l 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 41 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 ConnectionEncapsulation'_ .14 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 �c Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power - Final Utility Notice (Perm) COMMENTS: TW ha NO Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: Owner's Name: The Summit at PGA West This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMWIND. AMOUNT: DATE RECEIPT: CHECK #: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Date: 10/16/03 Weiskopf Partners I, LLC Phone No. 760 399-9945 Project Address: 81-075 Shinnecock Hills, La Quinta, CA 92253 Project Description: Single Family Dwelling APN: 761 820 010 Tract #: a Q 1(-0- Type of Development:=quare ding Area: Commercial 4869 Certification of Applicant/Owners: The person signing certifies that the above infornu penalty of perjury and further represents that he/she is authorized to sign on behalf Qf the Dated: Signature: Lot #'s: a'-2j Industrial and makes this statement under SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABO ROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code 65995 4869 $2.19 $10,663.11 Building Permit Application Completed: Yes/No Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement By: Carey M. Carlson, Asst. Supt., Business Services Note: Certificate issued by: Marcela Valdez, Facilities Clerk Signature: Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide () a wr)tten 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 protes position 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. 7 X\\ID viV:chnrdvcs c,e�l ti ;cvrtiiial.t of colnpliance!Orm tatlw Ct- i. S .doc 1/16/03 T Date: October 2, 2003 Owner: Weiskopf Partners 1,LLC 80-070 Chanticleer La Quinta, Ca 92253 PERMIT FEE SUMMARY Builder: Kahuilla Construction 78-070 Calle Cadiz La Quinta, Ca 92253 Project: 1 SFD, The Summit @ PGA West, Tract 29147-1. Lot 23 Lot Plan Sq. Ft. Address APN Permit # Fees 23 3B 4,869 81-075 Shinnecock Hills 761-820-010 0310.0.? .$5,720.47 Total Area: 4,869 Total Permit Fees $5,720.47 * Reflects $1,000 credit to plan check fee