9907-042 (SFD)-LICENSED CONTRACTOR DECLARATION `
�I hereby affirm under penalty of perjury that l am licensed under provisions'of
hapter 9 (commencing with Section 7000) of Division 3 of;the.BusineSs•and
Professionals Code, and my License is in full force and effect: y
License•#- Lic. Class Exp. Date
6.9,1405
t Date . f r °Signature of Contractor -
OWNER -BU ILDER�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 myemployees 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
I,.as owner of the ro ert
p p y, am .exclusively contracting' with licensed
contractors to construct the project .(Sec. 7044, Business & Professionals.
Code).
O 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 .wor.kers!
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 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
worker compensation laws of California, and agree that if I' should become
Xa
ct to the workers' compensation°provisions of SectiohVbo of the Labor, I Shall forthwith comply Withthose provisiogs.Q- e-1 'Applicant
Warning: Failure to secure Workerskompensation 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 tris
application.:. ,
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed'undee 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. (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 purpo es.
,,Signature (Owner/Agent)., ✓ N bate � "
BUILDING PERMIT PERMIT#
L,,
•DATEJ VALUATION AFS LOT ,TRACT1
1 ( [( r9.�
JOB SITE .- FAPN
�•
ADDRESS 78.602 `4AEAMG ROM TURN
! . 770-30&020
OWNER
CONTRACTOR/ DESIGNER / ENGINEER
9:B>AViA 4l
S'.14C11.V 1. lYlt B;.� .N.t tf S.d'l.. �'. ;
!+H'9C`LFGl�`►i r+Ctic
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.32zq SA>nar'% s DIAZ, 1"... », ..
4;5-270 CU, 1M g1I2.1.VE,
t 14DALE CA. 917 :
�':6 . N» �}iE,LS CFl/.l
- .
h (��i?210
` 1, YS30��t7�'•L�J7 5 \..��1.lY lir,��
USEOF PERMIT
fNJLE r.[• iVFIL9 l,.3WU,LWO
-
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Ui S -C, 1-5.31, 'fs F 8160.) IR .AfIaKICYdiM4 IS RfiQtJ°f9. D.
OU IT r 0 11VI It", UIN A'S rRU low 6,5W 1041 SP
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'
N'8T1V V-'TT0N A*ND KAN' CHF.i"KLESS
PRE,PA,f.DVRF,§
411,250.00
O�
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OT
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RECEIPT -i
DATE
BYE`
DATE FINALED
INSPECTOR
INSPECTIOU 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 _.jp -QO
Exhaust Fans
O.K to Wrap
Framing T✓ '
F.A.U.
Compressor
Insulation -�? OO
Fireplace P.L.
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_
Drywall - Int. Lath
Final
Final 0YrPOOLS
BLOCKWALL APPROVALS
- SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final I I
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 — S—
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
TJI� � ee
O4_> -.I3
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
12
Final 44
Utility Notice (Perm)
Building
Address 78-6Q2
uwner mik
0
P.O. BOX 1504 APPLICATION ONLY
76-495 CALLE TAMPICO
ril]J+. = RID& Tl1%11 LA QUINTA, CALIFORNIA 92253
Address 6229 ♦riiii Diaz Street
City Ir;dxAale zip99 706 JTbe'26-334-0383
Address
State Lic.a�scny
& Classif. �i-r v OF Lk QU1L
Arcn., tngr.,
Designerzn pWign & Eynln WiM
Address 7� 4-545-847'0
20351IriT�,l'I1;? A`vQ., Su9.ta 2
ity Zip State
C
�`un Ani mss. 92707 LiC. a 035023
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
q OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness 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 thealleged 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).
[-2 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, 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
or improvement 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 I 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 I am exempt under Sec. B. & 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. O 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, alter 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, Gull Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 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
ateMailing Address
City, State, Zip
BUILDING: TYPE'CO�INST. OCC. GRP.
A.P. Number � 1y - 306 - D2.)
Legal Description &� L 9 t T �76 - 2
Project Description %Y D
tz
Gsc.44 M I24�5'
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Coy -r4< -_-T : IDL:►. o is C4 e m X14 (At 1506-
Estimated
s05
Estimated Valuation
PERMIT I I . AMOUNT
Plan Chk. Dep. --
Plan Chk. Bal. ,
Const. y ;
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Y
S
t �
TOTAL
REMARKS
ZONE: BY: 4f
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback fiom Center Line '
Side Setback from Property Line
FINAL DATE INSPECTOR
I
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
L _ •
Desert Sands Unified School District
47-950 Dune Palms Road.,
Notice:
oad-
Notice: La. Quinta, CA 92253
e
Document Cannot Be Duplicated 760-771-8515 .,
' r . r. •
' CERTIFICATE OF COMPLIANCE
Date 9/9/99 APN # 770-300-020
No'. 19284, Jurisdiction ' La Quinta.
