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0109-233 (SFD)�r- LICENSED CONTRACTOR -DECLARATION I hereby affirm underipenalty of perjury that I am licensed under provisions of Chapter 9 (commencing witli 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 671203 DateIt_%-Signature of.Contractor' f OWNER -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). 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',6f the Labor Code, for the performance of the work for whick4his permit isiss6ed. 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 Policy No. ' •{•d`IA�Ta�'f.1�7C{ Mtf4�bYi��7`�f9' 4N:9.RHi7Y�s'KIF':ii'F (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 4those provisions. Date: 'f °1 "3, Applicant f Warning! Failure to secure WorkersCompensation 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 the above-mentioned property for inspection -purposes. Signature (Owner/Agent) Date PERMIT # BUILDING PERMIT " DATE VALUATION LOT �1n.R� TRACT 43 JOB SITE ADDRESS . + ,. y(-4694YfA Mh1j()CX'.MMypq �APNr '�"%tY^•a�iOtF'^Q.a4 OWNER CONTRACTOR/DESIGNER/ENGINEER, MONTE u1 L011AL ' AWREW M—PIM C°C)xRP.OR 17aR 1604 WW L,.An SWAI PA=WAY 44835 57FIT ONNYON RD 1! ORTH&M 'f .%:rZi~ IEW WA 98008 PALM Dlz Mer GA 922613 (760)3A.6-.3220 CB119 030,41 M USEOFPERMIT. MOLE F.P.ili]L Y1:i`�'r'L�...f:WO SFI`V 117c�spry�N'T {lpwig�e y��}r'Yq1..yL(�{!ap`iyR�lyd�yp�1s,�ya�`r�gy.y�y?t�et��Lrtik�k}"y�q??y��64�td�03�yft";1 i41,137 »"ktl.•7.., �+, 1`..14.�'S,L C�i�2F,.f�4Li 'A+If•11,VYi. F-7y�•:�.+Vl/S(40 THE 6;dgro.T•J1.t�!.pi;PD " x 5PECIMS ACT OF f0' IF A]'PL1C.fJB.1X,1S P,IQVIUD CLfibp.il>iR C°O1. STRUCT1t: N %0471 Do 81< PORCHMATIO C gFe'tO'ti &'CIFtT 07.0.0 3F - :41rew 4OpK Oil, (110 VX"R7M1C nT R:ib,:{�l,��rq..Y. {•� . PSyamAI W. SUMMARY CONSTRUCTION FFX 101 -ON -418-000 r?t:6r,34 PLAN CHECK iEF, 1d7-000.4?10-:318 �31,003.V FE DE'P031T 101.000.439-318 4030,0t1 ,MZMA FICAf..teZZ 101-'001-421-000 $125.50 lsMY IC.ALMI 141-000.424-000 $30140 F^LL7MBINC3 FEE 1 Q2 »d)0"19-000 131'><3.E NO MOTION F819 " ReT. OW .101-.00 -241 a000 CIRAIDYNa Tsrz 101-000-4-23-000 - DEVELOPER.IMPACT FEE S'1,!107ft1Q DEVELOPER ,AFZni IN PUBOC; PLACES aVJTSiC Z)0.000-14-)-000 $039.144 7.1J.1.Pii• �.tT�.i. R1..l ci.O.d�JCi AM PI_r. N `.d.7J",. -.til, LESS PRE-PA.'SFAES 41,210,00 i. n'. 97 TERM 0: v TOOr ,a RECEIPT DATE Bl DA=FyFIND � INS;; INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings D Ducts Slab Grade Return Air Steel Combustion Air Roof Deck ZQ Y Exhaust Fans O.K. to Wrap v - -O F.A.U. Framing — C;,74Y7<f 7 Compressor Insulation 4Z ejZ Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wail Firewall Exterior Lath , O 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 — U 2 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection p Z? Encapsulation Gas Piping 1 Gas Test Appliances Final Final- Utility Notice (Gas) �Q �� ELECTRICAL APPROVALS Temp. Power Pole Underground Underground Conduit Rough Wiring Low Voltage Wiring FbRures � Main Service Sub Panels�j Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power03 Final _ Utility Notice (Perm) COMMENTS: P38 6ns�`",����`��Q2 (, 2 2 - /,Vote-�� `�f �ol�'! �G 2,6 -o�?�� � I/G/� ✓ ��� 7.3-' Rte" ,/ Alt�- �,� �S L r � T,_ r24"C?� Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 1/9/02. APN # 770-300-028: No. 2281.2 Jurisdiction La Quinta owner NameMonte & Lola Leen Permit #0109-233 No. 78-691 Street Talking Rock Turn Log # City La Quinta Zip 92253 Study Area Tract # 28430-2' Lot # 43 Square Footage 7047 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 detemiined 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, 2.05 X •7,047 or $ 14,446.35 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 7 Palm Desert National Bank Jody Jones; Teleph'ome 760-346-3228 ' Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Annette Barlow Payment Received $14,446.35 Check No. 083431 Signature 10TICE: Pursuant to 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 REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE O ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING O O OTHER JOB LOCATION LAQv A REPORT SEQUENCE NO. TYPE OF S RUCTE PER . DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT INAUXJOR NRS. CHARGED ENGI ASSISTANTS HRS. CHARGED INSPECTION DATE - - GENERAL, _ CONTRACTOR Nl� �"^� t SUB 1CSZ� CONTRACTOR 0 1 k'VeLd-L A-u4t-1115 ; d +V( PAI V COPY SENT TO CLIENT O CONT DON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. SIG ToURE OF REGISTERMANSPECTOR TE 6F REPORT. REGISTER NUMBER REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY O SAS ❑ POST TENSIONED CONCRETE ❑ ASPHALT�QTHER O REINFORCED MASONRY ❑ FIRE PROOFING i JOB LO — a/l 4L Y-,.� �`A ` N/ •�'y- fV�`) • ` `I REPORT SEQUENCE N0. TY R TUBE -� •"; j�N S- _e ` PERMIT NO. T � DAV OF WEEK MATERIAL DESCRIPTION "�•J�`— l� ARCHITECT, A II -Cr NRS. CHARGED 6 ER l ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL t \ ��_ l{/, �� �NTRACTOR CONTRACTOR l,'�QIL' �i�/ (. ` S enV7 (4 MMf8�. Qg,t cry t v.� o� 7 v"y .St I- SL3-- a- COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS '4by1-T--- L000' SIGNATURE OF REGISTER INSPECTOR oL Cr7 gis o 6/ DAT OF REPORT REGISTER NUMRFR REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY O E40 -0�� ❑ POST TENSIONED CONCRETE O ASPHALT ❑�`P`ER O REINFORCED MASONRY ❑ FIRE PROOFING JOB L I b N &A LAv �a1R REPORT SEQUENCE N0. TV Of�Ti CTURE PERM NO._ a 9_25 0 AY OF WEEK MATERIAL DESCRIPTION ARCHITEC Ip1,51�2C HRS. CHARGED EASSISTANTS N-5Ok NIe(s HRS. CHARGED INSPECTION GENERAL SU DATE CONTRACTOR Q CONTRACTCIR Co V ovi pk6 IFILAa (W � COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. 1 (GNAT RE OF REGISTERED SPECTOR 94 01-111 Db / -vf� D TE OF1 REPORT REGISTER NUMRFR REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING ❑ ❑ OTHER JOBFq � 1 I 1 K n r �"�� (,A- V O�YcJ,t/ V Vkk/m Gu REPORT SEQUENCE NO. TVP O Ti CTURE 'DESCRIPTION I _/'1 `V jV�/w_'_ PEijilQlT ft) DA 1 '01AV F WEEK MATERIAL _ ARCHITECT ,N OFC Rf/ `\) HRS. CHARGED &A 1�R � `C, It ASSISTANTS MRS. CHARGED INSPECTION DATE - GENERAL f� w J�t SUB CONTRACTOR r, r CONTRACTOR Lt COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. UVV` SIS TURA OF REGISTERE@ INSPECTOR-II�� ATE F REPORT REGISTER NUMRFR REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OFjQ�EINFORCED INSPECTION PERFORMED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ ✓V❑'POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION-7n�_ �, U' - &C( K�/l_-C.rT%a REPORT SEQUENCE NO. TYPE OF STRUCTURE PERMIT NO. 10 DATE DAY OF WEEK MATERIAL DESCRIPTION `t0 GAP E 8TL'EC� t 'Iov'o s ARCHITECT DAVi iiss'� , INSPECTOR , b, HRS. CHARGED C-&, C-dzq-k- ENGINEER AO saw 0; S'p1.s ASSISTANTS MRS. CHARGED A /� SUB INSPECTION Cp TRACTOR AP&WO t's" CONTRACTOR RTS DATE s_ b -o -L 06r-e-gAuv dq cr-t--&�-e- t i,.j Sla-6 % eg, o &-1e LoL--?'aC . At, L. S pe&L C4-' �O 1V-'0Zlt r--A.m S l CA -b eDl..o L'0 � �-e � - t �-e p C� c-6 t --.%C- Ae Te— Co s`1 S 6 ck cL�r� o� tN Q.e-4ww S l a-\ a S c s..ec- q' CL O 2, OtF t' A C 6� C -g e. (L S T G 46 f- w- -¢ Ck 6 aJ -f- S &s -r S w t lrS ©-(-� COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS gw� SIGNATURE OF REGISTERED SPECTOR S ` � ^ %tl It- cz 11 k I. 21z Y� DATE OF REPORT REGISTER NUMRFR SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY. 37630 Medjool _Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE ❑ REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY ❑ ASPHALT ❑ FIRE PROOFING ❑ R JOB L 0 .- ' ��, , / l CWX,_V Tu• n Ij K -PERMIT L f /J� , ` _ �JQ fly/�"�- REPORT SEQUENCE N0. TVP OF TORE ��f 11•.�� �V`� NOR`�L.V DA O AY OF WEEK pbt MATERIAL DESCRIPTION 7" ARCHITECT INSPECTORHRS. CHARGED 1 ER n -�1 � uv-' ASSISTANTS MRS. CHARGED INSPECTION SUB 1 RDATE}CONTRACTOR= �NT on • ""' COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE ❑ _ PAGE .. OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M? KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. �ko-oo-_ AA'�' IGNATUOF REGIST INSPECTOR -0 Ton -7 IZ4­0 J A E OFR PORT REGISTER NUMBER oo04 - C) 109