Owner NameFrank Mendicina -Permit #
No. 78-602 •• Street Talking Rock Turn Log #
City La Quinta zip 92253 Study Area
Tract # Lot # Square Footage 6504
i
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 6,504. or $ 12,552.72 .tlie 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/ Verdugo Banking Co. / David Larson' y Telephone '772-1011
Name on the check
By Dr. Doris Wilson .'
Superintendent -
F. N.
Fee collected /exempted 6 _ Sylvia Carrasco Payment Received $12;552.72 t �'
' Check No. 9765261
Signature amb
V
TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify youthat the 90 -day approval period in which you may protest the fees or other payment idenl�ed
ove 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
lect 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 all4waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt , Copy - Accounting
TRADITION GOLF CLUB 760 564 2356 08/30/99 14:215 :01/02 NO:667
August 2, 1999.
Via •First C1= Mail
and facs6nils (714.641.1091)
,
Mr. Erick Trabert'
DENNIS CHERRY ASSOCIATES .
20351 Irvine Avenue, Suite 1
Santa Ana Heights, CA 92702
Re: Mendicina Residence - Construction Documents —1 Submittal
Lot 38, Tract 28470-2, 78-602 Talking Rock Turn
Dear Erick,
The AI)RC of Tradition Golf Club met on July 9, 1999 and reviewed the above referenced
lot. Please make, revisions and resubmit based on the following comments: .
Architgaural Re3dew
1. Approved as submitted..
Material Board Review
1. To be reviewed again on August 4, 1999: .
landscape Review
1. Turfgrass must be Hybrid Bermuda overseeded with Annual -Rye grass.
2. Star Jasmine, Lily Turf, Mondo Grass and Ajuga will all burn i1 summer desert
climate, please select appropriate plant material for use in low desert full sun
conditions.
3. Provide rear yard fencing details.
4. Provide mailbox detail.
5. Show plant material on adjacent lots and golf course to make sure planting blends
TRADITION GOLF CLUB 760 564 2356 08/30/99 14:2115 :02/02 NO:667
with appropriate plant selection.
The committee would like to compliment you on a nice set of plans.
If you have any questions or need additional information, please do not hesitate to call-:
Sincerely,
Christina J. Dores
Architectural Review Coordinator
pc:, MM Frank Mendicina, via first class mail
1
PUBLIC vv%jrxr%o CLEARANCE LETTER
FOR
CUSTOM HOME LOTS
Dear Builde'r:
PriorAq issuance -of a building permit, you will.be required to obtain clearance from the,
Public Works Department for one, or more, otthe following:7.
1. Verificati,:-Ln that rough grading is complete. and the pad elevation" certifications
prepared by a licensed surveydr, or engine6r;'are on -file in .the. Public- 4'
Department.
h e " �r required
2* Verification that infrastructure improvements and 66 re-' tract -improvements
are complete, or sufficiently advanced to warrant building permit issuance:-
3. Prepare an engineered grading plan that provides for on -lot storm waierTitbntildm,
and have it checked and approved by the Public -Works Departments
• Tract 26524 (Estancias)
• Tract 26769 (Mountain View Estates)
•r W
4. Prepare an engineered grading plan that provides for building -pad gfadiiTd.- in
accordance with the existing 'soils report and tract grading. -plan, and Nivie" ltl-�`
checked and approved by the Public Works Department.
• Tract 28034 (South Valley Estates)
K to
FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT
Certificate of Occupancy'
City of La Quinta -
Building -and Safety Department
This Certificate issued pursuant to ,the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuancei this structure was in compliance with 'the various ordinances
:of .the City regulating bur/ding construction or use. For the following:
-BUILDING
ADDRESS:-
7.8-602 TALKING
ROCK TURN
Use' Classification:
SFDBldg.
Permit No:: 9907-042
Occupancy Group:
R 3.' Type of Construction: VN'
Land Use Zone. -'-'RL
Owner of Building:
FRANK MENDICINA
Address:.
6229 SANTOS DIAZ ST
City:
IRWINDALE, CA 91706
By:
STEVE .TRAXEL
Date:
03-07-01
Building Official.
POST IN A CONSPICUOUS PLACE
7 �TJON TANDY
37630 Medjool Ave.
'- DEC 16 RECD Palm Desert, CA 92211
Office (760) 772-7192
.SPECIAL' • Fax (760) 772-7193
REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
O POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOCATION o I PC N
�,u� f' �IV G Z"
IV �1G61./l
REPORT SEQUENCE N0.
TVP OF STRUCTURE.
bI c 1+4 r lk R&S
PERMIT NO.
DA_ TE
I?�"
DAV OF WEEK
MATERIAL DESCRIPTION ^
S
ARCHITECT
INSPECTOR
HRS. CHARGED
•-�
ENGINEER
ASSISTANTS
MRS. CHARGED i
INSPECTION GENERAL I� �p o f I� CON��OR
DATE CONTRACTOR �j ` >C
Ato
-C /_'d�
1N
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
--•:•�-o.0 w�r„q.L111.D I N.G_LA W S
SIGNAT RE OF REGISTfLAE INSPECTOR
4(4-71
DATE OF REPORT REGISTER NUMBER